Luteal Support after Lupron Trigger


#1

Hi all - our RE decided to use a lupron trigger prior to our IVF retrieval today to avoid OHSS (my estrogen levels were kind of high). We had 15 eggs retrieved.

Anyway, everything I’ve read says that Lupron works great in avoiding OHSS, but “aggressive” luteal support is needed. My RE always includes PIO and estrogen patches in his protocols, so he’s not changing anything (like increasing the dosages). I start PIO tomorrow - day after retrieval - and estrogen patches the day of transfer in 5 days.

I’m just worried that nothing was changed due to the Lupron trigger. Perhaps his protocol was conservative enough already that nothing further is needed? Has anyone else done a lupron trigger and if so, what was your luteal support (dosage and when you started)?

Thanks in advance!!


#2

[QUOTE=sweetc]Hi all - our RE decided to use a lupron trigger prior to our IVF retrieval today to avoid OHSS (my estrogen levels were kind of high). We had 15 eggs retrieved.

Anyway, everything I’ve read says that Lupron works great in avoiding OHSS, but “aggressive” luteal support is needed. My RE always includes PIO and estrogen patches in his protocols, so he’s not changing anything (like increasing the dosages). I start PIO tomorrow - day after retrieval - and estrogen patches the day of transfer in 5 days.

I’m just worried that nothing was changed due to the Lupron trigger. Perhaps his protocol was conservative enough already that nothing further is needed? Has anyone else done a lupron trigger and if so, what was your luteal support (dosage and when you started)?

Thanks in advance!![/QUOTE]

I’ve done the Lupron trigger twice. I was on 1cc of PIO for one cycle and 2cc the other because bloodwork showed my p4 was below 20. As for estrogen patches, I was on three once, then four the other time. My RE didn’t plan estrogen if it was an HCG trigger, so that was added, but the PIO would have been the same with the HCG trigger. I hope that helps. Good luck!


#3

[FONT=Calibri][SIZE=3]I would closely discuss the luteal support with your RE. I used a Lupron trigger (Actually Lupron Depot that has a dosage of 3.75mg) and I was put on Crinone and vaginal Estrace twice a day. The concept that the medications applied vaginally are directly absorbed by the uterus where it is need, but cannot be measure by blood test - Didn’t like that but I didn’t say anything since it was my 1st IVF and I believe in my Doctor’s experience. Well, my pregnancy ended in a miscarriage at 6 weeks. [/SIZE][/FONT]

[FONT=Calibri][SIZE=3]After a talk with the RE to determine what could have caused the miscarriage, of course genetics could have been an issue, but I’m sure it was the Lupron trigger the problem. The embryologist described my 2 embryos as perfect as it can be, so I don’t believe it was genetics, but the Lupron. If I could re-do, I would still use Lupron because OHSS is serious, but I would have frozen all my embryos instead. [/SIZE][/FONT]

[FONT=Calibri][SIZE=3]So my advice to you is don’t be shy. Tell your RE your concerns and ask for what you feel is the best for you. I wish I had done that.[/SIZE][/FONT]


#4

Thanks for the feedback. I finally went back to my notes, and one nurse had given me different directions a few days earlier than the final ones given on day of retrieval. I called, and they did note that the retrieval ones were a mistake. I started estrogen patches and PIO shots the day after retrieval - at higher dosages than in the past. Also, I will be monitored (via blood tests). So while I feel much better about the luteal support issue, I’m pretty upset that my cycle would have been ruined if I didn’t call. So the lesson is to question everything, I guess!!