Alternate protocols for FET

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ckwheatley22
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Alternate protocols for FET

Post by ckwheatley22 » Wed Nov 28, 2018 4:18 am

Hello.
I have had one failed FET using the estrogen/progesterone HRT protocol. I had nausea and mild headaches and very, very painful breast and lymphs nodes as my estrogen got to about 1800. My doctor suggested an ERA with the same protocol adding Lupron as I have a history of Stage II endometriosis . I did it. On Lupron, I was periodically dizzy, excruciating headaches, insomnia, etc. and my lining was thinner than with my failed transfer. My ERA came back pre-receptive +2, so the doctor said we had to repeat the ERA. I started the Lupron and had migraines within 48 hours of my first shot, so I told my doctor I had to stop. I will not do Lupron again. I want to know what other protocols you would recommend for FET?

Dr. Cassidenti
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Re: Alternate protocols for FET

Post by Dr. Cassidenti » Wed Nov 28, 2018 8:56 am

I’m so sorry to hear that you are having difficulties with all the hormones. There are unfortunately many different side effects of the medications that we use. As you probably know, the reasoning behind using a hormonal replacement cycle for a FET is to be able to better predict and plan for the actual transfer. However, in your situation, given that you are having such bad side effects, I would recommend considering doing a FET during a natural cycle. This would prevent you needing to take high doses of estrogen. This means that if you are ovulating that you would be followed until you ovulate and then the transfer would be timed based on your ovulation. This would make timing of the FET slightly less predictable which may be hard if you are a planner. If you don’t ovulate on your own but ovulate on medication, you could also consider doing a cycle with Clomid and timing the transfer to occur once there has been documentation of ovulation. You can also have an ERA done during one of these cycles as a Mock to determine if you are receptive and also to better individualize your transfer.

I hope that this is helpful. Best of luck with your next FET.

Denise Cassidenti, MD
Reproductive Partners Medical Group, Inc.

ckwheatley22
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Re: Alternate protocols for FET

Post by ckwheatley22 » Wed Nov 28, 2018 2:10 pm

Thank you so much! Is there an advantage to Letrozole over Clomid in a medicated cycle? I've read that Clomid thins the lining and mine was barely 7 my last cycle using estrogen.

Dr. Cassidenti
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Re: Alternate protocols for FET

Post by Dr. Cassidenti » Wed Nov 28, 2018 2:47 pm

There is not really an advantage of either Clomid vs Letrazole. It is basically whichever will give you the best lining. Some patients do better on Clomid whereas other do better on Letrazole. A natural cycle without medications would hopefully prevent one from having to worry about any side effects of either Clomid or Letrazole. Hope that helps.

Denise Cassidenti, MD
Reproductive Partners Medical Group, Inc.

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