IVF #4 – Stim Day 9- The 411

baby - ivf 4 stim day 2

Tonight is hopefully my LAST night of stims !  I mixed and injected all the meds and surprisingly this cycle, I do not have one bruise !   WOW !   I made it through without looking like a human cushion pin !!

I have a monitoring appointment in the morning and more labs and I am praying that the other follicles catch up to the 20, 16 and 14 leads that I had on Monday.  I feel a lot fuller and more bloated.   My acupuncturist noticed my abdominal bloat this morning.

I went to acupuncture with my mom and then we grabbed lunch at a place she read about since she was craving fajitas.  She ended up not even liking them, which is typical lol.   Her taste buds are so off, I do not even know why she even tries to eat out.

After starting Taxol last week, my mom started experiencing radiating pain.  She text me at 2 am to ask if I was awake so that she could figure out something to take for the pain in her back.  I gave her a flexeril but it didn’t do much to help.  We called her Oncologist’s office this morning and they wrote a script for Vicodin.  I went and picked it up this evening and filled it when I went to pick up my Emla cream.  I found the numbing cream does help when injecting the PIO (progesterone in oil).

I have packed my box of spices and treats, packed up all my meds, needles and supplies and I am shipping those boxes to the hotel tomorrow so they will be there when I arrive on Thursday.  My hotel has a kitchen in the room, which I love, although they do serve a full breakfast daily and dinner Monday thru Thursday.  I always eat breakfast, but I usually just have to concierge take me to the grocer and I buy food to cook since I am so picky.   My mom is going with me this time, so I will have company !!  I am excited that she will be coming along.  Being that Upstate NY is extremely cold and it is to be -2 on Thursday, I doubt we will venture out except to the grocer.  We will probably go see a movie on Saturday at the mall if I am up to it.

Please send up some prayer that this last injection pushes these little follicles to where they need to be.  I will drink a few cups of Ballerina Tea tomorrow when I get  back from my appointments and “clean out”.  I found that by cleaning the digestive tract, I did not have nearly as much bloating and discomfort post-procedure since I emptied my colon and intestines the day before.

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Saizen (Human Growth Hormone) for IVF – The 411

baby- saizen

Saizen Growth Hormone Helps Infertility

Adequate growth hormone levels are critical for good ovarian follicle development, and growth hormone levels are known to decline significantly with age. Studies show that adjuvant growth hormone treatment during IVF can help older women to beat the odds and have a higher take home baby rate – even when their ovarian reserve is poor and previous cycles have failed – by restoring youthful hormone hormone production within follicles. Some studies show that younger women who are poor responders reap the benefits also.

The results are quite amazing. In one study (1) one hundred women, 40 years of age or older – all of poor prognosis – were studied as they pursued IVF, half received growth hormone with their ovarian hyper-stimulation medications, half did not.

The numbers of eggs, embryos and pregnancies were similar in both groups but the growth hormone-treated women had far fewer miscarriages and a higher take-home-baby rate. Women being co-treated with growth hormone had far less biochemical pregnancies, and a pregnancy rate of 26% compared to 6% in untreated cycles. The delivery rate was significantly improved also, 22% of cycles versus 4% in the untreated group.

During the stimulation phase of the IVF, treated women had higher estradiol and growth hormone levels within the ovarian follicles thought to lead to healthier eggs and higher embryo quality. The researchers of this study (1) concluded that:

“Administration of GH (growth hormone) during ovarian stimulation alleviates age-related decrease in assisted reproduction treatment efficiency. This effect appears to be mainly due to an improvement of oocyte developmental potential, but GH action on the uterus cannot be excluded…”

“In conclusion, this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

Previously in a study (2) on 20 women who had responded poorly to ovarian hyper-stimulation, 24 IU (intramuscular injection) of growth hormone was given on alternate days alongside gonadotrophin stimulation. The researchers concluded that:

“…in a subgroup of patients who respond sub-optimally to standard ovarian stimulation regimens for IVF-ET and who have ultrasound-diagnosed polycystic ovaries, systemic growth hormone is an effective adjunctive therapy.”

In another study (3) on growth hormone supplemented IVF cycles in poor responders, 159 women were studied as they pursued a total of 488 IVF treatment cycles between 2002 and 2006, comprising 221 cycles with growth hormone and 241 without. Growth hormone co-treatment was shown to increase pregnancy rates in fresh and frozen cycles in all age groups – especially younger age groups – the researchers concluded that:

“GH cycles resulted in significantly more babies delivered per transfer than non-GH cycles… (20% versus 7%). The data uniquely show that the effect of GH is directed at oocyte and subsequent embryo quality.”

Previous studies have shown that the levels of hormones within ovarian follicles – especially growth hormone – are critical for the development of normal healthy embryos that are able to implant. Levels of growth hormone are tightly correlated to an oocyte’s ability to be of high quality, with a high potential for implantation. (Mendoza et al. 1999,2002)

A large study on 100 couples where the female partner was over 40 years also showed benefit. The women were split into two groups, to receive growth hormone treatment (8 IU of Saizen from day 7 until the day after the hCG trigger) alongside IVF or a placebo. The study concluded that:

“this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

Another similar study (4) on poor responders who received co-treatment with growth hormone with ovarian hyper-stimulation found that:

“…the GH cycles had better performance in terms of the number of oocytes fertilized and the pregnancy rate.”

Different studies have used varying amounts of growth hormone but many such studies concur that co-treatment with growth hormone can give you better odds of succeeding, especially if your prognosis is poor.

This article is purely for educational and informational purposes and is not intended to substitute for medical diagnosis or treatment for which you should consult a physician.

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References:

1. Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone. Tesarik et al. Hum. Reprod. (September 2005) 20 (9): 2536-2541. doi: 10.1093/humrep/dei066 First published online: April 28, 2005
Human Reprod. (1991)6(47):526-528 Co-treatment with growth hormone of sub-optimal responders in IVF-ET. E.J.Owen et al.

Growth hormone supplementation improves implantation and pregnancy productivity rates for poor-prognosis patients undertaking IVF. Yovich JL and Stanger JD.Reprod Biomed Online 2010 Jul;21(1):37-39
The value of human growth hormone as an adjuvant for ovarian stimulation in a human in vitro fertilization program. JObstet Gynaecol Res. 1996 Oct;22(5):443-50. Wu et al.

Source:  http://www.bellaonline.com

IVF #4 Upcoming – The 411

baby - ivf egg and sperm

Last night, Dr. Robert Kiltz, who owns CNY Fertility Center and Spa, called me and said he wanted to schedule a phone consult with me for Saturday morning.  He said he was reviewing my file and would call me.  This morning, as promised, he called to discuss my latest failed cycle and to make a plan to move forward.

He wants me to try one more cycle with my own eggs prior to moving on to donor eggs.  He feels that I have good equality and is happy that he sees all my embryos making to blast.  He feels that I need to do a few things:

–  Add Saizen / human growth hormone to my cycle to improve maturation and egg quality

– Use neupogen post transfer

– Do a neupogen wash

–  Do a Hysteroscopy with biopsy

– Do an endometrial scratch on day two of my cycle to improve implantation

– Continue on an estrogen priming protocol

– Use 300 Gonal-F and 300 Menopur with Lupron for stims again

I have decided to give my own eggs one more last shot while I am saving up for a donor egg cycle.  I am going to detox my body first.  All of these hormones have take a toll on my body.   I am going to start a protein train on Monday (protein shakes only, apple sauce, sf popsicles, sf jello, water, diluted apple juice, oatmeal).  I will actually start by drinking only water with lemon, cayenne pepper and grade A maple syrup for two days to detox my body from my sugar habit.  It really does work !  By drinking loads of the lemon cayenne tea, it cuts sugar cravings and helps you follow the Bariatric diet more easily.

For those that did not know, I had gastric bypass surgery March 31, 2004.  When I follow a strict diet for short periods, it helps me refocus and I also drop weight pretty quickly.  I want to get back to my starting weight prior to starting stims.  I should be able to drop the few pounds I have gained due to the hormones.  It can only help with my quest to get pregnant.  Weight loss releases the hormones that are stored in body fat back into the bloodstream.  This is why a lot of women who became infertile due to obesity find themselves pregnant unexpectedly after gastric bypass, lapband, or significant weight loss.

Ironically, one of my friends out of the blue reached out to me late yesterday and said that God had laid on their spirit to relay to me to hold on…. that my bundles of joy were on the way.  I told my friend to go back and relay a message for me…  I will hold on, but can He speed up this timeline ! lol