Oh, I thought 2 embryos will be thawed, not all 4??? I may not totally understand what your doctor said; just my own interpretation of what you told here, it seems like if the embryo can survive freeze-and-thaw (that's why it shows signs of growth), it must be healthier or stronger as compared to those that can't survive thawing; so, it has a higher chance in implanting. I think it's logical deduction, and this is true in many cases.
To make one healthy baby, you only need one embryo...a good one. It seems you have it, just keep our fingers crossed. Add oil for you and also for a few other jm's here who also happened to have their ET/FET in these few days.
thanks cutecutetown for your reply again. you are such a nice and kind medical professional as you are so caring and supportive to us... i agree with you that some dr are not as caring as we patients expected, which can be q. disappointing... but i can empathize that sometimes it's difficult indeed as they see so many patients with simliar questions every day.... anyway, so far my current dr is giving me enough confidence which is good to alleviate my anxiety, and it's so fortunate to have you as our companion and adviser here too!
i try to massage my legs and raise it high for some time before sleep, hope it will make it better...
i looked up some medical journals just now and see that pregnancy rate is related to endometrium thickness. i know there's not much i can do about it now, but i tihnk it's fine as long as the follicles develop well and egg retrieval is smooth, so that i may have eggs ready for use in the future. but just curious, is the endometrium lining building up day by day until ovulation/mensturation? or will it "stop growing" at some point despite the continual secretion of estrogen?
p.s. my hormone test results, E2 2.6iu, LH 37xx (i dunno the unit)
thanks for your reply. sorry that i didnt relate this post to my previous posts. I had one day 5 embryo FET (yes, the harmonal cycle, not natural cycle) this time. and yes, i had both progesterone in both vaginal and injection (the injection one called Gestone and did by myself) form on a daily basis. i didnt have any HCG injection by myself and it's only done on the date of FET and on third date of FET. i will not be visiting my doctor again until checking bingo. that's why i am worrying that whether my low progesterone level will affect success rate? anyway, i know nothing that i can do...but i just want to know more about the normal/optimum level of progesterone..thanks.
sorry, one more thing. i noted that you mentioned that there may be problem that i may not be administering the shot properly. do you meant that it's better to be injected by the nurse? how improper can that be?
The doctors I have worked with are never really too concerned about the endometrial thickness unless there are some kind of pre-existing pathology related to the uterus, e.g. fibroid, previous curettage for abortion. I verified quite some time ago with a doctor from outside my centre that there is no such thing as a too-thick uterine lining, although too thin may be of concern.
Given my absent-mindedness, I asked one of my doctors the same again this morning. She confirmed the above. For jm's who are or will be reading this post, for your general information only, when your endometrial lining is uniform (supposedly with no obvious pathology as shown on an ultrasound scan), a lining of above 7mm to up to 18 or 19 mm should be ok for embryo implantation. Not a golden rule here, but at least you can have a peace of mind. If your doctor says otherwise, then you should listen to your doctor instead. And in case if you really have a thin or thick endometrium, this is not the end of the world; this can be taken care of by your doctor with relative ease or alternative ET arrangement.
Back to your curiosity question, the endometrial lining grows day by day, but not by a lot each day. It sheds upon menstruation, that's why on day(s) when your period is the heaviest, you may find blood clots. In simple terms, the lining is building up before and after ovulation, but in a micro level that when you look at a ruler and see how "big" 1mm is, you will know what magnitude we are dealing with here.
Lastly, your 2.6iu is LH, 37xx is E2 (the unit is probably pmol/L). Looks fine at this stage, just a reference, the measurement on your next dr visit when your follicles will be more ripe should provide more clues.
cutecutetown
Thanks for the info. I still can't tell for sure what your "18" progesterone level could imply because the unit is missing. A very general reference range for mid-luteal phase serum progesterone level is 5-20 ng/mL or 16-64 nmol/L (the numbers may vary a little due to different machines used in different blood labs). If you are purely on vaginal progesterone, your blood level should not be raised by a lot because vaginal support doesn't seep into your bloodstream. This is also the reason why I asked if you are sure about the hormone of the shots.
When women are on progesterone injections, the serum level usually is ~30-60 ng/mL (some can be lower or higher); I think that's why your dr said your level is somewhat low because the progesterone in the shot should show up in your blood. However, your "18" is still ok as if you haven't done any shots. Also, you are given one HCG injection; and if you have read my posts #998 & #1002, you will find that vaginal progesterone alone is good enough as luteal phase support. Just make sure you keep doing your vaginal progesterone daily as instructed.
As for your progesterone shot, it is an intramuscular injection, which could be tricky and quite challenging to some people. I don't know if your nurses have taught you how to do it properly, and I don't have any nursing training to teach you here either. So, you are still more experienced than I am in giving yourself intramuscular shots; but if you are in doubt, I think you can find a general doctor to inject for you.
thanks for your information. Actually, i did 2 progesterone shots before my blood test show '18' in progesterone. does that meant that my body doesnt absorb well the progesterone shot?
yes, i read your previous posts and i am thinking whether my low progesterone level because i got no corpus luteum left after the hormaonal induced ovaluation during FET cycle. i am really worrying that i will fail becuase of my low progesterone level....just wondering what will be the effect of low progesterone level? early M come?
anyway, i was being told that progesterone shot need to continue until 12 weeks (if luckily pregnant). how about after 12 weeks? i read from your post and interpret that if no corpus luteum, then no progesterone can be produced? sorry, i have kind of inadequate knowledge in this area....
thanks cutecutetown! i'm so touched that you even asked your colleague for the question i raised! thanks a lot!!
I was told that my fibroid was located in the "external" side of the uterus, so I suppose this is different from those that you mentioned to be modulating the impact of endometrium lining, right?
I mixed up the two hormones tim
I started to have 2 injections today.. it's really more painful than usual! haha~
點評
cutecutetown
Sometimes I wonder how women undergoing ivf can endure so many injections! It seems to me that while the shots are painful, most of you think "no pain, no gain"?? I can't really agree with that i
發表於 11-5-19 23:27
cutecutetown
Right, your external fibroid may block access to retrieve eggs from one ovary, but it should not have any impact on the endometrial lining.
發表於 11-5-19 23:25
I just had my first attempt of IVF this month.
However, it is terminated today (day 7) because the follicles are not synchronised (1.7cm x1, 1cm x3, several<5mm).
I don't want to wait for the next spontaneous cycle as it takes me at least 3 months. Can I take hormones e.g OC pills/Progestogen to induce the next cycle?
And I want to know how to make the follicles more synchronised next time. Anything I can do?
Maybe I didn't explain very well in my last reply. Let me try another way:
(1) Vaginal progesterone : the absorption is local within the reproductive tract (vagina > up the cervix > into the womb); since the medicine effect is local, it won't go all the way into the blood. Therefore, if we try to measure serum progesterone in these women, level will often be very similar to those who don't have any progesterone. In some, the level may be marginally raised, almost unnoticeable.
(2) Progesterone injection: it is an intramuscular shot (the needle is longer to go into your muscle layer; that's why I mentioned in my last reply that this may be tricky because its administration goes much deeper than your superficial layer of skin). By this route, the progesterone will be carried by your bloodstream; in other words, although your womb is the only place that needs this hormone, the hormone actually goes around with your circulation. When you measure serum progesterone, it will show a higher level than normal.
Back to your case, although we still don't know the unit of measurement, your doctor expected a higher level than normal mainly because you had progesterone (2). Since you will continue to inject yourself daily, as long as you are injecting it correctly, your serum level should increase. If my interpretation is correct, you only had 2 days of progesterone shots before checking your blood level. Sometimes it takes a while for the hormone to "accumulate" long enough and high enough before it shows its presence in blood.
Besides, you had one HCG injection; together with your vaginal progesterone, the endometrium is well supported. Keep up with the medication you are given, make sure you take them at the right time and you will be alright. To me, and many other doctors who only give vaginal progesterone as routine luteal phase support (i.e. medication after ET), progesterone shots are just something extra and likely to be redundant.
Some IVF doctors are playing very very safe in giving progesterone for up to 12 weeks. (Believe it or not, some just take it off once you bingo.) After an embryo has implanted, it produces HCG to sustain itself and its "bed" (I don't want to go into the biology; it is a little too much for you and other jm's). In short, even by the 8th week of gestation, it is super safe to take off any progesterone medicine.
I think your ivf doc will be able to help you with starting up another ivf attempt as soon as your body allows. You do not take hormones on your own to induce the next cycle; rather, your doctor will give you medication and instructions to do so.
For synchronising the follicles, same idea again, your doctor will take it into consideration when starting up your next ivf. Follow his/her advice will be fine (Hint: you may be given contraceptive pills to achieve that). There is nothing you need to do in preparing for the next ivf.
Although it is sad having to "terminate" this attempt, it is actually better this way because asychronized cycle almost always gives bad result. Fortunately, each cycle is independent of each other and your doctor will try little twists and tricks to help you. Please come back and tell us how you do.
thank you very much for your useful information. it help me to understand more on the use of medicine. just a short question, is vaginal progesterone more effective than injection because it go straight to the womb. thanks
點評
cutecutetown
They (vaginal vs. injection) are equally effective; injection is the "old" method, vaginal is "newer". That's why old-school prefers the old method, but the new one is more convenient.
發表於 11-5-20 11:15
While I am still waiting for my preg test, my sister has gone thro 1st attempt of FET. She did once IVF and got pre but unlucky as I was last time, her fetus stop growing during the eighth week. Advised by her doc, she has done 刮宮. This took place in late Jan this year.
After a few months of rest, as advised by her doctor, she started to take a blue pill everyday, then she went back to the doc and the doc said the endometrial lining is still not thick enough. So this cycle she could not do FET. Is that blue pill helping with endometrial lining? If the blue pills doesn't help, what could she do?
i thought i won't bug u again so soon but sth happened and i'm here again.... i found that i had some menses-like fluid coming out since this afternoon... it's not very much, but enough to make my outer pants dirty already... i called up my clinic but the nurse said they could ask the doctor only tmr morning...
i used to have some browny secrection between cycles, esp in the week before and after ovulation... but it's seldom this red in color. since i need to work tmr, we plan to have the injection done by my hubby at home... the nurse just now suggested me to go on giving the injections tmr, and she'll call me back after asking the doctor...
i'm not really too worried, coz anyway it happened and i dun feel any physical discomfort in fact... but just wanna know what it might be and its meaning... do u have any idea?
p.s. sorry i'm not familiar with this forum, wanna ask how to read the complete msg in your last '點評"?
Do you know if your sister had thin endometrium before her miscarriage? I doubt if 刮宮 will have any effect, or even short-term effect, on the endometrium. Did she have her 刮宮 done in HK?
I think the blue pill is probably estrogen; it usually helps. Will she continue the blue pill for one more cycle? Sometimes it just takes longer, and if it still doesn't help much, her doctor will try other ways. Sorry to say that I am not familiar with ways or tricks to make the endometrial lining thicker.
Since your sister has bingo before, I think she/her womb may need a little time to recover and adjust to any medication. See if she will do better in the coming cycle.
cutecutetown
點評
bigears
thanks cutecute town. she didn't have thin endometrium before her miscarriage. Yes, she has her 刮宮 done in HK. just worried about her becoz she felt very sad...
發表於 11-5-20 22:18
You mentioned of receiving 2 (daily) injections in the message before last. Did you remember to inject both everyday?
I can't really explain why you are having the secretions; I have heard of similar scenario from a few patients in the past, but not common. I don't know if my suspicion is correct, but based on what you described, just make sure you, or your hubby, remember to do both injections, especially the one which has just been added to your daily routine.
The 點評 function only allows very short comments; what appeared is the entire comments, nothing hidden. Sorry about the last one because for some reason there was an "i" at the end as if the message wasn't done. I couldn't go back to revise it either.
Hope your doctor will call you tmr. I think you will have another ultrasound soon, even without the secretion problem. Blood test is likely, let's see what the hormone levels will be this time, you should be about time for egg retrieval.
cutecutetown
Thanks Cutecutetown. We did do both injections (Gonal-f & Centrotide) everyday. I discussed with some other jm in another thread and one suggested may be related to fibroid. I don't know. I'll wait for the call tmr. Willl see the doctor again on Monday.
點評
cutecutetown
Cetrotide is the newly added medication that you must remember to take!
發表於 11-5-21 09:15
cutecutetown
Maybe it's the fibroid, but it's on the outside of your uterus, not inside.
發表於 11-5-21 09:12
some further questions:
- do u mean taking OC pills can make the follicles more synchronized in the following cycle?
- any difference for IVF between natrual cycle vs cycle induced by hormones?
- any drawbacks for taking OC pills in this way?
1. If you haven't taken OC pills for your last ivf cycle, this is something that your dr may consider. But you shouldn't just take it on your own; your dr will advise you when and how to start.
2. Not sure what your line of thought was; many differences indeed. The most important one is that in a natural cycle, you only ovulate one egg and if lucky, you get that egg fertilized naturally inside your body. Cycle induced by hormone usually get you more than one egg; together with egg retrieval and ivf, you get these eggs fertilized outside of your body and then the transfer of 1-2 embryos directly into the womb, bypassing the fallopian tube.
3. No, it may just take a little longer (usually 2 weeks) before giving you the hormone injections.
I was really sad when I know 3 embryos died. But these days, I calm down and be relax...tried to not thinking about why the embryos died! Yes, you are right, I ony need 1 embryo to pregnant! Thank you so much!!!
點評
cutecutetown
We are equally stressed & upset in the lab when we see thawed embryo(s) not surviving. "Strong" survivor must have a reason why it survived; so, keep our fingers crossed. Add oil!!
發表於 11-5-22 23:32
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