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Mbre - October 13th, 2007 4:12 PM

HI Everyon and Dr. J.

I know my question is probably typical of anyone on the 2ww. I had a 5 day transfer on 10/10/07. Prior to the dayof the transfer the embriolgist called to say my embi was a grade b (A-D scale) but was growing a little slow, but not to worry. So they called me the next day and sai that they infact will still continue witht the transfer on the scheduled date. The transfer was extremely painful! My doc said I have one of the narrowest cervix he has ever seen!ANd he hasa been in the buisness longer than my age (27). But he promised he would get my blas inside my uterus. After the transfer I received and HCG shot( booster I guess) and was told to come back one week from today 10/10/07 so one week will be 10/17/07.
OK so here are my questions.
1. A slow grwoing blas, will that mean it will hatch later and possibly implant a day later than normal.
2. I am day 3pt I feel nauseos and my nipples are hard( sorry), can it be possible that my lil blas implanted or is it possible that I am preparing for my next cycle. Do you really feel anything when the blas is implanting>
3. What is a narrow cervix and what/how will it affect me in the future of a pregnancy/
4. I am taking supositiry progersterone and estridal and i have become moody in the past 2 days is that normal?

Windy - October 13th, 2007 5:02 PM

Mbre-
I'm not an expert, just a RN who is working on a 2nd IVF transfer, which has been successful so far. I'm not sure why they gave you a HCG booster at transfer, but if that is what they gave you, it could be the reason for the breast issues and nausea. When I took mine for retrieval I threw up the next morning and my breast were super sore for the following week. I am currently 6 weeks along and have had no nausea or breast tenderness with this actual pregnancy. The progesterone could be the cause of your moody behavior, but I'm not sure with the suppository, I take the shots. Good luck, It only takes one embi to make a perfect baby!!!!! I wish the best for you.

Mbre - October 13th, 2007 8:42 PM

Yeah she gave me an hcg shot after the transfer and I said y and she said to make your body think your pregnant. I had it on Wednesday today is Saturday and the moodiness and naususa started today. Since I had a 5 day transfer, I should be past the implanation stage if i were pregnant. I wouldnt get a positive result on a p stick, is it to early? Congrads on your baby. I have my beta on Wednesday. I will probably break down and test MON, TUE and then at the Docs on Wednesday. I will try and wait... did u have a 2 3 or 5 day transfer? and did you feel any implanantion on signs prior to beta test?

thanks mommie3b!



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B. Jacobs, M. D. - October 14th, 2007 8:47 AM

1. I tsounds as though the quality of your embryo was good, even though it was not the fastest growing.

2. We really cannot make determinations from symptoms, alone. It is a bit early to have symptoms from a pregnancy.

3. It is not uncommon to have a stenotic (narrow) cervix. There are a number of ways to address the problem. Your physician will have to determine what he/she fells is the best in your case.

4. Vaginal progesterone does not typically produce much of a blood level. There is a great likelyhood that your moodiness is largely caused by stress.

Good luck.

Mbre - October 14th, 2007 9:24 AM

Thanks so much Dr. J for your insight.
One more question. Am i to feel anything when the little embue is implanting? It seems I want to feel something as a validation but it is a mere fragment of my mind.
You are the best! I appreciate your helpful answers as I go throught the wait. I test on Wed but will brake down and test tomorrow.

B. Jacobs, M. D. - October 14th, 2007 2:04 PM

Tere are no symptoms associated with implantation. You will probably not have any symptoms, at all, for at least 2 weeks after retrieval.
Good luck.

Mbre - October 14th, 2007 7:16 PM

I tested today and it was negativ am I to early. If i had a 5 day blas transferred on 10/10/07. Shouldnt it have implanted by now. I hope I just teseted to early, I used the 5 day sooner test as well, so arent the more sensitive? god Im hoping its just slow

B. Jacobs, M. D. - October 14th, 2007 10:43 PM

I recommend getting a test performed by your physician about 2 weeks after egg retrieval.
Good luck.


B. Jacobs, M. D. - October 17th, 2007 5:31 PM

I have not been impressed with the Clomid protocols or the so called minmal stimulation protocols. I am a bit far away from you to help you, but you may wish to contact Dr. Peter Horvath in Albany.
Good luck.

Mbre - October 19th, 2007 3:49 PM

Dr. J.,
Are you saying that he can help my situation or is he a fertility specialist. How would IVF work with him so far I am NYC. I am willing to give it a shot. I have one question for you,

Dr. Sher must have read this website becasue he must have cut/pasted my question and gave an answer with the same thing you said about clomid not being impressive soemthing about they used it back in the 80/90's. But he also said that the stress on the cervix from all the poking in trying to implant the blast could be a reason that it is not implanting. Does this sound right? Also SIRM in NY, have you heard any good things about them?
So ,
1. Does the poking and jabbing of a 30 minutes transfer do infact put stress on the uterus therefore no implanantion
2. SIRM, have you heard of them? Good/Bad? Of course Dr. Sher recommended I come in.

I really appreciate your honest feedback. I am 27 good egg quality and sperm qaulity I had no idea this would be this had 2 failed IVF!

Best Regards,

B. Jacobs, M. D. - October 19th, 2007 9:48 PM

Dr. Horvath is a Reproductive Endocrinologist. We were on the faculty together at Albany Medical Colege several years ago. l do know Dr. Sher. He is a very charming man, and has built quite an empire. Some of the ideas he expresses have some interesting potential, but some are not quite "ready for prime time".
Good luck.


Mbre - October 22nd, 2007 5:59 PM

Cycle started on Saturday, so today I went in for blld and u/s. I told him that I did not want use clomid again. He told me he think I have a low ovarian reserve becaue I do not make alot of folecules. My first cycle with gonal 150mg for 5 days made 5 eggs(Columbia Hospital) and with the clomid 50mg I mad only 2 eggs, 1 cyst. I also told him about the uterus stress from the constant jabbing at my narrow cervix, he said he would dialte it more next time.
1. Is that accurate for him to assess me having a low ovarian reserve? What is that ? I ovulate every month
2. How can a I know if the doc is putting the egg in teh "right" spot in the uterus. what is a tight spot?

Thanks again,

B. Jacobs, M. D. - October 22nd, 2007 7:13 PM

One of the tests of ovarian reserve is to count the number of visible follicles at the time of ultrasound examination. If you have greater than 4 visible follicles on each ovary, you probably have adequate ovarian reserve.

We use ultrasound to determine the location of the tip of the embryo transfer catheter when we deposit embryos in the uterus. I know of no other way to determine where inthe cavity embryos are placed. Some people try to do it by determining how deep they pass the catheter. Using a soft catheter, which is associated with better pregnancy rates than a rigid one, thereis a potential for the cathetr to loop back on itself, and not deposit embryos where you want them.
Good luck.


Mbre - October 23rd, 2007 9:51 AM

;) Hi Dr J

Hi Dr. J.

Ok on day 3 cycle (yesterday) after my 2nd failed IVF, I went in to take my blood work. My doc said he believes I have a low ovarian reserve becasue I have a big cyst in my left ovary and nothing going on in my right. But last month before we started my IVF i had 4 in one and 3 in the other. so i do not know why he would suggest that and put me in turmoil, if its not true. I am a low responder to meds as I said before in my first IVF i was on lupron for 21 days and gonal for 6 days 150mg and only produced 4 follicules. all fertilized. But this doc put me on clomid 50mg for 8 days and I only made 1 follicule and now I am left with a big cyst.
Ok I got my blood back here are my levels from yesterday day 3
fsh-6
estrogen-90 >lh-2
progesteron.2
an
d
ofcourse beta-bfn.
Ok so with my "low reserve"
narrow cervix he has put me on birth control for 10 days 2 tablets a day and he said that he will be more aggressive and that we will probably freeze our blast to let me rest for a month after retrieval and then put the blas in.

1. Does this sound ok? Birth control to get rid of my cyst and to rest my ovaries?
2. If i have a low reserve would it be outrageous to ask for 3 blast to be transfer? I did have 2 fail cycles, I am 27.

Thanks so much

B. Jacobs, M. D. - October 23rd, 2007 6:00 PM

You will have to wait for your cyst to go away, before you can start a new cycle. That really has nothing to do with ovarian reserve. The birth control pills will not make the cyst go away faster, but will be benficial for other reasons. I do not know what protocol your RE uses for "poor responders". There are several. Putting in 3 as opposed to 2 blastcysts, statistically, does not improve pregnancy rates. It dooes increase the risk of multiple pregnancy. You do not want that.
Good luck.


Mbre - October 23rd, 2007 7:10 PM

Dr. J

1. Can you elaborate on how does pregnancy rate dnot increase with 2 blast but can increase multiple pregnancy?
2. Also I have read that your RE wants a full bladder on transfer day but my RE wanted an empty bladder, and he did not use the u/s but for 3 min out of the 20 min I was on the table, is that normal?

Thanks
Mbre

B. Jacobs, M. D. - October 24th, 2007 5:17 PM

Your cyst does not have anything to do with ovarian reserve. I do not know which protocol your RE is going to use for you. There are a few for poor ovarian reserve. Starting on birth control pills first seems to be common to all the protocols I have seen.
Good luck.


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