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Back to back IVF Cyle?

Posted: Sun Nov 26, 2017 7:55 am
by rohi
Hi Dr Wisot,
i just finished my last egg retrieval with dismal results - 9 eggs, all immature. It was a bad judgement call from my RE as I only had 1 follicle at 18 and the rest were still small even at 8,9, 10mm. This is my 3rd retrieval and i always stim for 13 days with good result (12/13 retrieved, 10 12 mature each time). My RE has a weekend plan and triggered me on day 10 this time even though i was clearly not ready.

My question now is, i want to start another cycle for collection immediately once i get a bleed in a few days. I need to get my last cycle in for the year or else i lose my insurance cover. Do you know if it will impact my cycle if i start right away? I am thinking that since my antrals were recently exposed to gonadotropins, starting stimulation immediately might help us get more eggs, and more mature quickly too. Is my thinking correct?

Also, do you think i could do about 7 days of bcp when my period comes (in about 5-8days) and then start the injections 3 days after stopping the pills. I am thinking that the pills might help resolve any cysts that might appear after our retrieval.

Or you think i should just skip the OCP and just start stims on day 3 of bleed?

Thank you for your insight sir!

Re: Back to back IVF Cyle?

Posted: Sun Nov 26, 2017 7:07 pm
by Dr. Wisot
There is varying opinions of doing back-to-back cycles among Res but you have a good reason for doing it: insurance.

Rather than a very short course of BCPs, if your ovaries are clear you could consider three days of antagonist before starting stims which is one protocol I have used for a quick start in egg freezing cases when patients have to start chemo quickly. But a short course of BCPs is probably better than no BCPs at all.

Good luck with it. Let us all know how it turns out.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Re: Back to back IVF Cyle?

Posted: Mon Nov 27, 2017 10:20 am
by rohi
Thanks for the prompt response Dr Wisot! So do I do the 3 days of antagonist when my period starts, from CD1 to CD 3 then start stims on CD 3? Do i then stop the antagonist and restart later or do i carry on with it? What is this protocol called?

Re: Back to back IVF Cyle?

Posted: Mon Nov 27, 2017 4:46 pm
by Dr. Wisot
I cannot prescribe or give details of protocols in this venue; your doctor has to give you the protocol. But you get the general idea.
Sorry I cannot be of more help.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Re: Back to back IVF Cyle?

Posted: Thu Nov 30, 2017 12:38 pm
by rohi
Thank you Dr Wisot. You have helped so much already!