FET protocols?

[ayanaR]

Hi ladies,

my last embryos this cycle and I need to pick between artificial and natural cycle. What protocol did you use? What were they like? How did you feel? Were they successful? I am reading that the artificial one is more risky pregnancy but easier to implement and I am old and have other risk factors for pre-eclampsia! But at my clinic the artificial one is the more successful one so I need to trade off success for health it seems. I am going crazy thinking of this.

[Tryingtolivewell]

Oh my god. I was exactly in this situation 3 weeks ago. Going crazy deciding between artificial or natural modified (with clomid and trigger). It was my last embryo as well.

I eventually went with the artificial protocol because I had already tried the natural protocol with my first embryo which was of good quality. But that did not stick.

I spoke to another doctor and some other women on Reddit and this is what I found - there is usually no difference in the success rates of artificial Vs natural. I prefer a natural because your body manages things by itself and it is less stressful on the body (artificial needs injections till week 8-10). But usually doctors like to switch protocols and see what works for your body. It it all a matter of chance, and many people have success when they switch the protocol.

That's why I went with artificial, since it was my last embryo and the stress of making the right decision is enormous. I am still in my 2WW, so don't know what the result but the artificial protocol has been manageable up till now. Plus you have the advantage of selecting your transfer day.

As my husband told me when I was freaking out - make a decision based on your knowledge right now and go with it, (I was flip flopping been the two a lot since I was very scared of taking injections for 8 weeks).

Hope this helps.

[ayanaR in reply to Tryingtolivewell]

Thank you so much for your response. It is so reassuring to hear that I am not the only one struggling with this (not that I like that you struggled!). I was set on the natural because the it has fewer risks for pregnancy especially for older people like me (46) and some of those risks run in my family and they are cumulative.

But the problem for me is that the doctor is saying that at their clinic the artificial does way better. For good quality euploid embryos the rates are the same but for poor quality NC is 36% LBR and artificial is 51%. In general these numbers don't mean much if you don't control for things like embryo quality in a more fine grained way (there are lots of grades within poor quality - If grade 1-2 is good and grade 3-4-5 are poor are there a higher proportion of grade 5 in the NC for poor quality?) I hate it when clinics release some data but it is bad quality data. His claim is that the AC cycle somehow creates a better environment for poor quality but RCTs show them equal.

My clinic does very few NC transfers so there is something to be said about choosing AC just because of their experience in it. I was so obsessing about this that I didn't ovulate this month even though had a nice follicle growing.

I am glad that you managed to make a choice Tryingtolivewell . I am wishing you a baby in a few months!

[Cherie2023 in reply to ayanaR]

Hi, I am 41 and we went ahead with controlled fet. My LH was fluctuating they had to give an injection to suppress certain hormones and then did the transfer. I've had couple of failed cycles in the past. This time all going well so far. Will be 8w today. Injections suck, I had my doctor switch it to subq to reduce soreness o my back. They allowed for 10 days and now back on the IM shots. Can't help it. Good luck to you.

[Glaedy]

I was always going for medicated cycles because I have hormonal imbalance without, if you don't have issues with your hormonal levels thickness of uterine lining then you could do natural, not sure how it works with pre-eclampsia risk Did your consultat advised you more one choice over other? Or did they told you about pros and cons?

[ayanaR in reply to Glaedy]

My consultant advised me to go with artificial but I not because my body requires it but because it is easier for the clinic. I don't really like my clinic any more but also don't want to risk moving the embryos.

[Doodlebug23]

Hi, I just turned 48 and just had my 7th transfer with embryos 9&10. Fellow oldie 🙈

My clinic don’t have a preference between mediated and natural and say the results are virtually the same.

I’ve had 1 natural before (2nd transfer BFN), but the rest mediated, simply for the control and cost - clinic is abroad and so I had to pay for scans in UK and natural cycle they wanted 3 and a blood test.

This time my clinic suggested trying natural again as my periods are still regular and never had issues with my lining.

I did ovulation tests till saw the peak and then had Ovitrelle trigger shot. Transfer was 5 days after that. No scans or bloods which felt weird. But all ok so far 🤞🏼 I’m in 2ww day 4.

I will be high risk pregnancy regardless due to my age and hypertension. But I’ll just take that as a positive as I’ll get more closer monitoring, more scans and be under a consultant I think.

X

[ayanaR in reply to Doodlebug23]

Hi Doodlebug. How are you dealing with the 2ww? Hoping things are looking up fellow oldie

[Doodlebug23 in reply to ayanaR]

My TWW ended last Sunday. I had bloods on the Friday 10p5dt and POAS on Sunday which was day 12. BFP!!! 😱😱💖🌈💖

Bloods came back at 79, and then follow up bloods taken on Monday 636!

I shall now of course be advocating natural! Have you made a decision as to what you are going to do yet? X