Injectables - Master Thread

[jrsygirl]

I'm strating my drugs tomorrow for an IUI this month and would appreciate any unput you all have to offer!

[Dasha]

Good luck with your IUI. I conceived on my 3rd cycle using Gonal F and Ovridel. Once I gave myself the first shot sub-Q I got over all my fears and found it to be quite easy. I was also able to give myself the trigger shot sub Q.

I was fortunate that I had very few negative side effects in all three cycles.

Hopefully all it will take is one cycle for your BFP.

[gmooter]

After many, many failed Clomid cycles, I switched to Gonal-F and Ovidrel. DH's SA was fine so we decided to try without IUI. The shots are very easy and don't hurt one bit! My 1st injectibles cycle I produced a ton of mature follicles (between 6-8). They mentioned canceling but ultimately left it up to me and DH as to whether we wanted to go ahead with the trigger. We did trigger that month and I did NOT get PG, much to my surprise! I had to sit out a cycle after that because I had some residual follicles that were too big. The following cycle I had the same protocol and ended up with 4 good looking follicles. I'm now expecting a daughter in 4 weeks!! Good luck!

[Sinclair319]

I'm also curious--I'll start femara next week, followed by FSH injections, trigger, and IUI.

[cc8]

Like gmooter (Hi G!), I went through several failed clomid cycles (50, 100, 150mg) and also a failed IUI + clomid cycle before moving on to injectables. I got PG on a round of Follistim + IUI + accupucture (I used the accup for relaxation reasons, primarily).

Hope this helps.

[kat]

I didn't take Follitism, but I did take Gonal-F (same idea) during my IVF cycle. The shots were a piece of cake (especially when compared to the progesterone shots I've had to take for the past 7 weeks LOL). For the IVF cycle, we used Novarel (another trigger shot, roughly equivalent to Ovidrel). No problems there, either. Do you know whether you'll be using the Follitism pen? I know a lot of women loved the ease of that "system" (though frankly I didn't mind the mixing).

I did four rounds of Clomid + trigger shot before our IVF cycle. For two of those, we used Ovidrel (and Novarel the other two). I may be one of the few people in history to experience this (my RE had never had anyone complain about it), but I had a skin reaction to the Ovidrel. The first cycle was far worse -- really bad and constant itching on my torso and arms (like a sunburn). Second cycle was slightly better. I hadn't had that experience with Novarel so we switched back to the Novarel for the final Clomid cycle, and I had no problems (my RE's guess was that some "other" ingredient in the Ovidrel -- which, unlike Novarel, is synthetic -- was causing the skin issue).

Anyway, as I said my RE had never had any other patients complain about the Ovidrel (and he's the dept. head at a huge teaching university, so he's seen tons of patients over many years). And when I posted about it on the WC, no one had had that problem, either. So I'm just weird :), but I wanted to let you know just in case you sense anything weird with the Ovidrel.

Good luck to you!!!

[jrsygirl]

Thanks for all your feedback! I started my Folistim last night (with a pen...so easy to use its completely idiot proof!)

Has anyone had any side effects while on it?

[Sidsou]

Yeah! The first couple shots scared me, but then you really get used to them. The pen sounds great!

I never had any side effects with any of the injectible meds I took (Follistism, gonal F, ovidrel, progesterone, lupron - I've done a few IUIs and IVF) although I had nasty ones with Clomid.

Good luck!!

[Ole Miss Bride]

I got pregnant using Follistim/Ovidrel, and I had very good experiences with the drugs. The Follistim really didn't cause any side effects. The only side effects I noticed were right after I triggered. The more follies I had, the worse I felt -- crampy, bloated and generally icky. It passed, though, and I think it's fairly common to feel that way -- there's a lot going on in there!

Good luck. The shots are so, so easy, aren't they? And I think Follistim is so much easier than Clomid as far as side effects go.

-Betsy

[jennylou]

scarla - It's usually quiet over the weekends, so I wanted to let you know that if you check out the IVF thread you'll probably hear a lot about injectibles...some of those ladies are looking ahead towards IVF but not their yet. Good luck with your new cycle protocol!

[angelgirl8]

hi...

after 3 rounds of clomid, my RE planned to have me try 3 rounds of injectibles. i actually only did 1 round before moving on to IVF, but that was only because i over-responded to the injectibles.

i think many women do injectibles without doing IVF because it's a much simpler protocol. you'll definitely find that there are significantly fewer side effects from injectibles (follistim, etc.) than clomid! watching the video and going to a class will definitely be helpful. it really is less scary than it sounds!

[bottleored]

I did 3 rounds of injectibles (Gonal-F) - 3rd time was the charm :) I had done 6 rounds of Clomid before that. The injectibles give you more eggs with fewer side effects.

The pen is pretty easy - you don't have to measure anything and it's easier to handle than standard syringes. You do have to be monitored more closely because it's a lot of drugs. I had b/w and u/s for 5-7 days while I was giving myself shots so they could tell me each day what to do that night. You usually have a trigger shot (hCG) to make sure you ovulate when the eggs are ready. We only did an IUI the last cycle.

HTH! Good luck!

[Suzlywoozly]

I did the follistim pen for my first round of IVF. The side effects are a piece of cake compared to the clomid. I took clomid for 10 cycles and was going insane the entire time. Are you doing the injections yourself or having DH do them for you? You can't screw up anything on the pen... all you do is drop the cartridge in the pen, screw it back together, screw the needle on and dial in the dose on the top of the pen. With the dial in dose thing, there is no way for you to screw up giving yourself the wrong dosage. The only thing I use to forget was to dial in the dose!! I would almost get poked and remembered that I forgot that step! Only negative thing to say about the pen is that it can be really akward to figure out how to hold the first time.

[Scooter]

We tried 5 rounds of clomid and 2 rounds of femara (4 IUIs total) before moving on to injectables. Those injectables are so expensive that we wanted to maximize our chances, and did an IUI. I was too freaked out to give myself the shots the first month, so DH did all of them including the hCG (which was just subcutaneous). We had to attend an injectables class, which taught us how to administer the shots and also how to mix the medicines. I wasn't on Follistim, and I didn't get one of those fancy pens--I had to mix the proper dosage myself--you may have to do that with your hCG trigger.

We got lucky and conceived on our first try with injectables! :D Fewer side effects than clomid or femara, but lots of bloating after O. Some mild moodiness. We were worried about overstimming, so I was on a very low dosage and produced just 2 good follicles. Good luck!

[wife&wannabemom]

After 8 rounds of clomid and 3 IUIs, we moved to Follistum and got pregnant on our first round!!!! Our baby boy was born on 8/29. I also used the Follistum pen and had DH give me the shots as well as my HcG shot. We did an IUI because I have some cervical scar tissue that was problematic.

There are alot less side effects with the injectables adn I highly prefer them over the clomid. Good luck!

Sorry to hijack your thread but i had to say hi to my fellow Still At It girls...

bottleored - Congrats!!!!! H&H 9 months to you!

angel & scooter - Hi girls....hope you're pregnancies are going well!

jennylou- Hi sweetie!!!!

[cc8]

Another injectables (Follistim) + IUI success story here. Follistim is super easy to use and I'm glad we moved onto injectables (finally!) after 3 unsuccessful rounds of clomid.

DD is now 3 months old ;)

[AusMarchBride]

Scarlatav Feel free to come visit the IVF thread and ask any questions about the injections. There's lots of ladies there who'll be happy to help.

IVF Anyone thread (http://www.constantchatter.com/showthread.php?t=6388)

[Ole Miss Bride]

I did three rounds of Follistim+IUI (I failed to ovulate on Clomid), and I conceived all three times. The first two were miscarriages, but my last round resulted in the baby boy I'm carrying right now.

BTW, the miscarriages had nothing to do with the Follistim -- we're dealing with a genetic issue that causes m/c.

Good luck! Follistim is so, so easy. Except for the monitoring, it's a piece of cake compared to Clomid.

-Betsy

[jennylou]

Since I'm on month five of clomid and I anticipate only doing one more month of it, I figure the next step will be injectibles. My insurance covers squat when it comes to fertility drugs....any idea on prices?

[jennylou]

Well, crapstick, I was afraid they would be that much. That's a whole heck of a lot more than clomid ($56). I was hoping to quit my job, but with an expense like that, I might not be able to.

[Suzlywoozly]

My insurance (Personal Choice) did not cover any of the meds, I paid $1,531.00 for this cyle. That was for the medications only. I don't know yet how much the IUI will be. I also work at a small CPA firm where its mostly men so I'm not surprised my insurance doesn't have very good infertility coverage.:rolleyes:

Was that just for the follistim? I imagine you need a lot less than I did for my IVF cycle and I paid $1,584.00. That was for Four 600 IU cartridges. I didn't even use all mine. How many cartridges did you buy and what was the units on each one? I can give you the number of the place I bought mine from if you ever need to purchase it again (hopefully not since this IUI will work like a charm:) ).

I started out at 225 units BUT I was doing IVF and that requires more of the stims. I think 75 units sounds about right. I did the injections in the stomach. I heard that the thigh hurts worse than the stomach. The injections didn't hurt, it was the after effect when I stood up. It stings like bees :(

[cc8]

Scarlatav - with injectables, doctors constantly monitor your follie development and increase/decrease the dosage - as needed - depending on what they see on the U/S. I started out with 50 IUs (Follistim) and got bumped up to 75 IUs after 3 days. Follistim comes in a pen-type device and self-administering the shots is super easy. (I am a big chicken when it comes to stuff like that and by day 3, I was just 'stabbing' myself with the pen like it was no big deal).

Jenny - (Hi there!). My insurance actually offers $10K lifetime for fertility treatments/procedures. I know a lot of insurance companies don't offer any coverage. One possible route might be to look into "supplemental health insurance". Not sure what the costs are, but I had SHI during the 3 month period I was unemployed. My SHI was with Blue Cross. You can also use speciality online pharmacies - I think they may offer fertility drugs at a 'discount'.

[Scooter]

Jenny, the prices really vary by brand. I wasn't covered by insurance at my other RE office, and was told to expect between $600-1500 per cycle, depending on what the protocol was (how many amps and for how long) and on which medication it was. At my 2nd RE's office, if I'd been put on Gonal-F it was going to cost about $1500-2500. I was 50% covered by insurance and paid $300 for Bravelle--my RE had me on 1.5 vials a day for 9 days. (each vial was 1amp which equals 75IU. So what is that, 112.5IU per day.) It comes in a little box with 5 vials and each box is a certain amount of money. Downside, you can't buy a partial box or reuse any medication that is left over in a vial. So everyday I used 1.5 vials and threw a half vial of it away. :( And with Follistim you usually get it in this "pen" thing where you just put the dose in and use that instead of a regular syringe.

So the administration of the injectables can vary along with the price, and I don't know if the two are related or not. It's something to ask your Dr about, which brands they use and what the expected costs are. Also, ask how much you'd be on--would the Dr consider you a good responder to the clomid, and therefore you'd have a lower dosage of the injectables? That's going to affect the price. Would he have you on one brand or two (they do that sometimes)? How long does he usually have you stim, a week, two weeks, what?

[angelgirl8]

scarlatav...i would suggest injecting in the abdomen...it's normally fattier and i really had very very little pain when injecting there. just pinch an inch of skin and inject there.

also, dosages are pretty different for each person and each protocol and each diagnosis, so it's hard to say what the norm is!


as for pricing: it sort of depends on the dose you'll be taking because that determines how many pens/cartridges you'll have to buy.

the best prices i found were online at freedomdrug.com, but more local pharmacies in your areas might be cheaper than the NYC pharmacies (they can't possibly be more expensive!)

my gonal-f (the equivalent of follistim) was $206 for a 300iu cartridge and $619 for a 900iu cartridge. my hCG trigger was $30.

i think follistim was a few dollars cheaper, but it was hard to compare because it comes in different sizes.

the other big expense (if you don't have insurance) was the charges for the constant monitoring. i think our injectibles cycle worked out to about $1200 -$1500 for everything.

[Ole Miss Bride]

I think I paid about $420 for a 600IU cartridge of Follistim. My RE's office charged a flat rate for an injectables cycle -- all bloodwork and unlimited monitoring for $950. That, plus the drugs and IUI, and my cycles would usually cost about $2k each. My insurance covers nothing for IF.

As far as where to inject, that varies for everyone. I greatly preferred injecting in my thigh (the fatty upper part, almost my butt) than my tummy. I'm fairly thin, so I don't know if that had anything to do with it. But angelgirl's a skinny minnie and she preferred abdomen, so it's all just a matter of preference, I guess.

-Betsy

[jennylou]

Hmmm, I'm liking the under $500 cost for the injectibles that some of you paid! My insurance won't cover an IUI, but they'll cover bloodwork and u/s (if coded to check for cysts because of the pcos).

[angelgirl8]

jenny...that's really good. the IUI itself didn't cost that much, i don't think. if you want, i can look it up in my records.

[Sinclair319]

Not sure if you're still looking for responses, but I did 5 days of Femara (the 'new' Clomid) then the Follitism pen (37.5 for 6 days, then 75 for 3 days) then trigger. I had an IUI, got pregnant but at the 6 1/2 week u/s there was a sac, but no growing baby. We later found out it was due to a chromosomal abnormality--it had nothing to do with the actual procedure.
Good luck!

[amygrrl]

jenny - my totally non-medical opinion would be that given you have pcos, you will be on a SUPER low dose.

[Kelly's Girl]

I did a search and came up empty handed.

For anyone who took FSH shots to stimulate ovarian growth, did you have to take them at a specific time? My RE has always recommended to give shots b/w 5-7 p.m., and I TOTALLY forgot tonight. I injected at 7:45. Do you think this is okay?

I ask because the first time I did injectibles, on my first night, I did the shot late (b/c they'd sent me home with no needles! :eek: ) the IUI didn't take. Logically, I know they're probably not related but I can't help but be worried I've already blown it.

[Scooter]

It's probably ok--when's your next u/s? I'd definitely mention it to the Dr. I seem to remember having a problem with one dose once and the RE saying it wasn't a big deal in the long run if I was consistent with all the other days.

[Kelly's Girl]

Thanks, Scooter. I have an u/s and E2 on Monday morning, so I'll definitely mention it to my RE.

[jodylovesscotty]

It shouldn't be a big deal. There were a couple of times I did my shot in the morning at the RE's office and then the next day at night, and the RE was the one who told me to do it that way.

[OCNative]

I'm starting my injectibles tonight, the Follistim.
All the comments here make me feel somewhat better.
Wish me luck!

Thanks,
P:)

[taffers]

Good luck!

But you won't need it...it's really not that bad. I'm a HUGE baby when it comes to needles so for all 3 of my IUIs I had DH do all the shots until the last 2 of my 3rd cycle, which I did myself...it was actually better doing it myself because I didn't get all worked up. Yes, I would get all worked up every.single.time. because I'm such a baby!

[OCNative]

thanks Taffers. sorry for my delayed response. :)
I'm on day 5 of my injectibles tonight. I had u/s and blood test today, and they called to tell me to do 125 dose. The last four nights I did 200.
I go back tomorrow a.m. for u/s and blood test.

[OCNative]

Had blood test and sono on Sunday, Monday and this a.m.
DH gave me the Ovidrel shot tonight as per the RE's instructions.
Follicles looked good today and per the phone call from the medical assistant, this looks like a good cycle for me. So IUI will be Thursday morning.

I'm paranoid about side effects, and ready way too much about the Ovidrel.
I need to try not to think about it all.
Wish me luck!

[jessied1025]

This is my first cycle with Follistim. I started the injections on Wednesday. I was pretty nervous because I don't do well with needles. The pen makes it a peice of cake. I have noticed that after the shot I generally feel a bit icky and tired. I have only had 2 shots, but definately am aware of my ovaries!

[OCNative]

jessied,
It sounds like you are doing okay with the shots. The pen isn't bad at all.
I did have black and blue spots on my tummy though.
Good luck.

[OCNative]

Anyone else gearing up for an IUI?
I will be doing my 2nd soon. The first one failed last month.
Waiting for my cycle to start so I can begin round of Follistim, and then Ovidrel.
They lowered my does from last time. I did 5 days of Follistim 200iu, and then 2 days 125iu. RE prescribed 150iu per day this time.
Just looking for others with similar experiences.
Thanks. :)

[Scooter]

OCNativer, if you're looking for others going through what you are, have you checked out the Still At It (http://www.constantchatter.com/forum/showthread.php?t=33817) thread over in the FP Groups section? I notice you're still fairly new to the boards, so you might not have seen that one yet. :)

[OCNative]

scooterThanks, no I haven't seen that thread yet.

[j*east]

Thanks for all the info and experiences here already.

A question:
When did you ovulate on injectables? Typically I O around CD 17+, and I'd love for it to be earlier. I realize it will vary, so I'm just looking for a general sense. Thanks!

ETA: another question. Should I just basically stab myself with the pen? Or go slowly? I think I get the rest of the process, except speed of injection. Thanks!

[Scooter]

Quick post--O'd cd14 but with a trigger. Usually they do triggers with them so it'll be timed right.

Stab quick, going slow draws it out and is more painful!

[taffers]

Hi j*east! :D

How exciting you're doing injectibles!

On injectibles (with trigger), I would O around CD13. With no meds, I typically O between CD 13-15. My 3 IUI cycles went like this:

IUI#1
Femara CD3-7
Follistim CD5-10
Trigger CD11
IUI CD 12&13

IUI#2
Femara CD5-9
Follistim CD7-11
Trigger CD12
IUI CD 13&14

IUI#3
Femara CD3-7
Follistim CD5-11
Trigger CD 12
IUI CD 13&14

It's really just all about how your body responds to the medication. I am a fairly quick responder, but some people aren't.

As for the shots, do them QUICK and straight in. If you go in at an angle, it kind of hurts. The needle is so small though that even if you do it cold (which can make it burn) or at an angle, it's still not very painful.

Good luck!

[j*east]

Thank you, Scooter and Taffers!

I realized the O day would vary. Duh. I also realized I could find out a lot about O days by looking at charts w/ injectables on FF. Seems like the average is about CD11-14, with not too many past CD 15 or so. One thing I noticed, for anyone with PCOS who happens by, is that they tend to have more days of injectables (but I'm guessing this is because of the lower dose, which is to avoid hyperstimulation, which women with PCOS are more likely to experience) and O a little later, more like CD15-20.

Interestingly, about the injection angle, is the nurse said to do it at an angle? I will take your advice though!

ETA: I just did it--piece of cake! I iced for a few minutes first (not to the point of numbness though) and I didn't even feel the needle go in. I totally forgot to let the medicine warm up (as I read somewhere to do), but it still didn't hurt. Whooo hooo! I am so relieved...I was scared!

[mcgwigan]

j*east Yes, definately go in with the needle straight...I can't believe a nurse would tell you to go at an angle! I found that the ovidrel was the worst if I didn't warm it up. I would actually hold it in my hand so it could reach body temperature ( since I figure room temp is only 70 or so).

Glad your first shot went well....good luck, I'll keep my fingers crossed for you!

Oh, I did want to add that I ovulated day 13 the first injectible cycle, which was pretty early and the 2nd cycle I ovulated on CD16, which is much more normal for me.

[j*east]

Thanks, mcgwigan! I may have misunderstood the nurse--she definitely said "go in at an angle" but she may have meant a 90 degree angle. :confused:

So far so good...but I am having some nausea and headaches, not sure if they're related.

[t3h_wookiee]

With the Follistim pen, it's definitely a straight up and down for the needle. Now my trigger shot last month had to go in at a 45 degree angle.

Also, I ended up ovulating on cd12 with the trigger shot, and that's with mild pcos. They had me on a pretty low dose (100), and I responded pretty quickly. RE was quite happy. We'll see if I ovulate sooner this time since I'm on a slightly higher dosage (125).

[JLRenheos]

Bump

I'm 9dpt (250Mcg/0.5ml of Ovidrel) & was wondering when I could start testing to see if the hcG is gone. How long did it last in your system?
I might go to the $tore today to pick up serveral hpts to see when the hcG leaves my system, so then I can hope for real thing.

[pocahontas]

JRen...not sure what "DPT" means since I always used it as "days past transfer" and it doesn't seem as though you did IVF, :confused: (does it mean "days past trigger"?) but if you are 9dpiui then I would say the normal consensus seems to be 10dpiui to test (although I'm sure plenty have done it earlier with + results that were not from the trigger) but I will say that most folx agree the trigger is out of your system definitely between 10-12 days.

[JLRenheos]

days past Ovidrel trigger. sorry for the mixup. We're ttc natural cycle w/OI.

I started testing yesterday w/$tore hpts. Tested last night-bfn. Tested this a.m. w/fmu-bfn. I'm hoping my body is telling me it's out of my system now. Now we wait...

[JLRenheos]

days past Ovidrel trigger. sorry for the mixup. We're ttc natural cycle w/OI.

I started testing yesterday w/$tore hpts. I'm 10dpo. Tested last night-bfn. Tested this a.m. w/fmu-bfn. I'm hoping my body is telling me it's out of my system now. Now we wait...

eta/update-I tested again @ 12dpo/trigger & I recieved a +hpt! ;) I've also tested at 13/14dpo w/a FRER & 2 lines showed up! I'm 4 wks.!

[pocahontas]

Cool...well good luck! :)

[ds2003]

We are staring injects in Jan and I'm curious to know what my first cycle will be like. Please share what CD you started injects and how much and how long. When did you have u/s and/or b/w? How many mature follies did you end up with.

Thanks. I will be taking Follistim and Ovidrel.

[ds2003]

I'm starting injects in Jan and wanted to bump up this thread.

I have PCOS, and have 2 anov cycles on Clomid. I will be using Follistim and Ovidrel.

[tandt]

We are staring injects in Jan and I'm curious to know what my first cycle will be like. Please share what CD you started injects and how much and how long. When did you have u/s and/or b/w? How many mature follies did you end up with.

Thanks. I will be taking Follistim and Ovidrel.

ds2003, I am in the same situation as you-- we're going to try IUI this month and will use the same injectables.

Unfortunately, our history/ability is unknown. We never tried before and then DH was diagnosed with prostate cancer and had his prostate removed.

Fortunately, we froze 5 vials of sperm before the removal, so we literally have just a handful of chances. So, the doc thinks going with injectables first (versus Clomid) will be better.

We're choosing IUI to see if we have success. Afterwards, we will likely move directly to IVF since our opportunities are limited.

For anything past the frozen, I guess they would have to go into DH's testicles to try and removed sperm, since he still has sperm production, but the prostate provides the fluid to 'protect' it for ejaculation and fertilization.

We have to wait until late this month to begin-- I'm traveling for work right now and will likely miss the dates.

Good luck!

[Blossom]

I just finished doing injectables for the first time.
I took Follistim for five days, one day @ 75, 4 days @ 100. I had bloodwork and two ultrasounds. I got one good follicle that measured 18 and I used Ovidrel to trigger. Right now I'm in the 2ww.

I'm not sure if this cycle will work though only because my DH and I didn't DTD enough since we got into a fight the day I triggered. :rolleyes: Next time I will strongly consider IUI.

The whole process was very easy. I think mentally getting past the idea of injecting yourself is the biggest issue to overcome.:)

[Sand]

got my injectables today.

did your RE's give you a specific time of day to do them? will it be a bust if I overstimulate? I dont have a problem getting pregnant, I have a problem staying pg and I'm afraid I'll have too many follicles and not be able to trigger (or end up with a litter like some stories i've read. is this even possible or am I reading the info i'm searching wrong?

oy, i feel like i'm walking around with a blindfold.

[Scooter]

Sand, I've always been told to take them in the evening, and that seems to work best with the timing of u/s and things.

The concerns of overstimming, like OHSS and high order multiples, is absolutely something to discuss with your RE. If you're put on a low dosage, the likelihood of overstimming is pretty low. Also, with injectables there's a little more leeway with the rate of follicle growth. They should do an u/s early on while after just a few days of stimming, so you can see exactly how your ovaries are responding. At that point there will already be some dominant follicles developing. Depending on the u/s results, they may change your dosage slightly, or have you take a couple days off and coast, so that they get a smaller number. You need to come up with a number, with the help of your RE, that would be your upper limit of how many follicles would mean a cancelled cycle. Some say 3 or 4, other REs will go with 6, but that's more controversial.

I can tell you that the first time I did injectables, I did 112.5IU (1.5 amps) every day for 9 days, ended up with 2 follicles, and conceived 1 baby. The second cycle, I was on 150IU (2 amps) for three days, and then 112.5IU again for the next 6 days. I was terrified because I had 4 follicles at my first follicle check u/s, but the decreased dosage worked great, and the 4th one stopped developing (even shrunk) 3 days later at my next u/s. That gave me 3 follicles, our personal upper limit, and based on my age & number of total dominant and small follicles, I was given an 18% chance of conceiving. If I did get pregnant, that pregnancy would have an 18% chance of triplets, 15% chance of twins, and about a 67% chance of a singleton. Cycle result: beta was 0.

So while it's very scary, and those odds can seem high, it's good to remember that these chances are still very low and with proper monitoring and communication with your RE, you can drastically reduce your odds of high order multiples.

I should add, on the OHSS front--on my last cycle since I had so many follicles, they cut my trigger shot in half (5,000IU of hCG instead of 10k). Somehow, that reduces the symptoms of OHSS. On my 1st cycle the 2ww as difficult because I was in so much pain & so bloated, but lowering the trigger shot dosage did the trick for me the last time.

[tandt]

Bumping up....

....to say that I began my first injections last night. I'm on Follistim 75 IU and go back to the doc on Wed for follow-up.

It was strange to inject myself-- plus, how in the world do you know if the meds went in? I'm so freaked out about this whole thing! :)

[sea74]

I was told that when doing the follistim that once you stick the needle in you need to count to 7 to make sure all the medicine is transfered into your body.

After I did the injections I'd have DH count it out for me. OH! The nurses also said to rub the injection site after to help disperse the liquid.

GOOD LUCK TO YOU!

[tandt]

Well, I went back to the doctor today-- for the first time since starting Follistim. This is our first try at anything, so I'm totally new.

I had 3 follicles on the right and just small ones on the left. The doc says these look promising and I'm continuing on my 75IU and going back for another ultrasound on Friday.

My husband's 'boys' (as I've been calling them- they're his banked sperm from before having his prostate removed) made it to the new center and all is looking positive for next week.

I know I'm completely jumping ahead, but since this is our very first try, I'm remaining optimistic. Just think-- this time next week, I could be pregnant. Wow-- NOW I'm nervous!

[dancn226]

Bumping up....

I will be starting injectables when AF starts. They are supposed to be delieverd tomorrow.

[Kelly's Girl]

I triggered last night for an IUI in the a.m. A site I found about IUIs indicated that the success rate for a "regular" woman TTC was about 1 in 5 each month. It then said that IUIs have a 10-20% success rate. This is about the same ratio, right? I have no better chance of getting pg with the IUI than just BD? Seems off.

[Scooter]

Kelly's girl, no, that's right. Although I've never heard 20%, only 18% for the tratment cycles. IUIs + injectables give you about the same chance each month that most couples have. There are some other factors that play into that percentage range, mainly how old you are, how many dominant follicles you have, and how many small follicles you have. To get higher odds you'd need to move to IVF.

For example, on our last cycle I was 31 and had 3 big follies and 4 small follies (like 6-8mm). The number of smaller follies you have can raise or lower your chances, because they are a sign of how well your body responded to the meds. Our chances were high, 18%. They were also able to look at a chart and tell me the breakdown of our chances for 1, 2, or 3 babies.

[Kelly's Girl]

Aw, man, I wish my RE were that explicit, Scooter! Were they right abt the twins? Mine just gave me the size of my follicles (24, 21, 17, several less than 8 on my right, and several less than 8 on my left) but nothing more concrete. He told me that we had 14.5 million sperm to turkey baste this a.m., and only said he was happy with that number.

I'm also curious about several other aspects, and wasn't sure if I should start a new thread, or continue here. For example, could the trigger get the 2 most dominant follicles to release an egg? Does the IUI mimic BD with respect to the speed of release of the sperm, and does that matter? When did I actually ovulate, so as to better predict (hopefully) a due date?

[sea74]

Kelly's Girl: My RE also said that you have about an 18% - 25% of IUI being successful and that it gives you the same % chance as a "normal" couple.

Does the IUI mimic BD with respect to the speed of release of the sperm, and does that matter? When did I actually ovulate, so as to better predict (hopefully) a due date? Also, from what I've read, it "speeds" up the process because you are using "washed" sperm as opposed to sperm released the traditional way need to shed their lining which can around 7 hours. I've also read many, many places that washed sperm ONLY live about 12-18 hours. My RE said this wasn't true but my GYN said it IS true. So, go figure! I think IUIs would be more successful if they could better determine the exact time the egg was released because it does seem that the washed sperm live a much shorter time.

I hope you were successful this morning :D

[Kelly's Girl]

Thanks, sea74! Now, no flaming- but I must ask. Everyone has to do what is right for them, and I don't know that I *will* drink, but tomorrow is my b-day. Is it true that there is no symbiosis (for want of a better word) b/w mother and baby until a week or more after O? I mean, implantation wouldn't have even occurred yet, IIRC. BUT, I don't want to decrease my sticky odds, either!

[laura]

Drinking will not affect whether you get pregnant or not, nor would it "harm" a potential baby you might conceive on this cycle.

[Kelly's Girl]

Thanks, Laura. I tried to explain this to DH, but he is adament that "we" start acting like I am pg effective immediately.

Maybe it was wishful thinking, but I honestly thought I felt something twinge after the IUI. Like I was O'ing? It wasn't the soreness of the trigger, it was internal...perhaps I just have my hopes up way high for this cycle.

[pocahontas]

Thanks, sea74! Now, no flaming- but I must ask. Everyone has to do what is right for them, and I don't know that I *will* drink, but tomorrow is my b-day. Is it true that there is no symbiosis (for want of a better word) b/w mother and baby until a week or more after O? I mean, implantation wouldn't have even occurred yet, IIRC. BUT, I don't want to decrease my sticky odds, either!

Happy Birthday, KELLY'S! My DH's is the day after you! :)

[taffers]

Thanks, sea74! Now, no flaming- but I must ask. Everyone has to do what is right for them, and I don't know that I *will* drink, but tomorrow is my b-day. Is it true that there is no symbiosis (for want of a better word) b/w mother and baby until a week or more after O? I mean, implantation wouldn't have even occurred yet, IIRC. BUT, I don't want to decrease my sticky odds, either!

You will be fine having a drink or two. You wouldn't have even implanted yet so there can be no harm before then. And frankly, I would say 90% of my friends drank more than a couple drinks during the 2WW b/c they didn't know they were pg. They all have healthy babies. Ah, how nice it would be to actually be pg without knowing it! :rolleyes:

[sea74]

I agree w/the other, partake and celebrate! :D My birthday is next week. If AF shows up I'll be tying one on. But really, I'm hoping for a "dry" birthday ;)

I'm not a huge drinker, maybe once a week. However, the only thing I won't do during the 2ww is take any medicine.

[dancn226]

Question.....I will be starting injectables probably Sunday! Anyhow, will they speed up my cycle? For expample, if I usually don't O until like CD 23ish...will it push my o date up? Clomid use to push it back? I was just carious if I will be able to get this IUI in before then end of the month? Help please!! :confused:

[kiddo]

It really depends on how your body reacts to the hormones. My 5 cycles on injectables have been really unpredictable. I've O'd the earliest on CD15 and the latest on CD26.

[j*east]

dancn, they did speed up my cycle. If you look earlier in this thread, you'll see some discussion of this--starting with post 43. Also, you can search on FF for injectible cycles and look at when they Od. Hope that helps!

[Scooter]

Some people are slower responders, so it can take longer to get the follies big enough to trigger. It also depends on your dosage and your situation--like with PCOS they like to put you on a low dosage and go slower to avoid overstimming. For me, it sped up my cycle. Here are the basic facts from my cycles:

Cycle 1: (under 30yrs old)
stimmed 7 days
1.5 amps (112.5 IU) of Bravelle
shots cd5 to cd11
triggered cd12
2 mature follicles
IUI cd14
progesterone started 2dpiui
pregnant with a singleton

Cycle 2: (2 yrs later, over 30yrs old)
stimmed 8 days
2 amps of Bravelle (150 IU) for 3 days
1.5 amps (112.5 IU) for 5 days
shots cd3 to cd10
triggered cd11
3 mature follicles
IUI cd13
no progesterone, 8 day LP

Cycle 3:
stimmed 8 days
2 amps of Bravelle (150 IU) for 3 days
1.5 amps (112.5 IU) for 5 days
shots cd3 to cd10
triggered cd12
3 mature follicles
IUI cd14
HCG shot 4dpiui (for luteal support)
had signs cycle was ending anyway, so started progesterone on 6dpiui
pregnant with twins


The RE told me that your start date for the injections depends on your age, which is why I started on cd3 this time and cd5 last time.

[kris97]

Injectibles *really* sped up my cycles. I usually ovulate on day 18 or 19, but during my two cycles on Follistim (75cc for 5 days the first time; 50 cc for 5 days the second time), they had me trigger on day 10 and 8, respectively.

[dancn226]

Kris~That is awesome. I usually O late to. That is why I was carious!

Scotter~So you did IUI when you were under 30 correct! I am only 28 and my dr. keeps telling me he si going to get us pg! So its like okay lets just do it. Do you think the age has sometning to do with chances? I have read in various places (of course on the internet), and they make it sound like age is a factor with IUI and chances?

j*east~I am hoping it speeds it up for me as well! We will see!!!

[Scooter]

Age can be a factor, but obviously isn't always. If you have a nice low FSH and lots of antral follies then it's not such a concern. And you can be over 35 and have a low FSH, or in your 20s and have a high one. It's more complicated than just age.

In my case, I started TTC just before turning 27, began IF testing while 27, had a lap & started treatment cycles when I hit 28, got pregnant at 29 and gave birth weeks after my 30th. Now I'm pregnant at almost 32--and my RE said that she wouldn't expect my chances to decrease anytime soon from what they were when I originally started this whole process at 27yrs old. However, when they were giving me my odds of these cycles working, age was one of the factors they took into account. (See the discussion above, at post #66.)

[dancn226]

For the follotism. I went to see my Dr. Asst. today and she showed us how to do it and all that fun stuff. But she didn't say if I need to do it at the same time every day, or if it matters? I plan on calling back, but what do you girls think? TIA:D

[amyintn]

dancn My RE instructed me with the Follistim to try and take it at the same time every night. I think I chose 7 PM but in reality, I took it anywhere from 6:30 to 8:00. It just depended on what our evening plans were.

HTH,
Amy

[Scooter]

Absolutely, take it at the same time everyday. Same as you would do with clomid or femara.

[dancn226]

Okay...I am on follitism, and I searched the whole internet for this. I took some sinus meds, and I did a shot of follitism lastnight. Well now after about 3 hours after taking the sinus stuff, I am so dizzy I can't stand it and weak! Has anyone that has been on follitism had this issue? Should I have no have taken the sinus stuff??? I am so dizzy!!!:confused::confused:

[Scooter]

When you search, you might not be getting any results because you're not spelling it right. If you try follistim you might get something instead. (ETA: I fixed the typo in the title so people can find this thread in a search.)

But if you're having drug interactions, you should call your doctor or pharmacist to ask about it.

[dancn226]

Okay, so I just go off the phone with the NP and she said do the 150 of follistim tonight like normal. So I have one shot tonight. But for tomorrow Sat and Sun, I have to do the 150 of follstim along with a shot of garlinex. They said this is supposed to stop Ovulation until I take the Ovriderl! Does this sound right??? Just cairous??

[hiphopgirl]

Quick Question: I've only seen one person in this thread that started with injectables. It seems that most of you started with Clomid and after being unsuccessful moved on to injectables. Is there a reason for that? Is it more expensive? Is it the fear of injecting ones self?

I only ask because it seems like it has a better outcome. I'd rather not mess around with something that is likely to be less effective. I'm still in the diagnosis phase of this process so it might be a moot point. I would just like to be prepared to have a discussion with my RE about this if I do need to take medication in one form or another. Thanks.

[taffers]

Okay, so I just go off the phone with the NP and she said do the 150 of follistim tonight like normal. So I have one shot tonight. But for tomorrow Sat and Sun, I have to do the 150 of follstim along with a shot of garlinex. They said this is supposed to stop Ovulation until I take the Ovriderl! Does this sound right??? Just cairous??

Yes, that's fine. I've done Ganirelex and Follistim at the same time.

Quick Question: I've only seen one person in this thread that started with injectables. It seems that most of you started with Clomid and after being unsuccessful moved on to injectables. Is there a reason for that? Is it more expensive? Is it the fear of injecting ones self?

I only ask because it seems like it has a better outcome. I'd rather not mess around with something that is likely to be less effective. I'm still in the diagnosis phase of this process so it might be a moot point. I would just like to be prepared to have a discussion with my RE about this if I do need to take medication in one form or another. Thanks.

I started with injectibles. I never did just Clomid (or Femara in my case). Lots of doctors just throw people on Clomid when they really shouldn't. I was never on just Clomid/Femara, and started right away with IUI/Femara/injectibles.

[laura]

I don't think Clomid is "less effective" - I think it really depends on the person and the diagnosis. I also think taffers is right, that doctors put waaaay too many people on Clomid and it skews the results.

[pocket]

Quick Question: I've only seen one person in this thread that started with injectables. It seems that most of you started with Clomid and after being unsuccessful moved on to injectables. Is there a reason for that? Is it more expensive? Is it the fear of injecting ones self?

I only ask because it seems like it has a better outcome. I'd rather not mess around with something that is likely to be less effective. I'm still in the diagnosis phase of this process so it might be a moot point. I would just like to be prepared to have a discussion with my RE about this if I do need to take medication in one form or another. Thanks.

IMO your instincts are correct. Injex are more effective, and easier to take too. Clomid is prescribed first because it is cheap and old so it has been used many times. It is often covered by insurance. It can be prescribed by an OB/GYN. You don’t need special training to take it and there is less of a chance you can screw it up.

Clomid improves the environment for your hormones to work by acting like a big estrogen sponge and fooling your body into thinking that estrogen is low. It interferes with the hormonal feedback loops in ways that can improve fertility. Unfortunately since estrogen affects many systems and tissues in your body it has effects on all of those systems. Also the effect is cumulative. So it can improve ovulation but it also thins your lining and dries up your cervical mucus and makes you a crazy bitch that no one would even want to have sex with anyway.

Injex are different. In an injectable cycle your natural hormones are suppressed completely and artificial hormones are introduced in controlled doses in order to produce a controlled cycle. They make you a blank slate hormonally using lupron which blocks your body’s production of hormones. This is the same drug they use to chemically castrate child molesters and I can report that I never once felt like molesting while taking it. Then they give you a gonadotropin to stimulate egg production. Then they give you a shot to simulate the LH surge and release the egg. Then they give you progesterone to maintain the endometrium long enough for implantation.

I hope that is pretty clear, but please ask if it is not.

Oh, and I am back on the wagon, BTW. Started bcp a few days ago on a longdown IUI. V. excited!

[allison]

Okay, so I just go off the phone with the NP and she said do the 150 of follistim tonight like normal. So I have one shot tonight. But for tomorrow Sat and Sun, I have to do the 150 of follstim along with a shot of garlinex. They said this is supposed to stop Ovulation until I take the Ovriderl! Does this sound right??? Just cairous??

This is part of my protocol. My Doctor said that it doesn't necessarily stop O but more like it postpones it. I also take a microdose ovidrel along with the follistim and ganirelix. The reason I got for taking it was that my body goes into early O mode before I should so they try to hold off to give my follies more time to grow.

[tandt]

Quick Question: I've only seen one person in this thread that started with injectables. It seems that most of you started with Clomid and after being unsuccessful moved on to injectables. Is there a reason for that? Is it more expensive? Is it the fear of injecting ones self?

I only ask because it seems like it has a better outcome. I'd rather not mess around with something that is likely to be less effective. I'm still in the diagnosis phase of this process so it might be a moot point. I would just like to be prepared to have a discussion with my RE about this if I do need to take medication in one form or another. Thanks.

Hi hiphopgirl, I went straight to Follistim-- we only have 5 vials of DH's sperm to use, so my doc wanted to go straight for the 'big guns.'

I was on Ganirelix on my last cycle, along with my Follistim for the same reason-- to stop ovulation. I took the Follistim at night as usual and the Ganirelix in the morning.

For me, the Ganirelix did not stop my O-- it's either that my body is in the <1% who do not respond to the drug or the drug batch was faulty-- still yet TBD.

It makes perfect sense to me because of what my doc told me last cycle.

For this cycle, I'm on Follistim with Repronex (the Repronex is to keep my levels high so O doesn't come) until they're ready for the Ovidrel shot to trigger. Good luck!


dancn, I wanted to x-post from the SAI thread

[hiphopgirl]

Laura and Taffers - Good point. I think that's what I was thinking about the "less effective" part. It seems like it is the "go to" drug of choice. I really want to be informed so I don't just follow doctor's orders like a sheep. I want to be able to understand what I am getting prescribed and why. I'd like to think that my RE knows what he is doing, but I feel like I don't have much time (due to my age). I'd like to target my treatment as quickly as possible.

Taffers - I didn't know you went straight to injectables too. I'm glad to see that there was at least one other RE who was willing to be aggressive.

Pocket - Thank you so much. Your post pretty much told me what I suspected all along. I had heard about all the negative side effects of Clomid and I've actually been more scared of taking that then I have been of injectables. Again, this is all academic since I have no idea what my diagnosis is. I just have a feeling that he'll want to go that route since he has already alluded to it.

this:

So it can improve ovulation but it also thins your lining and dries up your cervical mucus and makes you a crazy bitch that no one would even want to have sex with anyway.

cracked me up. Thanks for the laugh :)

Tandt - You were the one I was thinking of. I remembered your story. While my situation isn't that dire, I also don't feel like I have a lot of time to mess around. Perhaps I am over-reacting, but I just know my eggs aren't getting any younger :)

[dancn226]

:confused:Just a little fearful of this! Has this happend to anyone, other than Tandt? Just wondering????

[allison]

dancn, We don't know if I O'd early on the ganirelix on my last cycle, but it's possible I did. After one of my blood tests and scans, they found that I was in the early stages of O so that's when they prescribed the ganirelix and microdose ovidrel. I'm hoping that by starting both of those a day or two earlier (don't know exactly yet for this next cycle, still trying to get my betas down) that things will progress better for us.

[tandt]

dancn, We don't know if I O'd early on the ganirelix on my last cycle, but it's possible I did. After one of my blood tests and scans, they found that I was in the early stages of O so that's when they prescribed the ganirelix and microdose ovidrel. I'm hoping that by starting both of those a day or two earlier (don't know exactly yet for this next cycle, still trying to get my betas down) that things will progress better for us.


This is a RANDOM question-- do you happen to still have your box the Ganirelix shot came in? If so, what is the lot# on the side?

I was on it last month to suppress my O and it didn't work-- they're trying to determine if I was part of the <1% that doesn't respond to the drug or if it was faulty.

If your batch is similiar/matches mine, it gives more insight. Thanks.

[allison]

This is a RANDOM question-- do you happen to still have your box the Ganirelix shot came in? If so, what is the lot# on the side?

I was on it last month to suppress my O and it didn't work-- they're trying to determine if I was part of the <1% that doesn't respond to the drug or if it was faulty.

If your batch is similiar/matches mine, it gives more insight. Thanks.

I have two boxes sitting here, their lot # is 3880589850
I don't know if it worked or not since my body had started to go into O mode, but I did get pregnant even though it wasn't viable.

[dancn226]

Help girls..I am freakin out! I just stick it in and push the stuff out you know in my skin. I was just so proud that I could do these damn shot on my own, and no whe goes and totally freaks me out!!!!!!

[laura]

What he said is not untrue, but yes, I think he is overreacting assuming you are fine now.

[taffers]

dancn226: Don't worry, you're fine. I have *never* pushed air out of any of my bazillions of pre-filled shots, including Ganirelex. We only do that with the non-prefilled shots, such as Menopur. Maybe you're supposed to, but I never have, and I'm still alive! :)

[dancn226]

Taffers~Thanks so much!!! I just needed to here someone else say that! DH is a paramedic, so he knows a LOT more about all that stuff, and basically this was the first time doing the Ganirelex, so he wanted to do it! Ya know what I mean.

Laura~Thank you for helping calm me down! I was so mad at him for saying that!!! Men

[Scooter]

I've always had to mix all my shots myself and had DH give me most of them. Whenever he forgot to push the air out of the needle first, the needle just plain wouldn't go in my skin. Painful lesson, let me tell you. If there was air in the needle, I'm guessing it would have been harder to do.

[FallingforPhil]

Bumping for a question...

For the record, I'm on IUI cycle #4. The first 3 were with clomid, and #4 is with gonal-f and cetrotide to supress.

Today is CD 11. I had b/w and ultrasound this morning, which showed 1 18mm follicle (along with 2-3 10mm) and an e2 level of 345. I fully expected to be told to continue injections and come back on Thursday for more b/w, assuming I'd trigger Thursday and have the IUI on Saturday.

The RE's office just called with instructions to trigger tonight. :confused: I'm so confused! In all my clomid cycles, my e2 was MUCH higher (last time it peaked at over 1000) and I had at least one other follicle that had a chance of catching up.

Why in the world am I triggering so early? I'm feeling really panicky about it, b/c this will be our last IUI before moving on to IVF. I'm terrified that it won't work, and while I know that waiting won't necessarily mean success, it just seems to me that this is a little premature. Clearly, I don't have a medical degree, and should probably just trust my RE, but could someone shed some light for me?

(Also, I think he's just pissy b/c he didn't want me to do injectables at all--he wanted to go straight to IVF.)