Follow-up consultation with RE after MC
11 Replies
baby1234 - January 15

Hi everyone. I have a follow-up consult with my RE next weekend after an IVF resulting in mc (at 51/2 weeks). I was hoping I could get suggestions about what to talk to my doctor about at that visit. I do have some questions already, but I want to make sure I feel like I know as much as possible when I leave that appointment. I am wrting everything I can down so I won't forget while I am there. This was my first ivf and first bfp. Any help is appreciated. Thanks. Stacie

 

baby1234 - January 15

Any ideas anyone? Bump

 

Mega - January 15

Hey Stacie. I posted a couple of suggestions on the IVFers thread but I'll reiterate them here for you too. When I had my post m/c consult a few weeks back I asked my dr his thoughts on egg/sperm quality. I asked for theories on why the blighted ovum happened--a freak thing/bad luck he said. I also asked about what to try for next time, such as additional prog. support or perhaps estrogen support post tx. I asked him about trying AH again & if that might improve odds of implantation again. I hope this helps! I filled a whole
page of my (big) IVF notebook with questions for that appt. Then we get in there & my dr turns to my DH first to see if he had questions! My DH laughed & said no, question asking was my department not his. I just thought that was funny. Anyway, I know this is a tough time for you, but I hope you get some much needed answers & a bit of reassurance next weekend. Hang in there.

 

baby1234 - January 15

Thanks, Mega. I just read the other post too. I would hope that with what they transfered (2 A quality day 4 embryos) and the 1 B blast that was frozen that the quality was okay, especially because I started with 6 eggs that all fertilized. I am leaning toward immune problems as the cause (I have had hives for over a year and they mysteriously went away when I was pg and still haven't returned) so I definitely want to do the testing for that. I am also wondering about the 6 eggs after all of those meds. I had 5 mature and 1 immature eggs when I was doing the iuis and was on only the gonal f so I think that maybe I was over surpressed a little. I just want to make sure I have thought of as much as possible to talk to him about. I am a classic, "Why didn't I ask that?" person so I am trying to get as prepared as possibly can. Thanks for the ideas. If you think of anything else, please let me know. Stac

 

Mega - January 15

You're welcome! One question, what drug/drugs did you use for the IVF this time? Maybe they could mix up the drugs a bit this time as well. Most REs will tell you the drugs are all the same but I don't agree. Some women respond well to lh/fsh drugs like Menopur or Repronex & others like me do better with pure FSH like Follistim (me) & Gonal F (you), so that could be why you produced fewer eggs than you wanted as well.

 

baby1234 - January 15

I feel like I took a little of everything this time. I did the bcps, lupron, gonal f, menapur, ganirelex, and well maybe that was it for the stimming. After the retrieval I was on the steroid for 5 days (forget what it's called), antibiotics, estrogen patches and the pio shots. Everything was new except the gonal f. I did the same dosage of gonal f I took for the iuis except I was on two shots of the dosage a day instead of 1. I guess I won't know anything more until saturday. I sure hope he can give me some answers. Stac

 

baby1234 - January 15

Anything from af yet? Where is she?

 

baby1234 - January 16

Bump. Anyone else have ideas?

 

Ann1 - January 17

I am sorry for your loss. The dr may not be as concerned, since you haven't had more than one m/c. Hopefully, it was just bad luck. Some other things you can ask about are: getting pgd (pre-implantation diagnosis) on your embies before they are transferred, a DNA fragmentation test for your dh's sperm (a more detailed test than a regular analysis that shows the quality of the DNA in the sperm), and chromosomal testing for both you and your dh (done through a detailed blood test called karyotyping). Like you said, you should be tested for immune issues, and I don't know if it would be helpful to do an endometrial biopsy to check your uterine lining for implantation (not sure if that is only for initial implantation or for sustained pg as well). Hope this helps!

 

Mega - January 17

That's a good list, Ann. Stacie, I agree with those suggestions too. But like Ann said often dr's wait for another m/c to start looking into deeper causes. Though I was happy to hear my dr say if I did (God forbid) have just one more blighted ovum m/c he'd send me for indepth genetic testing. Looking over your drug list--you did ganirelex?! Do you remember what the dr said that drug does? B/c if I'm not mistaken that's a suppression drug too. Mainly for women who aren't candidates for Lupron. So if you did Lupron also maybe you really were oversuppresed. I'll do a google search on ganirelex though. Maybe I'm wrong. Very possible. Nope, no AF still. I'm thinking she got lost on the way to my house. Which is funny b/c she can usually find me no problem, but that's only when I don't want to see her I guess. LOL! So how many pages have you filled with questions yet?

 

Mega - January 17

Yeah, I looked up ganirelex, & it is used to prevent an early O. But that's also why you use Lupron & BCPs too. So maybe down-regging (using BCPs) & ganirelex together did oversuppress you. I know your dr is the pro in all this stuff, but I can't help wondering if you'd yield better results with either flare protocol skipping BCPs but using ganirelex OR down regging with BCPs & using Lupron too. Either or. Just a thought!

 

Ann1 - January 18

baby, to add to Mega's info about over-suppressing, there is also something you might want to ask your dr about called a "natural start." It is used for people that don't get a great response from injectibles. I can't remember the ins and outs, but I think you don' t suppress your system at all before you begin the meds (I may not be remembering correctly). I was going to have this done, because I didn't respond that well to the meds (fsh issues).

 

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