FET Protocol

STL34

6 Posts
Reply Posted on: Mar 19, 2015 at 3:03pm
What FET protocol would you recommend for a an immune patient doing an FET who cannot use a traditional BCP/Lupron to Lupron + estrogen type protocol? I ovulate through Lupron and BCPs (even with Lupron at 20 units). I would like to do a natural FET cycle but my clinic only does batches. Any suggestions?

Dr. Braverman

2026 Posts
RE: FET Protocol Posted on: Mar 20, 2015 at 11:19am
I would say that your best option is a natural cycle, I think they need to consdier this or you will only be trying with OCs or lupron until you dont break through. I would be happy to help you with this if you local.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

STL34

6 Posts
Reply RE: FET Protocol Posted on: Mar 20, 2015 at 12:54pm
Thank you Dr. Braverman. I am not local or I would likely have cycled with you!

What do you think about using Ganirelix to delay ovulation for a few days and then transferring 5 days after ovulation. Do you think delaying ovulation with Ganirelix would be acceptable? If so, how long do you think I could delay ovulation without having a negative impact on lining?

I know that a natural cycle IVF is the answer. I just don't know how to get there right now.

Dr. Braverman

2026 Posts
RE: FET Protocol Posted on: Mar 20, 2015 at 2:07pm
If you used ganarelix you would have to do a couple of days of gonal F or follistim then trigger with HCG, I dont think a couple of days would be a problem , not more than that.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

STL34

6 Posts
Reply RE: FET Protocol Posted on: Mar 23, 2015 at 3:52pm
Thank you Dr. Braverman! One more question, would it be good, bad, recommended or unheard of to do Femera as part of this type of FET? I know you have been using it with many of your endo patients. I had endo excised in 2010 before my successful IVF cycle (with your immune protocol) in 2011.

Dr. Braverman

2026 Posts
RE: FET Protocol Posted on: Mar 24, 2015 at 7:36am
Recommended.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Shg

10 Posts
RE: FET Protocol Posted on: Apr 13, 2015 at 11:41pm
Dear Dr.Braverman

What are your thoughts on FET protocol as follows:
no lupron or other suppression in the previous cycle.
Start Estrogen on day one of period, start Femara on day 2 (5mg x5days) monitor lining and intoduce progrsterone when appropriate. 5 day transfer, hcg boosters at transfer , transfer + 2 and transfer + 4.
I've failed a natural FET with femara and hcg trigger and boosters using the immune protocol and the embryos from the successful fresh cycle when I delivered a baby girl with your invaluable help. I am again in your immune management programme and have just repeated the tests following the failure, but I may not be able to have a consultation with you prior to starting the medication for the cycle so i may not be able to get your views on this over the phone.

Your thoughts are much appreciated

Many Thanks and Kind Regards
Lucky

Dr. Braverman

2026 Posts
RE: FET Protocol Posted on: Apr 16, 2015 at 1:37pm
using letrazole with out LH suppression may develop a follicle that could contaminate the cycle . Soemtimes estorgen will prevent this from happening but the risk is there. I dont have a problem with the rest of the protocol.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Shg

10 Posts
RE: FET Protocol Posted on: Apr 16, 2015 at 11:16pm
Thank you again Dr.Braverman

Is there anything that could be done to minimise that risk?
Starting the Letrozole a bit later or reducing the dose to 2.5mg perhaps? But if reduced, would its effect on be the integrins be same? Or is it just a case of accepting the risk and monitor and cancel the transfer if a follicle engages?
I don't have much room for error and a very short window to transfer as my job involves a lot of travel and this may be the only opportunity for a transfer before X-mas.
Kind Regards


LuckyS

Dr. Braverman

2026 Posts
RE: FET Protocol Posted on: Apr 17, 2015 at 6:18am
All of my data is with the 5mg so I would then take it and hope for the best, but start it after a few days of the estrace , less chance of a break through.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.
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