Tuesday, July 5, 2011

IVF #1 CD 6 (PIO vs endometrin, and 3 vs 5 day transfer)

So this morning I got up bright and early and headed out to my appointment. I realize I need to shoot to leave at 6:45 rather than 7, because I got there a little late. The office was quite busy and it took longer than I had expected. 

The ultrasound went fine and the tech actually said to me "We've seen a lot of each other over the past year." Yeah, that's an understatement! I've completely lost count of how many dates with "wandy" I have had at this point. I watched as she measured away. She didn't seem to measure many follicles on the left side, but there were a bunch on the right. I left sure that my dosage of Gonal-F would be upped. 

Since the regular nurse was out today I got a personal phone call from my RE this afternoon with the updates. Our conversation lasted 35 minutes and allowed me to ask a bunch of questions. He said I had "at least 8 good follicles." They were all around the same size and he said I am responding well. My estradiol level was 249, up from around 20 on Friday. He wants to keep me on the same dosage (150 units of Gonal-F) and to come back Friday for a repeat sono and blood work. 

I got the opportunity to ask about 3 vs 5 day transfers. I wasn't sure if the clinic even did 5 day transfers and my RE said it all depends on the number of embryos. The pro is that the embryos are heartier for 5 day transfers. It also gives a better opportunity to minimize the number of embryos. The con is that if we wait too long the embryos could arrest and we could be left with nothing to transfer on day 5. Dr. S said the literature states that the take home baby rates of both 3 and 5 day transfers are about the same. So, unless we have a large number of embryos we would be better off with a 3 day transfer. 

We also spoke about the number of embryos to transfer. He said the biggest factors were the age of the recipient and the quality of the embryos. Before the transfer we will have a better opportunity to discuss our odds given our specific embryos. 

I asked about progesterone. Last cycle my legs broke out in hives from the endometrin. I'm not sure why this happened since when I was pregnant I was on endometrin and didn't have any problems. As soon as I stopped it last cycle the hives disappeared. He said it is possible I developed an allergy to something in the tablet and that in rare cases people develop allergies to progesterone. He didn't seem to think this was the case, but said I may be better off with the PIO instead. I have also read that a lot of RE's prefer PIO for IVF cycles. Dr. S said it all depends on personal preference. For those of you who have done both, what is your preference???


  1. Sounds like things are progressing nice and steady. Glad to hear it! Your doc sounds really great too, I love how he takes the time to talk on the phone and answer your questions. Good luck on Friday!

  2. So glad to hear things are going so well! Yay!! I did the endometrin with my last FET, and even though it is easier (though messier!) I would probably stick to PIO. I did PIO with this transfer and got my BFP....I don't know if the PIO vs. endometrin had anything to do with it, but my RE did mention that he's seen more success with the PIO. They are a pain in the ass (in every sense of the word,) but you get used to it and you realize that it is worth it!

  3. I found you as I was searching for blogs regarding fertility. Hope you don't mind that I added you.

    I think we are also going to have to decide how many embryos to transfer. My husband and I are both leaning toward trying two. I like your idea (or your doc's suggestion) of basing the decision on odds.