Non monitored injectable cycle?


#1

I just finished triggering on my first injection cycle. I’m trying to plan options if this cycle is a bust…

I have to pay out of pocket for ultrasounds…not cheap. So…I’m wondering if there’s ever a case where you can take injectables (once you know how you respond) and not have to do ultrasounds? I am 44 and not the least bit worried about overstimming…

Has anyone ever done injectables and been monitored only through blood work…and could you trigger based on opk’s? Or don’t opk’s work with menopur? I did menopur this cycle, and I tried opk’s just to see…they seemed to match up with what was going on just fine.

My other option is to call my OB, who used to deal with injectables…ask her if she’d do one cycle with me. My ultrasounds were covered on clomid there and so they might be again.

I wouldn’t be scared at all to do injectables and trigger myself, because of my age. But I realize you have to know WHEN to trigger. And you need a script for it.

Are there any other options besides a full out monitored cycle for someone like me?


#2

My cycles went from nothing to 1 12-13mm follicle to hyperstimming with like 20 HUGE follicles.

I know it is tempting. I know how incredibly expensive this all is, but please think about what would happen. You may get these useless cycles that you trigger for and nothing or you may get way too many eggs, and end up in the hospital with hyperstim or highend multiples.


#3

You may get these useless cycles that you trigger for and nothing or you may get way too many eggs, and end up in the hospital with hyperstim or highend multiples. __________________

I hear you, I really do. And as far as a useless cycle that I trigger for nothing. Well, at 44, my odds aren’t great. I’d risk one cycle triggering for nothing. I have some donated meds and didn’t use them all this cycle. So it’s just a matter of using the rest up. I’d only do it once.

As far as over stimming…at 44…man, I really do not think I’d have to worry about that. Truly. I asked my OB how much he worries about that with someone my age. He flat out said, “Zero.” If I were your age, I wouldn’t consider it. I had a really good response with a pretty high dose of injectables. And that ended up being 3 eggies. I’d have triggered with 7-8 with no hesitation, had there been that many. I have no issues with pcos. So I can’t imagine with less meds, I’d have to worry.

Anyway…I didn’t even know if it was possible. I know it’s not a great scenario.


#4

I’ve wondered the same thing since I’m paying OOP for everything. The meds, U/S’s, bloodwork - everything. It gets really expensive.

I know there are ways to get injectable meds without a scrip on web sites but I have never done that.

For me, I do have PCOS, so - I don’t think I could every do an unmonitored injects cycle. That and I would have to know when to trigger, etc. Then if for some reason I didn’t ovulate I might need a scrip for provera.

For me it would just turn into a big mess or I would become another octomom which is the last thing I want to happen.

I think your OB saying that there is a zero chance of overstimming is going a little far - I think with the power of the injectable meds it is always a possibility, albeit a very small one.

The way I would look at it is like this:

  • If you do wind up overstimming and wind up with multiples are you willing to selectively reduce? If that is something that you don’t want to do then that is fine - but you need to monitor your cycles.
  • Are you willing to possibly get OHSS and basically risk your life to have a baby?

Again, personally I wouldn’t do it. While the risk would be worth the reward if it worked out it is a very risky thing to do if it doesn’t work out.


#5

The way I would look at it is like this:

  • If you do wind up overstimming and wind up with multiples are you willing to selectively reduce? If that is something that you don’t want to do then that is fine - but you need to monitor your cycles.
  • Are you willing to possibly get OHSS and basically risk your life to have a baby?>>>>>>>

So, if I didn’t overstim on the dose I did last cycle…there is a chance of overstimming on less than that? Like if I cut what I did in half…there is that much variance in how we respond? I don’t want to get OHSS for sure, but I can’t imagine how taking less meds would be dangerous?

As far as multiples, I wouldn’t selective reduce…but I only got 3 good follies on a high dose of injectables…I wouldn’t think I’d get more follies on less meds?

Or is there really that much uncertainty on response?


#6

I’ve wondered about doing it on my own as well, since it seems I do the same protocol each time… its juts when to trigger is the question…

but if you decide to do it, please let us know what happens. I totally understadn your frustration.

I went for an US today and was told I have 3 follies that are between 14-16 and that 15 is considered “mature.” They told me NOT to do gonal -f tonight and just ovadril for my IUI tomorrow and the next day. I was thinking "maybe I should do a 37.5 gonal-f injection before the ovadril to get more follies, and didn’t - THIS CYCLE. We’ll see what happens. Fingers crossed!


#7

I was thinking "maybe I should do a 37.5 gonal-f injection before the ovadril to get more follies, and didn’t - THIS CYCLE. We’ll see what happens. Fingers crossed! __________________

Yeah, I would have been tempted too. But with only one day, it probably wouldn’t have made a difference. I know I had 2 days to coast before my trigger and it felt tempting to throw in a couple more injections…but my Dr. said not to b/c he didn’t want that lead follie ovulating on it’s own before the trigger could release them all. That makes total sense. Although my lead was bigger than yours…at 19.

I was wondering, too…how much they can tell from blood work. I know in Europe they don’t do the number of ultrasounds even for IVF that we do in the states. Could they check E2 levels a few times (that IS covered with my insurance) to make sure you’re not overstimming? Can E2 levels tell you that? If so…that’d be good.

One could (theoretically, of course) just do a few days of injects (much less than the normal amount) and coast for a few days to get the LH enough out of your system…then watch opk’s to trigger. The pharmacists told me that although there is LH in menopur, it doesn’t negate opk’s use, just makes the opk’s darker b/c of the menopur’s LH combined with your own. So if you stopped the menopur…and the opk’s kept getting darker and then went positive, you could be pretty sure it was your own body, according to the pharmacist.

This is a last ditch plan, of course. I’m hoping my OB will take on an inject cycle with me (scans are covered with her), but if she won’t and my RE won’t monitor me with blood work…I just don’t know. I’ve got one cycle of inject meds left and can’t really afford the monitoring again.