Dr. Braverman - do you think you can help me?

winogurl

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Reply Dr. Braverman - do you think you can help me? Posted on: Jan 26, 2011 at 3:00pm
I will try to make this brief. I am in the middle of the second IVF/PGD cycle that has just been cancelled.

With my first round, we did Long Lupron and used HMG to stim, at doses of 300-375 IU QD. I had 12 follicles the day of trigger, but yielded only 3 mature eggs at ER. Those 3 eggs did fertilize and grow and I transferred 1 fair quality XX. There was never a definitive answer as to whether I ovulated prematurely or WHAT happened.

For this cycle, I was changed to the antagonist protocol and stimmed with Follistim 375 IU and Menopur 75 IU QD. I began Ganirelix on day 8. I've had 10 follicles all along, with 1 lead follicle. My E2 was 400 after 4 days of stims, and only 590 after 7 days of stims. Day 8 progesterone was 1.7, so Ganirelix was began. As of this morning (day 9), the lead follicle is GONE on u/s. Day 9 E2 came back at 682 and progesterone was 2.59. Cycle cancelled.

All that being said…do you think I have any shot of being successful with a cycle with you? I am definitely changing REs after this happening a SECOND time. I don't believe I should have ovulated ONCE during an IVF cycle, much less TWICE. I no longer have faith in my RE but I am not sure I should have faith in my body at this point either.

Any advice? Thank you so much for your time in advance.

Dr. Braverman

2026 Posts
Re: Dr. Braverman - do you think you can help me? Posted on: Jan 26, 2011 at 4:14pm
I would need to see the entirer stim sheets to go over and decide what the problem is. Sometimes pts have some leutinization, but did not ovulate and the cycle can be continued. Also you can start the ganarelix once the E2 is 400 to prevent the premature leutinization. Was there a documented full LH surge? You may do better with a long antagonist/agonist protocol and let the follicles mature a bit more. I really need your full history to decide what else could be done i.e HGH, priming, etc.
If you are local you should come in so we can go over your history or call my office and ask for Kim if you cant travel to us, she will set up a phone consultation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

winogurl

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Reply Re: Dr. Braverman - do you think you can help me? Posted on: Jan 26, 2011 at 4:34pm
Thank you so much for your quick reply! My LH has never been checked on either cycle. My RE says it is "unnecessary". I'm really not sure what a very inexpensive lab test would hurt, even if just for patient peace of mind, but I digress. I am not local to you and would be traveling to cycle with you if that is the route we should choose. I will be calling your office very soon to set up a consult for sure. I will have my RE send records to your office once I have been released from his care. Thank you again. I look forward to speaking with you soon.

Dr. Braverman

2026 Posts
Re: Dr. Braverman - do you think you can help me? Posted on: Jan 26, 2011 at 6:47pm
Look forward to speaking with you as well.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.