So for our fourth and final IVF we'll do a Microdose Lupron Flare. I'm perfectly OK with cancelling if this doesn't seem to be going well. But, my understanding is that the Lupron Flare tends to give higher Estrogen levels overall, so hopefully this will reflect on good quality embryos.
We'll do 2 weeks of birth control with a hysteroscopy on Thursday, April 3, 2014 just to check and make sure everything is ok and to do an endometrial scratch. Then somewhere around the 11th-ish, we'll stop the BCP and start the microdose Lupron and then we'll throw in 225 iu Menopur and 225 iu Follistim. Here goes.....
Update: The hysteroscopy went fine. My uterus looks normal as expected. I guess the uterine scratch was successful because I'm still spotting 4 days later. :$ I hope that'll stop soon. I'm still not sure how Letrozole will figure into all of this. I tried to ask while drugged after the hysteroscopy, but I don't think I was too coherent! :P
I'm just standing by to stand by......
Tuesday, April 1, 2014
Wednesday, February 26, 2014
March Plan...
Friday, February 28 - Get my period. Start 2.5 mg Letrozole.
Saturday, March 1 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg
Sunday, March 2 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg
Monday, March 3 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg
Tuesday, March 4 - CD 5 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Wednesday, March 5 - CD 6 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Thursday, March 6 - CD 7 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Friday, March 7 - CD 8 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Saturday, March 8 - CD 9 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Sunday, March 9 - CD 10 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg (BD)
Monday, March 10 - CD 11 - Follistim 300 iu, Menopur 150 iu
Tuesday, March 11 - CD 12 - Folistim 300 iu, Menopur 150 iu
Wednesday, March 12 - CD 13 - Follistim 300 iu, Menopur 300 iu, Trigger (BD)
Thursday, March 13 - CD 14 - (BD)
Friday, March 14 - CD 15 - Probable Ovulation Day (BD)
And the results are.....
BFFN
Saturday, March 1 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg
Sunday, March 2 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg
Monday, March 3 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg
Tuesday, March 4 - CD 5 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Wednesday, March 5 - CD 6 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Thursday, March 6 - CD 7 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Friday, March 7 - CD 8 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Saturday, March 8 - CD 9 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg
Sunday, March 9 - CD 10 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg (BD)
Monday, March 10 - CD 11 - Follistim 300 iu, Menopur 150 iu
Tuesday, March 11 - CD 12 - Folistim 300 iu, Menopur 150 iu
Wednesday, March 12 - CD 13 - Follistim 300 iu, Menopur 300 iu, Trigger (BD)
Thursday, March 13 - CD 14 - (BD)
Friday, March 14 - CD 15 - Probable Ovulation Day (BD)
And the results are.....
BFFN
Wednesday, February 5, 2014
February IUI Plan
Sunday, February 2 - Got my period. This is shaping up to be a strong period. After last month's period, I'm glad to see it. Start 2.5 mg Letrozole today.
Monday, February 3 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg
Tuesday, February 4 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg
Wednesday, February 5 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg
Thursday, February 6 - CD 5 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 30iu
Ultrasound: 11 follicles growing. The biggest ones are 10 and 8. Woohoo!!!!! E2 = 60
Friday, February 7 - CD 6 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Saturday, February 8 - CD 7 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Sunday, February 9 - CD 8 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Monday, February 10 - CD 9 - Follistim 225 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17.5, 12, 12, 12, 11.5. Estrogen =122.
DH and I got together in the evening.
Tuesday, February 11 - CD 10 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17, 16, 13, 12.5, 11. Estrogen at 157. P4 = 0.6
Wednesday, February 12 - CD 11 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 19, 18, 17, 15, 13.5, 13 and lining at 11.5. E2= 271.
DH and I got together in the evening.
Thursday, February 13 - CD 12 - Folistim 450iu, Menopur 150 iu
Ultrasound shows follicles at 20, 19, 18, 16, 16, 16 (but the tech thinks one of the 16s is a cyst). Lining at 13.5! And E2 = 397. 15,000 HCG trigger at 10:30 pm
Friday, February 14 - CD 13
Saturday, February 15 - CD 14 - IUI at 12:30 pm (They were running late.). :( So that's 38 hours past trigger and since I didn't take the Ganirelix Thursday night, it's technically possible that my body could've started surging earlier.... Eh. Who knows? What will be, will be. But, if there's a next month I'll definitely do the 2 IUIs instead of the one. DH's count was great. 415 million total sperm with an 88% motility. The sample ended up with 71M total and 63M motile. They just want to see anything above 10M in the sample and at least 50% motility, so it clearly conquers those goals.
So, I guess now we wait.
And the results are:
BFFN
I'm supposed to get pregnant and then miscarry. I'm supposed to at least get a +. I guess my body didn't read the script....
Monday, February 3 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg
Tuesday, February 4 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg
Wednesday, February 5 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg
Thursday, February 6 - CD 5 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 30iu
Ultrasound: 11 follicles growing. The biggest ones are 10 and 8. Woohoo!!!!! E2 = 60
Friday, February 7 - CD 6 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Saturday, February 8 - CD 7 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Sunday, February 9 - CD 8 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu
Monday, February 10 - CD 9 - Follistim 225 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17.5, 12, 12, 12, 11.5. Estrogen =122.
DH and I got together in the evening.
Tuesday, February 11 - CD 10 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17, 16, 13, 12.5, 11. Estrogen at 157. P4 = 0.6
Wednesday, February 12 - CD 11 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 19, 18, 17, 15, 13.5, 13 and lining at 11.5. E2= 271.
DH and I got together in the evening.
Thursday, February 13 - CD 12 - Folistim 450iu, Menopur 150 iu
Ultrasound shows follicles at 20, 19, 18, 16, 16, 16 (but the tech thinks one of the 16s is a cyst). Lining at 13.5! And E2 = 397. 15,000 HCG trigger at 10:30 pm
Friday, February 14 - CD 13
Saturday, February 15 - CD 14 - IUI at 12:30 pm (They were running late.). :( So that's 38 hours past trigger and since I didn't take the Ganirelix Thursday night, it's technically possible that my body could've started surging earlier.... Eh. Who knows? What will be, will be. But, if there's a next month I'll definitely do the 2 IUIs instead of the one. DH's count was great. 415 million total sperm with an 88% motility. The sample ended up with 71M total and 63M motile. They just want to see anything above 10M in the sample and at least 50% motility, so it clearly conquers those goals.
So, I guess now we wait.
And the results are:
BFFN
I'm supposed to get pregnant and then miscarry. I'm supposed to at least get a +. I guess my body didn't read the script....
Friday, January 3, 2014
January IUI Plan
January cycle IUI:
December 6th - D&C
December 29th or 30th - Probable ovulation (finally!)
January 1st - Estrogen patch and progesterone injection
January 2nd - PIO injection
January 3rd - PIO
January 4th - PIO and another estrogen patch
January 9, 2014 - Got my period. CD 1
January 10 - CD 2 - U/S shows an early large dominant follicle. :( at 13.
E2 = 57, FSH = 7.2, LH = 6.1, P4 = 0.985, Endometrium was at 5.27
So, this cycle's not looking too good. It's like my body's already started days ago. I think rhe eatrogen was not good for me. So, we'll play this out, but it's not looking good. 450 iu Follistim.
January 14 - CD 6: Follicles = 17, 12, 8 and a few more under 10. E2 = 84, LH = 2.15, Lining at 6.55
Continue Follistim at 450iu, add 150iu Menopur and Lovenox
January 16 - CD 8: Follicles = 17, 13, 11. E2= 142, LH = 2.35, Lining is at 10 with a triple line.
Continue Follistim at 450iu, 150 iu Menopur, Lovenox and add in Ganirelix
January 17 - CD 9: Follicles = 19, 15, 12. E2 = 202, LH = 2.14, Lining is at 9
Follistim 450iu, Menopur 150iu, Lovenox and Ganirelix
January 18 - CD 10: Follicles = 21, 17, 13. E2 = 249, LH = 1.17, Lining = 9.2
Follistim 450iu, DTD with DH in the am
January 19 - CD 11: Trigger at 4am.
January 20 - CD 12: DTD with DH in the afternoon. Should've ovulated 4pm-ish.
BFN
December 6th - D&C
December 29th or 30th - Probable ovulation (finally!)
January 1st - Estrogen patch and progesterone injection
January 2nd - PIO injection
January 3rd - PIO
January 4th - PIO and another estrogen patch
January 9, 2014 - Got my period. CD 1
January 10 - CD 2 - U/S shows an early large dominant follicle. :( at 13.
E2 = 57, FSH = 7.2, LH = 6.1, P4 = 0.985, Endometrium was at 5.27
So, this cycle's not looking too good. It's like my body's already started days ago. I think rhe eatrogen was not good for me. So, we'll play this out, but it's not looking good. 450 iu Follistim.
January 14 - CD 6: Follicles = 17, 12, 8 and a few more under 10. E2 = 84, LH = 2.15, Lining at 6.55
Continue Follistim at 450iu, add 150iu Menopur and Lovenox
January 16 - CD 8: Follicles = 17, 13, 11. E2= 142, LH = 2.35, Lining is at 10 with a triple line.
Continue Follistim at 450iu, 150 iu Menopur, Lovenox and add in Ganirelix
January 17 - CD 9: Follicles = 19, 15, 12. E2 = 202, LH = 2.14, Lining is at 9
Follistim 450iu, Menopur 150iu, Lovenox and Ganirelix
January 18 - CD 10: Follicles = 21, 17, 13. E2 = 249, LH = 1.17, Lining = 9.2
Follistim 450iu, DTD with DH in the am
January 19 - CD 11: Trigger at 4am.
January 20 - CD 12: DTD with DH in the afternoon. Should've ovulated 4pm-ish.
BFN
Monday, December 16, 2013
Embryoscopy and D&C
So, on 12/4/13 there was no heartbeat. Bean had grown a couple of days worth so was measuring 6w1d. I was 7w6d. This isn't really a blog about feelings, more about facts, but I think I'm feeling every emotion in the book. It's so complicated.
Back to the facts, the embryoscopy and D&C was scheduled for Friday, December 6, 2013. It went fine. The doc said that he was able to detach the entire gestational sac from the uterine lining very easily. Mostly, I think this is my inherent problem. The bean just never attaches fully to the endometrium. And, no one knows why. So, it was all sent off to Natera Labs for their analysis.
My follow-up appointment with the D&C nurse (I really like her, BTW) was Monday, December 16. And the results are..... Drummer roll please....
69XXX
Complete triploidy of maternal origin. So, for some reason, most likely, at meiosis stage 2 which is when the embryo goes from 2 cell to 4 cell, it all went terribly wrong. At least, that's my understanding. I learned that 2% of all pregnancies are triploidy. And it does not appear to be affected my maternal age. So, unlike other genetic abnormalities, it happens at the same rate if you're 20 or 40.
So what does this all mean? Well, maybe, just maybe, it's not me! Or at least it's not my uterus killing my children. This is great news. So maybe, just maybe, there will someday be a take home baby in my future.
Also, this doc is wiling to be aggressive with a gonadotropin IUI going forward which is just what I wanted to hear.
Lastly, myHCG was at 10. This is great news. It means that my HCG should be negative (less than 5) before my next cycle, so that shouldn't hold us up.
My planning for my next cycle with my regular RE was Tuesday, December 17th.
Back to the facts, the embryoscopy and D&C was scheduled for Friday, December 6, 2013. It went fine. The doc said that he was able to detach the entire gestational sac from the uterine lining very easily. Mostly, I think this is my inherent problem. The bean just never attaches fully to the endometrium. And, no one knows why. So, it was all sent off to Natera Labs for their analysis.
My follow-up appointment with the D&C nurse (I really like her, BTW) was Monday, December 16. And the results are..... Drummer roll please....
69XXX
Complete triploidy of maternal origin. So, for some reason, most likely, at meiosis stage 2 which is when the embryo goes from 2 cell to 4 cell, it all went terribly wrong. At least, that's my understanding. I learned that 2% of all pregnancies are triploidy. And it does not appear to be affected my maternal age. So, unlike other genetic abnormalities, it happens at the same rate if you're 20 or 40.
So what does this all mean? Well, maybe, just maybe, it's not me! Or at least it's not my uterus killing my children. This is great news. So maybe, just maybe, there will someday be a take home baby in my future.
Also, this doc is wiling to be aggressive with a gonadotropin IUI going forward which is just what I wanted to hear.
Lastly, myHCG was at 10. This is great news. It means that my HCG should be negative (less than 5) before my next cycle, so that shouldn't hold us up.
My planning for my next cycle with my regular RE was Tuesday, December 17th.
Thursday, November 14, 2013
Ultrasound Results
Ultrasound set for Thursday, November 21st. I'll be 6 weeks exactly.
Beta recap:
14 dpr: 79.4
18 dpr: 300
20 dpr: 542
25 dpr: 1172
And the results are:
Miscarriage #6
No one is surprised here.
No heartbeat.
Gestational sac was 5mm. It's supposed to be 15 mm.
Yolk sac was 2.4mm. It's supposed to be 3.4mm.
There was a possible fetal pole at 1.2mm. It's supposed to be about 3.4 mm.
And, of course, there's supposed to be a heartbeat.
I'm trying to set up a consult with Dr. Morris of IVF1 who can hopefully do an embryoscopy. This will give us a chance to look hard at anything that's there and then make sure they get a direct sample from the bean itself to do genetic testing. The earliest appointment I could get is for next Wednesday.
Doc wants to do a more detailed u/s with color flow Doppler, so I'll do that on friday. I think I'll need it to convince Dr. Morris to do the embryoscopy anyways.
*****UPDATE*****
So, 5 days later I followed up with Dr. Morris and what do they find? Of course, a heartbeat. But, it's too slow at 89 BPM and the bean is measuring too small.
The CRL was at 3.15mm which puts the bean at 5w6d when I'm 6w6d.
The yolk sac is extremely enlarged at 6.92 mm which is a seriously bad sign.
The gestational sac is at 8.36mm which is small at the size of a 5w3d bean.
There's nothing to do but wait it out. I go back in next Wednesday for a followup.
Beta recap:
14 dpr: 79.4
18 dpr: 300
20 dpr: 542
25 dpr: 1172
And the results are:
Miscarriage #6
No one is surprised here.
No heartbeat.
Gestational sac was 5mm. It's supposed to be 15 mm.
Yolk sac was 2.4mm. It's supposed to be 3.4mm.
There was a possible fetal pole at 1.2mm. It's supposed to be about 3.4 mm.
And, of course, there's supposed to be a heartbeat.
I'm trying to set up a consult with Dr. Morris of IVF1 who can hopefully do an embryoscopy. This will give us a chance to look hard at anything that's there and then make sure they get a direct sample from the bean itself to do genetic testing. The earliest appointment I could get is for next Wednesday.
Doc wants to do a more detailed u/s with color flow Doppler, so I'll do that on friday. I think I'll need it to convince Dr. Morris to do the embryoscopy anyways.
*****UPDATE*****
So, 5 days later I followed up with Dr. Morris and what do they find? Of course, a heartbeat. But, it's too slow at 89 BPM and the bean is measuring too small.
The CRL was at 3.15mm which puts the bean at 5w6d when I'm 6w6d.
The yolk sac is extremely enlarged at 6.92 mm which is a seriously bad sign.
The gestational sac is at 8.36mm which is small at the size of a 5w3d bean.
There's nothing to do but wait it out. I go back in next Wednesday for a followup.
Friday, November 8, 2013
Next steps: Letrozole and Neupogen (G-CSF)
Let's be real. This will probably be a miscarriage. So, it always helps me to have a plan.
First off, 'm going to have a consult with the doc on Monday when I do my repeat beta.
My thoughts are this: With this pregnancy, no matter what the number is I'd like to keep the progesterone going strong until the late 6 week or early 7 week time frame. The day before Thanksgiving is 6w6d, so I'll try to get an u/s then. If there's going to be a heartbeat it'll be there. (I'll take a miracle. And, I figure someone must live in the tail ends of the HCG bell curve, I'd be thrilled if it was me.) But, there won't be. So, then we can have a D&C. This will give us the opportunity to karotype the bean. I think this will give us a firmer answer as to whether this is a soil or seed problem. At this point, the odds are there's a problem with the endometrium (the soil), but we haven't ruled out that maybe we just make a lot of genetically incompetent embryos (bad seeds). I think this'll give us some answers.
Moving ahead, we have only 4 IVFs covered by insurance. I'm not sure, but I think after the fourth IVF all infertility benefits cease. And, overall, I don't think the lab is really doing anything for us. We seem to make great embryos that make it to blast all the time. So, an IUI would give us just as good of results as an IVF. I'd like to talk the doc into keeping the same high dose of stims. I think we need every target we can get to get a baby out of this. So, I'll ask about that.
The meds I want to add are this:
Letrozole (Femara) Letrozole is a first line med to get women to ovulate. But, it has the nice side effect of regulating Beta 3 Integrin levels. There's no reason to think I have this problem, but it's such an easy fix and fits in well with an IUI plan I don't see any reason not to.
http://www.ncbi.nlm.nih.gov/pubmed/22246449
The other thing I want to add is more controversial. It's Neupogen (G-CSF).
I've read the article numerous times to try to figure out what Neupogen actually does, but I still have a hard time understanding it. According to the article, "Granulocyte colony-stimulating factor (G-CSF) is a cytokine which stimulates neutrophilic granulocyte proliferation and differentiation. It is expressed and produced by the decidual cells, and its receptor, c-fms, is expressed by the trophoblastic cells"
The great part is this, "Results In the group treated with G-CSF, 29 out of 35 (82.8%) women delivered a healthy baby, whereas in the placebo group, this figure was only 16 out of 33 (48.5%) (P = 0.0061, odds ratio = 5.1; 95% confidence interval 1.5–18.4). Significantly higher β-hCG levels were found in gestation weeks 5–9 in women treated with G-CSF versus placebo"
http://www.medscape.com/viewarticle/712831
I REALLY like the idea of higher HCG levels. I have always suffered from this problem. I wonder if the HCG is a chicken or the egg sort of problem. Which comes first. Does a bad embryo produce poor HCG numbers? (The common theory). Or, can the low HCG numbers cause the body to not make the necessary changes to fully accept the implanting embryo? It would seem as if the problems fed off each other. But, no one seems to really know the full effects of HCG on the endometrium.
http://www.medscape.com/viewarticle/410898_4
http://endo.endojournals.org/content/148/2/618.full
http://repbiol.pan.olsztyn.pl/docs/pdfs/repbiol_vol1_num1_page10.pdf
Sigh. So much to think about.
But, that's the plan for next time. IUI with Letrozole, Follistim, Menopur. Lovenox, Prednisone, HCG trigger and progesterone support. And, I'll also ask about HCG boosters in the 2ww.
First off, 'm going to have a consult with the doc on Monday when I do my repeat beta.
My thoughts are this: With this pregnancy, no matter what the number is I'd like to keep the progesterone going strong until the late 6 week or early 7 week time frame. The day before Thanksgiving is 6w6d, so I'll try to get an u/s then. If there's going to be a heartbeat it'll be there. (I'll take a miracle. And, I figure someone must live in the tail ends of the HCG bell curve, I'd be thrilled if it was me.) But, there won't be. So, then we can have a D&C. This will give us the opportunity to karotype the bean. I think this will give us a firmer answer as to whether this is a soil or seed problem. At this point, the odds are there's a problem with the endometrium (the soil), but we haven't ruled out that maybe we just make a lot of genetically incompetent embryos (bad seeds). I think this'll give us some answers.
Moving ahead, we have only 4 IVFs covered by insurance. I'm not sure, but I think after the fourth IVF all infertility benefits cease. And, overall, I don't think the lab is really doing anything for us. We seem to make great embryos that make it to blast all the time. So, an IUI would give us just as good of results as an IVF. I'd like to talk the doc into keeping the same high dose of stims. I think we need every target we can get to get a baby out of this. So, I'll ask about that.
The meds I want to add are this:
Letrozole (Femara) Letrozole is a first line med to get women to ovulate. But, it has the nice side effect of regulating Beta 3 Integrin levels. There's no reason to think I have this problem, but it's such an easy fix and fits in well with an IUI plan I don't see any reason not to.
http://www.ncbi.nlm.nih.gov/pubmed/22246449
The other thing I want to add is more controversial. It's Neupogen (G-CSF).
I've read the article numerous times to try to figure out what Neupogen actually does, but I still have a hard time understanding it. According to the article, "Granulocyte colony-stimulating factor (G-CSF) is a cytokine which stimulates neutrophilic granulocyte proliferation and differentiation. It is expressed and produced by the decidual cells, and its receptor, c-fms, is expressed by the trophoblastic cells"
The great part is this, "Results In the group treated with G-CSF, 29 out of 35 (82.8%) women delivered a healthy baby, whereas in the placebo group, this figure was only 16 out of 33 (48.5%) (P = 0.0061, odds ratio = 5.1; 95% confidence interval 1.5–18.4). Significantly higher β-hCG levels were found in gestation weeks 5–9 in women treated with G-CSF versus placebo"
http://www.medscape.com/viewarticle/712831
I REALLY like the idea of higher HCG levels. I have always suffered from this problem. I wonder if the HCG is a chicken or the egg sort of problem. Which comes first. Does a bad embryo produce poor HCG numbers? (The common theory). Or, can the low HCG numbers cause the body to not make the necessary changes to fully accept the implanting embryo? It would seem as if the problems fed off each other. But, no one seems to really know the full effects of HCG on the endometrium.
http://www.medscape.com/viewarticle/410898_4
http://endo.endojournals.org/content/148/2/618.full
http://repbiol.pan.olsztyn.pl/docs/pdfs/repbiol_vol1_num1_page10.pdf
Sigh. So much to think about.
But, that's the plan for next time. IUI with Letrozole, Follistim, Menopur. Lovenox, Prednisone, HCG trigger and progesterone support. And, I'll also ask about HCG boosters in the 2ww.
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