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Cancelled IVF cycle ... low E2 level

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#1 Julia1977

Julia1977

    Julia

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  • Dx:DOR

Posted 24 November 2012 - 02:18 PM

Hi Dr. ....

I just had my first IVF cycle cancelled due to low Estrogen (136 on Day 8 of stimulation). My protocol was BCP for 23 days, Superfact 0.5 for 12 days, start stimulation by 2 menopur +1 bravelle per day & reduce superfact dose to 0.25. Bravelle was increased to 3 per day from Day 4, and to 4 per day on day 6).

Honestly it surprised me as I went through 2 complete (but failed) IUI cycles (with 3 good sized follicles in each cycle) whereby estrogen was never an issue ... instead ...there were some concerns regarding my FSH/LH levels.

Before those 2 IUI cycles, I had a cancelled IUI as it was then that the RE discovered a possibility of POR/DOR as a result of elevated FSH level after taking clomid for stimulation.

why would the Estrogen level pattern change that much from one cycle to the other? is it the hormonal blocking by superfact? or the quality of eggs? if I managed to grow the eggs in the IUI cycles, why is it that different in IVF?

Another question, what is the maximum time before I get my next period after cancelling IVF on Day 8?

Thanks in advance for the feedback.

Best regards

Age: 37
TTC: 3.5 years. Dx: Endometriosis stage IV in 2004 + Poor/Diminished Ovarian Reserve (relatively high FSH + low AMH)
ART Attempts: 1 cancelled IUI + 2 Failing IUIs + 1 IVF (Cancelled) + 1 IVF (BFN) + 1 IVF (BFP then miscarriage)

****************************************************************************************
IVF#1 (Nov 2012): (long protocol)
(Menopure, Bravelle)
Cycle cancelled due to poor response (Estrogen levels not increasing)

IVF#2 (Feb 2013): (microflare protocol): menopure (3 vials x 2 per day)
4 eggs retrieved (2 on each side) .... all mature, 2 eggs fertilized out of the 4 ICSI'd. Transferred 2 embryos of average quality (1 @ 5 cells & the other @ 7 cells) with AH -->
 BFN

 
April 2013: Laparoscopy: Removal of cysts from right and left ovary and some little endo spots and freeing right ovary from adhesion.
 
IVF#3 (June/July 2013): Microdose flare + Saizen+testosterone
5 eggs retrieved, 3 mature and fertilized by ICSIET of 2 6-cell embryos grade 2 and 3 --> BFP,

1st Beta= 57. US on 8th week: baby measures at 6 weeks and no heartbeat. Confirmed missed miscarriage, M/C at 9 weeks

 

Full panel of blood work analysis done for possible etiology of miscarriage. Everything was normal, except for a heterozygous MTHFR mutation (prescribed high dose folic acid)

 

IVF#4 (Dec2013/Jan 2014): Microdose flare+Saizen+testosterone 

4 eggs retrieved, all mature and fertilized by ICSI, ET of 1 6-cell embryo an 1 8-cell embryo graded 2 and 3. Non left to freeze --> BFN

 

IVF#5 (April/May 2014): Antagonist Estrogen Priming -Cornell Protocol (Clomid+ Menopur+Gonal F + Orgalutran)

6 eggs retreived, 4 mature and fertilized by ICSIMay 11: Day 3 ET on mother's day of 2 grade 2 8 cell embryos with less than 10% fragmentation. Non left to freeze

--> BFP : 1st Beta: 315.2, 2 (May 25th), 2n beta: 2715 (May 31st) smile.png --> June 19th, U/S shows one bean measuring right on track at 8w1d and heart beat above 150.

20w U/S confirms we are having a BOY ... Screening was negative and all measurements were normal. EDD: Jan 29th, 2015

 

Jan 30th 2015: My little baby boy was born ...can't be more grateful

 

Details in the "About me" section


#2 snowmom

snowmom

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Posted 24 November 2012 - 04:42 PM

Just saw this and wanted to jump in and tell you that I was cancelled from low e(barely registered on b/w). Dr said I was over suppressed from the lomg protocol, same as yours. I stopped stims, got my period in about two weeks, and started a natural start ivf, completely unsuppressed. Got my bfp, but turned out to be bligted ovum. Next cycle was microdose flare protocol after being on dhea for a month. Great response that time, with six embies, transfered two, froze four and bfp with one healthy babe now. DOR is a tough dx, but workable with the right protocol. Good luck.
Me 40: Total tubal blockage, 1 ovary, DOR DH 35: Poor motilityTTC since 1998DS natural conception 1996DS&DD ivf icsi 2008DS ivf icsi 2013.Our family is complete.Donated four frosties. IP's got bfp!

#3 Julia1977

Julia1977

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  • Gender:Female
  • Dx:DOR

Posted 24 November 2012 - 10:10 PM

Thanks a lot Snowmom! Your reply made my day :) .... I hope things will look as positive for me in the future ....
so how many times did you do IVFs? 3 times?
Wish you all the best for the coming weeks ...
Thanks again and best wishes

Age: 37
TTC: 3.5 years. Dx: Endometriosis stage IV in 2004 + Poor/Diminished Ovarian Reserve (relatively high FSH + low AMH)
ART Attempts: 1 cancelled IUI + 2 Failing IUIs + 1 IVF (Cancelled) + 1 IVF (BFN) + 1 IVF (BFP then miscarriage)

****************************************************************************************
IVF#1 (Nov 2012): (long protocol)
(Menopure, Bravelle)
Cycle cancelled due to poor response (Estrogen levels not increasing)

IVF#2 (Feb 2013): (microflare protocol): menopure (3 vials x 2 per day)
4 eggs retrieved (2 on each side) .... all mature, 2 eggs fertilized out of the 4 ICSI'd. Transferred 2 embryos of average quality (1 @ 5 cells & the other @ 7 cells) with AH -->
 BFN

 
April 2013: Laparoscopy: Removal of cysts from right and left ovary and some little endo spots and freeing right ovary from adhesion.
 
IVF#3 (June/July 2013): Microdose flare + Saizen+testosterone
5 eggs retrieved, 3 mature and fertilized by ICSIET of 2 6-cell embryos grade 2 and 3 --> BFP,

1st Beta= 57. US on 8th week: baby measures at 6 weeks and no heartbeat. Confirmed missed miscarriage, M/C at 9 weeks

 

Full panel of blood work analysis done for possible etiology of miscarriage. Everything was normal, except for a heterozygous MTHFR mutation (prescribed high dose folic acid)

 

IVF#4 (Dec2013/Jan 2014): Microdose flare+Saizen+testosterone 

4 eggs retrieved, all mature and fertilized by ICSI, ET of 1 6-cell embryo an 1 8-cell embryo graded 2 and 3. Non left to freeze --> BFN

 

IVF#5 (April/May 2014): Antagonist Estrogen Priming -Cornell Protocol (Clomid+ Menopur+Gonal F + Orgalutran)

6 eggs retreived, 4 mature and fertilized by ICSIMay 11: Day 3 ET on mother's day of 2 grade 2 8 cell embryos with less than 10% fragmentation. Non left to freeze

--> BFP : 1st Beta: 315.2, 2 (May 25th), 2n beta: 2715 (May 31st) smile.png --> June 19th, U/S shows one bean measuring right on track at 8w1d and heart beat above 150.

20w U/S confirms we are having a BOY ... Screening was negative and all measurements were normal. EDD: Jan 29th, 2015

 

Jan 30th 2015: My little baby boy was born ...can't be more grateful

 

Details in the "About me" section


#4 silverdollar

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    Kids, sewing, photography, cooking, growing stuff in my garden.
  • Dx:DOR
  • My Clinic:Victoria Fertility Centre

Posted 25 November 2012 - 11:58 AM

Hey Julia - I'm not an RE but wanted to tell you the same thing happened to me twice! Cancelled cycles are almost harder than getting a negative result in my opinion. You have so much invested and not even a chance at getting pregnant that cycle. I agree that a different protocol would likely produce better results. You may respond better with no BCP's prior, so you aren't as suppressed or even a cycle with lower amounts of stimulation meds (sounds counter intuitive, but this can be the case). It often takes some tinkering with us DOR gals to get there, and just remember every cycle is different. Take a bit of time to process and regroup after this cycle and hopefully you'll come into the next opportunity feeling more ready.

Unexplained IF/ DOR. Began TTC in 2008.
After a wild and crazy ride on the treatment train, our baby GIRL arrived on Jan 6, 2012
Hold on.... Surprise spontaneous just 7 months postpartum while still breastfeeding!!! Baby boy born May 2, 2013
My heart couldn't be more full :)
 
Full details are now in my profile "About Me" page

#5 Julia1977

Julia1977

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Posted 25 November 2012 - 01:47 PM

Hi Silverdollar ...
Your story keeps me inspired and full of hope ...
Yes I think I should discuss the protocols with my RE to see that BCP issue ...
Will certainly keep posting my updates ... and will be looking forward to yours ...
All the best

Age: 37
TTC: 3.5 years. Dx: Endometriosis stage IV in 2004 + Poor/Diminished Ovarian Reserve (relatively high FSH + low AMH)
ART Attempts: 1 cancelled IUI + 2 Failing IUIs + 1 IVF (Cancelled) + 1 IVF (BFN) + 1 IVF (BFP then miscarriage)

****************************************************************************************
IVF#1 (Nov 2012): (long protocol)
(Menopure, Bravelle)
Cycle cancelled due to poor response (Estrogen levels not increasing)

IVF#2 (Feb 2013): (microflare protocol): menopure (3 vials x 2 per day)
4 eggs retrieved (2 on each side) .... all mature, 2 eggs fertilized out of the 4 ICSI'd. Transferred 2 embryos of average quality (1 @ 5 cells & the other @ 7 cells) with AH -->
 BFN

 
April 2013: Laparoscopy: Removal of cysts from right and left ovary and some little endo spots and freeing right ovary from adhesion.
 
IVF#3 (June/July 2013): Microdose flare + Saizen+testosterone
5 eggs retrieved, 3 mature and fertilized by ICSIET of 2 6-cell embryos grade 2 and 3 --> BFP,

1st Beta= 57. US on 8th week: baby measures at 6 weeks and no heartbeat. Confirmed missed miscarriage, M/C at 9 weeks

 

Full panel of blood work analysis done for possible etiology of miscarriage. Everything was normal, except for a heterozygous MTHFR mutation (prescribed high dose folic acid)

 

IVF#4 (Dec2013/Jan 2014): Microdose flare+Saizen+testosterone 

4 eggs retrieved, all mature and fertilized by ICSI, ET of 1 6-cell embryo an 1 8-cell embryo graded 2 and 3. Non left to freeze --> BFN

 

IVF#5 (April/May 2014): Antagonist Estrogen Priming -Cornell Protocol (Clomid+ Menopur+Gonal F + Orgalutran)

6 eggs retreived, 4 mature and fertilized by ICSIMay 11: Day 3 ET on mother's day of 2 grade 2 8 cell embryos with less than 10% fragmentation. Non left to freeze

--> BFP : 1st Beta: 315.2, 2 (May 25th), 2n beta: 2715 (May 31st) smile.png --> June 19th, U/S shows one bean measuring right on track at 8w1d and heart beat above 150.

20w U/S confirms we are having a BOY ... Screening was negative and all measurements were normal. EDD: Jan 29th, 2015

 

Jan 30th 2015: My little baby boy was born ...can't be more grateful

 

Details in the "About me" section


#6 Julia1977

Julia1977

    Julia

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  • Gender:Female
  • Dx:DOR

Posted 18 February 2013 - 10:34 AM

Just saw this and wanted to jump in and tell you that I was cancelled from low e(barely registered on b/w). Dr said I was over suppressed from the lomg protocol, same as yours. I stopped stims, got my period in about two weeks, and started a natural start ivf, completely unsuppressed. Got my bfp, but turned out to be bligted ovum. Next cycle was microdose flare protocol after being on dhea for a month. Great response that time, with six embies, transfered two, froze four and bfp with one healthy babe now. DOR is a tough dx, but workable with the right protocol. Good luck.

 

 

Hey Julia - I'm not an RE but wanted to tell you the same thing happened to me twice! Cancelled cycles are almost harder than getting a negative result in my opinion. You have so much invested and not even a chance at getting pregnant that cycle. I agree that a different protocol would likely produce better results. You may respond better with no BCP's prior, so you aren't as suppressed or even a cycle with lower amounts of stimulation meds (sounds counter intuitive, but this can be the case). It often takes some tinkering with us DOR gals to get there, and just remember every cycle is different. Take a bit of time to process and regroup after this cycle and hopefully you'll come into the next opportunity feeling more ready.

 

 

Hi Ladies ...

 

It's been a long time. I have been following up on some of your posts, and I don't know if you have been updated about my cycle.

 

Yesterday was my beta day and I got my official BFN. I had some hopes, but anyway ... it's just not our time I guess.

 

So ... 

I just got a call from the clinic this morning saying that RE reviewed my file (I was surprised at the prompt feedback!! they are just amazing). As per the nurse, Re said that the only thing we can do differently next time is adding Saizen (Human Growth Hormone) during stimulation, as I had already been on the aggressive protocol (microdose flare). I've read some positive things about Saizen, I wonder if you did use that during your cycles, and if it is different from DHEA.

 

As we will not be around almost half of March, I think we aim to do another cycle in April. But the first step is for me to get AF, and accordingly we can do the calculations for the possible dates. Most probably I will do a BCP-free cycle, then go for a BCP cycle after which I start the next IVF cycle (probably in April).

 

Wishing you all the best


Age: 37
TTC: 3.5 years. Dx: Endometriosis stage IV in 2004 + Poor/Diminished Ovarian Reserve (relatively high FSH + low AMH)
ART Attempts: 1 cancelled IUI + 2 Failing IUIs + 1 IVF (Cancelled) + 1 IVF (BFN) + 1 IVF (BFP then miscarriage)

****************************************************************************************
IVF#1 (Nov 2012): (long protocol)
(Menopure, Bravelle)
Cycle cancelled due to poor response (Estrogen levels not increasing)

IVF#2 (Feb 2013): (microflare protocol): menopure (3 vials x 2 per day)
4 eggs retrieved (2 on each side) .... all mature, 2 eggs fertilized out of the 4 ICSI'd. Transferred 2 embryos of average quality (1 @ 5 cells & the other @ 7 cells) with AH -->
 BFN

 
April 2013: Laparoscopy: Removal of cysts from right and left ovary and some little endo spots and freeing right ovary from adhesion.
 
IVF#3 (June/July 2013): Microdose flare + Saizen+testosterone
5 eggs retrieved, 3 mature and fertilized by ICSIET of 2 6-cell embryos grade 2 and 3 --> BFP,

1st Beta= 57. US on 8th week: baby measures at 6 weeks and no heartbeat. Confirmed missed miscarriage, M/C at 9 weeks

 

Full panel of blood work analysis done for possible etiology of miscarriage. Everything was normal, except for a heterozygous MTHFR mutation (prescribed high dose folic acid)

 

IVF#4 (Dec2013/Jan 2014): Microdose flare+Saizen+testosterone 

4 eggs retrieved, all mature and fertilized by ICSI, ET of 1 6-cell embryo an 1 8-cell embryo graded 2 and 3. Non left to freeze --> BFN

 

IVF#5 (April/May 2014): Antagonist Estrogen Priming -Cornell Protocol (Clomid+ Menopur+Gonal F + Orgalutran)

6 eggs retreived, 4 mature and fertilized by ICSIMay 11: Day 3 ET on mother's day of 2 grade 2 8 cell embryos with less than 10% fragmentation. Non left to freeze

--> BFP : 1st Beta: 315.2, 2 (May 25th), 2n beta: 2715 (May 31st) smile.png --> June 19th, U/S shows one bean measuring right on track at 8w1d and heart beat above 150.

20w U/S confirms we are having a BOY ... Screening was negative and all measurements were normal. EDD: Jan 29th, 2015

 

Jan 30th 2015: My little baby boy was born ...can't be more grateful

 

Details in the "About me" section






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