Ask Our Doctors – Archive
Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.
Im currently preparing for FET with embryos we made from donor eggs. I’m on cd 75 (which has never happened before) but fsh is always high since i only have half of an ovary. Had large cyst removed November. Had baselines on friday which showed lining of 6 with mild fluid in cul de sac. DHEA 514, testosterone 74.3, lh 63, estrogen 30, prog .7, I cant find anything about all of these numbers showing bad/ok timing for a fet. Im currently on letrezole and lovenox twice a day and go back this friday for recheck. Does dhea have any affect on lining for transfer good or bad and is it true that with a transfer lining is really all that matters as long as prog and estrogen get built in in time? Im so confused.
I had IVF after being diagnosed with PCOS and Hydrosalpinx (tubal litigation was done for hydros). I was put on metformin, gonal-f, menopur, lupron, cetrotide, progesterone, and estrace. Anticipated 14 follies going intro retrieval, 8 were retrieved, only 3 were mature (a 4th one they tried to mature but failed), 2 fertilized, and 1 made it to day 5 transfer (we actually did get pregnant but ended up 6 months later with stillborn due to placenta abruption). I’m re-consulting with my RE today, and although I trust him greatly, I was curious to see what your recommendations are for protocol changes that results in more mature eggs?
The cause of the stillborn needs to be explained. Can you provide any further information in this regard?
Geoff Sher
Hey again Dr. Sher. We just had an unsuccessful FET and are gearing up for our next transfer at the end of February. I have hypothalamic amenorrhea and don’t ovulate on my own. I stopped all PIO and estrace last Monday, the 22nd. Day 1 of my cycle was Friday, the 26th.
I went in or an ultrasound on Day 3 (Sunday) and everything looked fine. Was told to start BCP and I’ll take for just 12 days. Then we’ll go right into estrace in prep for the FET (skipping Lupron since I don’t ovulate). My question is in regards to cycle timing, etc..
I presume the reason I don’t need to be on BC very long is because I don’t cycle/ovulate on my own? Just felt a little weird to me to “start” what should be mid-cycle. Does it make sense/sound ok to you?
If your lining is <5mm you could start without having a period. However, it is important to recognize that hypothalamic amenorrhea is associated with sustained and severe hypo-estrinism and you need sustained estrogen priming to establish estrogen receptor render the endometrium receptive to estrogen stimulation. This is why menopausal women often have a poor uterine lining in spite of short-term estrogen stimulation prior to egg donation-IVF. In my opinion, 2 months ofe E/P cyclical therapy should be considered prior to embarking on ovarian stimulation with or without IVF to build endometrial receptivity to estrogen in advance. If your lining fails to get to 9mm with controlled ovarian stimulation, this could be the reason, in my opinion.
Good luck!
Geoff Sher
Hi Dr.
I had a 5th day et In 22 Jan.
I did my beta HCG today 29 Jan, (day 8 post et).
HCG level v.low (0.2).
My Dr. Said I should repeat in 3 or 4 days.
Is it possible it would raise to normal level?
Best
It is unlikely (but not impossible) in my opinion.
Geoff Sher
Eight weeks ago I successfully delivered a beautiful baby girl after FET. This comes after a missed miscarriage some months before. Routine blood work on the placenta showed several clots and I was sent for blood work. Found to have a protein C of 187 and Protein S of 41. Hematologist said no anticoagulation is needed in future pregnancies as I have had one successful pregnancy. I’m wondering if a second opinion is needed. I have only 2 frozen embryos remaining and I want the best chance of carrying them. In your opinion, would you advise anticoagulation in future pregnancies?
Sorry, I meant “routine biopsy” of the placenta
I would take a 2nd opinion because in my opinion, discretion is the better part of valor and I probably would consider using Lovenox/Clexane.
Geoff Sher