About Me

2 years to conceive a baby is the last thing I thought could happen to us...

Let me tell you a bit about myself. I'm 25 and my husband is 27. We have been together since Oct 13, 2000 - I was 16 & he was 18. We've got married Dec 24, 2006. We started trying to conceive in February 2007 with no success.

In September 2007 we were referred to our current doctor (RE) and she specializes in Gynecologic Reproductive Endocrinology & Infertility MSc, MD, FRCSC at fertility clinic in Toronto. Me and my husband did many test which all came back with great results. We were tested through Sonohysterogram, Laporoscopy, Hysteroscopy, Hysterosalpingogram (HSG), Semen DNA Fragmentation to name a few...

We did 3 IUI's; Then we decided to start doing IVF to increase our chances. Unfortunately, we found out that I have unexplained poor response to medications. We spent over $36,000 out of the pocket just in 2007 & 2008 for all our procedures. We had 4 failed IVF attempts, some canceled after weeks of expensive injections. Every cycle was a heartbreak and the pain never goes away.

Our diagnosis is UNEXPLAINED INFERTILITY
Unexplained poor responder
Unexplained elevated prolactin
  • Natural - Feb.’07-Oct. ’07;
  • IUI#1 - Nov '07- Clomid 50mg (cd5-9); HCG; Progesterone 400g;
  • IUI#2 - Jan '08- Clomid 50mg (cd5-9); HCG; Progesterone 400mg;
  • IVF#1 - Long Agonist Protocol; Feb '08 - BCP; Mar '08 - Suprefact / Puregon 175IU; Canceled after 9 weeks of injections due to 3.2cm cyst on the right ovary
  • IVF#2 - Long Agonist Protocol; April '08 BCP; May '08 - Puregon 200 IU/Orgalutran 250 mg; ER May 14 - ET May 17; 5 eggs-3 mature-2 fertilized; Day 3 transfer; transferred two 8-cell & 7-cell grade 1 embies; Progesterone 600mg;
  • Natural - June ’08; Aspirin 81mg/Pre-Seed;
  • IVF#3 - Short Antagonist Protocol; July '08 - Canceled after 10 days of injections due to elevated prolactin 36.6 & poor response; only 8 follicles and not developing
  • IVF#4 - Short Antagonist Protocol; Aug/Sept' 08 -Gonal-f (225iu)/Menopur (150iu); Cetrotide (250mg);Ovidrel 10,000 IU; Progesterone in oil injections (50mg), Aspirin (81mg) Cancelled after 12 days of injections (less than 7 follicles); Later converted to IUI#3
  • IVF#5 - Estrogen Priming with MicroFlare Protocol; Oct '08 - Start Estrace Oct5 (7DPO); Stop next CD2 after AF (Oct11) start stim with Gonal-F (450iu) & microdose of Lupron/Suprefact (0.05iu); Took Aspirin 81 mg; Almost canceled due to poor response after 13 days of injections (only 6 follicles developing) + ovarian cysts; ER on cycle day 21 (!!!) after 18 days of stims; Got 10 eggs; 7 mature; 5 fertilized with ICSI; Day 5 transfer of 2 blastocysts (2AB both); one was hatching; None to freeze, all arrested; Crinone 8% & Estrace 6mg after ET
  • Greater than 50% of patients achieve pregnancy on their first IVF cycle.
  • Close to 50% of patients who had a second cycle also achieved pregnancy.
  • Finally, 40% of patients who did a third cycle achieved a clinical pregnancy.

Statistically, most people have become pregnant by their third cycle.

Sunday, June 29, 2008

PUREGON vs. GONAL-F

Tottaly Obsessed!

I start stimming this Monday. I am also very interested on the outcome of my ER this time. I think I am definitely on higher stim dose now, just a slightly different medications. I am on totally different protocol and being a nut like me, I spent most of my weekend researching medical data available on the net. Not like it will help me have better results, just being nosy. Here is some of the stuff I put together for anyone else interested.

It is long, sorry, just had to share Very Happy Very Happy

Before I WAS ON:


Gonadotropins (Follicle Stimulation) injections of:

Puregon 200 IU

GnRH antagonists (Ovulation Prevention) injection of:

Orgalutran 250 mg

Result: 5 eggs retrieved, 3 mature, 2 embryos transferred on day 3 (both 8 cell grade 1 no fragmentation, even cell division)

I WILL NOW BE ON:


Gonadotropins (Follicle Stimulation) injections of:
Gonal - F 225 iu
Menopur 150 iu

GnRH antagonists (Ovulation Prevention) injection of:
Cetrotide 250 mg

Result: Coming Soon Wink


I did some research and gathered some information from various published medical studies/articles, since I have to know everything as to what I’m injecting into myself. I guess I am a control freak! Anyhow, here is some general info on my follicle stimulation drugs if anyone interested:

PUREGON: Follitropin beta belongs to a class of medications called gonadotropins. Follitropin beta contains a hormone similar to the human hormone, FSH (follicle stimulating hormone). For assisted reproductive technology procedures, the usual initial dose is 150 IU to 225 IU daily.

GONAL-F: Follitropin alpha belongs to the class of medications called gonadotropins. It is a synthetic version of the naturally occurring follicle stimulating hormone (FSH), a hormone produced by the pituitary gland that helps egg development in the ovaries. Doses usually range from 75 IU to 450 IU (5.5 µg to 33 µg) per day. For Assisted Reproductive Technologies, therapy with Gonal-f® should be initiated in the early follicular phase (cycle day 2 or 3) at a dose of 150 IU per day. Treatment is usually started at a dose of 150 IU or 225 IU (depending on your circumstances) once a day. Usual range is 150-300. Doses larger than 450 IU of FSH per day are not routinely recommended.

MENOPUR: Menotropins are a mixture of naturally occurring hormones that include follicle stimulating hormone (FSH) and luteinizing hormone (LH). The recommended initial dose of menotropins is 225 IU injected under the skin daily for a maximum of 20 days. The dose may be adjusted according to your response, but should not exceed 450 IU.

PUREGON vs. GONAL-F: Both of these medications are made from highly purified human Follicle Stimulating Hormone prepared by recombinant DNA technology. Both are non-urinary products and contain only FSH. There is no LH component. Meanwhile, two published direct comparisons between both follitropins (Tulppala et al., 1999 ; Harlin et al., 2000 ) justify the conclusion that the slight differences between the two molecules do not have any clinical significance. The fact that in the IVF studies, the odds favor follitropin alpha and not beta appears to be mainly due to the fact that, compared to the follitropin beta studies, the control patients perform significantly worse in the follitropin alpha studies (difference: –5.5%; 95% confidence interval: –10.7 to –0.3%; two-tailed P = 0.037). This should have been recognized by the authors.

American Journal of Obstetrics & Gynecology. 189(2):342-346, August 2003. Williams, R. Stan MD *; Vensel, Theresa MD; Sistrom, Christopher L. MD; Kipersztok, Simon MD; Rhoton-Vlasak, Alice MD; Drury, Ken PhD

Abstract:
OBJECTIVE:
Our purpose was to assess the efficacy of two recombinant follicle-stimulating hormones, follitropin beta (Follistim, Organon, West Orange, NJ) and follitropin alfa (Gonal F, Serono, Norwell, Mass) on pregnancy rates in varying age groups of women undergoing in vitro fertilization (IVF).
STUDY DESIGN:
Three hundred sixty-five IVF cycles were retrospectively compared, 233 by use of follitropin beta and 132 by use of follitropin alfa, both after gonadotropin-releasing hormone agonist down-regulation. Assignment to each medication was indiscriminate. The primary outcome measured was pregnancy evidenced by fetal heartbeat on ultrasonography. Secondary outcomes included days of stimulation, ampules per patient cycle, estradiol level on the day of human chorionic gonadotropin administration, total follicles present on the day of human chorionic gonadotropin administration, follicles greater than 14 mm, oocytes retrieved, mature eggs, fertilization rate, and embryos transferred. Outcomes were stratified by age, including women less than 36 years old, 36 to 39 years old, and more than 39 years old.
RESULTS:
There was no significant difference between follitropin beta and follitropin alfa in either the primary or secondary outcomes, although the pregnancy rate was significantly decreased with advancing age.
CONCLUSION:
Success rates are similar, when stratified by age, in women undergoing IVF with either follitropin beta or follitropin alfa.

2 comments:

Terri said...

Hello All.. first time here... I am pleading to anyone out there. I have had 2 IVFs years ago, and now started my 3rd. After Using up almost all of my Gonal F - I don't have enough follicles to continue. I am to start a New Cycle next month with a Micro flare Lupron. I have used up all monies available and NEED more Meds.. I got ONE MORE chance.. PLEASE!! if there is anyone out there with any Gonal F or Bravelle.. Please! I just want to try one more time... it's going to work! Please! And Thank you! amorci1013@hotmail.com

Sarah said...

I feel what you're going through. I have just gone thru a failed IVF early this week. It is heart wrenching.

I am now seeking to find out how to keep embryos from stopping its growth. Our doctor said the only clear indication which can be seen from our 1st IVF (5 failed IUI's) is that the embryos did not grow beyond day 7. Do you know of any pages or references on what drugs or test results on how to keep them growing? Is it due to the drugs which are not suitable? I was on Serono 8% and Duphaston 10mg during the 2 week wait.

Hope to hear from you soon. Lots of hugs.