Monday, December 29, 2008

Naturally Timed FET vs Suppression?

I could use some of the vast knowledge our community has accumulated. I'm debating the pros and cons of a naturally timed FET vs suppression. My local RE says that without suppression, about 15% of women will ovulate. Considering my age and that my cycles are no longer as regular as they used to be, and that I will be traveling for my transfer (plus they will be culturing the embies after thawing, so we may not be sure of the transfer date until the last minute), suppression seems to make sense. I would like to hear about other's experiences with FET protocols.

Other miscellaneous FET questions:

Are hot baths okay up until transfer?

How soon after transfer would you fly? One of the top clinics here in NYC, which has a lot of out of town patients, tells their patients they can fly the next day. My flight will be short (about 2 hours), but it makes me nervous. I’m planning on taking just a carryon with wheels, but I will be on my own, so still some shlepping involved. Since I may not have a firm transfer date (depends on how long they decide to culture the embies once they see how they thaw), I’m trying to decide whether to add an extra day to the trip, so that if I do wind up with a day 5 transfer, I could fly home 2 days after transfer instead of the day after.

Thanks, all!


Anonymous said...

the only meds I did for my FET were estrogen, the antibiotics, and the progesterone. It was dubbed a "natural FET". I was told that the estrogen suppression was enough and I found it to be so so so easy on my body. I think warm baths are fine right to transfer. And travel? Well I flew to my clinic the day before transfer and flew back two days later. Check my blog archives from July to read a play by play.

SO excited for you!!

Nikki said...

The one time I was scheduled to do FET, they had me on Lupron and then estrogen. (My FET got cancelled right at the end - but that's a different story)

I think warm baths are ok till transfer.

And regarding travel - some doctors recommend bed rest, some do not. My local RE here doesn't really push bed rest, but I know CCRM recommends a 48 hour bed rest. When we get to do our transfer, we will be flying back on the 3rd day after transfer (the day after the 48 hour mark)

Good luck to you!!

bleu said...

My FET I had wanted natural and discussed it with my RE but we ended up doing a low dose Lupron and I was actually very ok with it. There just seemed less possible issues that way in the end. I did get pregnant with that cycle, later m/c'd but it did work.

As for baths up until fine after wait a few days.
Flying I see no issues with unles it means when you get to your destination you will be super busy.

Niki said...

I think it sounds like the controlled FET is the best option. You have to be SO careful with a natural FET because you don't want to put the embryos back too soon or too late--the amount of time the lining is exposed to progesterone is imperative for implantation. So, if you o earlier or later than you think you did and transfer the embryos it could cause implantation failure. Does that make sense? I guess I'm saying that I'd go with the controlled, medicated FET. As the others have said they are easy for most (I'm unusual with needing injections of estrogen).

Warm baths are fine up to transfer and I think they are so relaxing, so lounge in your warm bath girl!

Not sure on the travel stuff in terms of riding a plane?! However, my RE requires 48hrs of bedrest after the transfer. Some do and some don't.

I'm super excited for you! It's exciting that we're going to be transferring on the same day (or close to it)! :) So, I guess we'll be biting our nails together during the 2ww!

Mo said...

Hmmm...I haven't done FET so don't know the answer to all of your questions. When we were considering it tho, my RE said that we could go without meds as long as we were monitored with blood draws to know when ovulation would occur. Given all your parameters (age, traveling, etc), maybe you'd want to use the meds just to take any guesswork and extra stress out of the situation.

So that's my two cents.

When are we having a margarita at Cafe Frida?

Cara said...

No idea but wanted you know that I'm sending great thoughts and LOTS of hugs your way!!!

battynurse said...

I know nothing about FET as I've never done one before but I know that my doctor told me it was ok to fly right after transfer on my fresh cycle and I did fly the day after. The only thing was I was worried about the lifting my smallish suitcase into over head bins. I tried as much as possible to ask others to lift for me, explaining that I wasn't supposed to be lifting due to injury or whatever.

I Believe in Miracles said...

For my FET I was surpressed. I took Lupron up until a couple days before and then I started on the estrogen (patches) and progesterone (PIO).

I was told not to drink the night before the transfer, so I would imagine warm baths, etc apply once you are enroute to transfer - so not 24 hours ahead of time. Apart from that I took HOT showers as much as I possibly could (i.e nozzle was on 10 oclock and now my showers are 'cool' with the nozzle on 3oclock).

I was told to rest the day of the transfer, but then it was ok to move around but not lift anything heavy and no exercise. They did say specifically not to fly the next day. (Or was that the ER? I think it was ET.) Not necessarily bedrest, but modified. I stayed mostly on the couch for 2 days afer my FET.

I'm really excited for you too!!

Kristin said...

I think given all the factors involved, a FET with suppression makes the most sense. Praying hard for you my friend.

Geohde said...

Baths are fine. Flying also fine.

Standing on your head after transfer/trampolining etc all fine :). Really.

As for the FET, if timing and control is critical, an artificial/suppressed cycle might be safest.

Personally, I never did one because they either do straight HRT cycles or ovulation induction or natural NATURAL cycles :)


Meg said...

Hmmm, I guess I would go with the option that gave me the most control over timing.

Very exciting stuff! Good luck!

bleu said...

Hey hun I just realized I had written about this when I went through it and spoke with my doc so if you are interested here is a link to that post when I was questioning all things FET.

Hope it helps.

Dora said...

Thanks, everyone. I think the verdict is that my old ovaries can't be trusted. Also, with the traveling and culturing, we need some flexibility with the timing.

Should I expect to be a total bitch on lupron? I've never taken it before.

Thalia said...

Glad you've decided on the medicated FET. The results are usually better with this, as one of your commenters said, the timing of 'ovulation' and hence the state of your lining, and synching this with the developmental stage of the embryo is the deciding factor in whether implantation occurs. With a natural cycle they can only pinpoint ovulation to within a 12-24 hour window, with a medicated cycle they know within an hour or so. Much the best choice.

Re baths, the reason not to have them after egg collection on an IVF cycle is nothing to do with heat but because your vagina is punctured by the needle and so you need to avoid infection by sitting in the water. On an FET you haven't had that problem, so you can have baths before and after treatment, although after the embryos are replaced you need to reduce the temperature a bit.

Re travel, there is absolutely no evidence that bed rest, not lifting things etc has any deleterious effect on the outcome of your cycle. In fact, the only authoritative study on this showed a HIGHER pregnancy rate in those who returned to normal activity as opposed to those who did complete or modified bed rest after transfer. So travel when you want to, don't worry about lifting your bag, you will be absolutely fine either way. The embryos aren't replaced into liquid, they are replaced into a medium a bit like raspberry jam - sticky and solid. They're not going anywhere once they are replaced!

bleu said...

Hey Dora, Lupron was one of the only drugs that DID affect me with the bitchiness. I will say though, that the lowered dose I was on for the FET was WAY better than with the fresh IVF dose. Some docs, though, do not do differing doses for an FET so who knows.

I also know many who never have the bitch with it, but then I didn't have the bitch with Clomid and I know many who went nuts so it really is a "you have to wait and see" thing.


Anonymous said...

Good luck Dora - I did a DE IVF cycle, so sort of like having a FET...I was on Lupron and that was probably good since I seem to love making cysts of the bad variety. The Lupron didn't make me more b#tchy than usual! I think I was more emotional (like when I'm having AF), but nothing huge. Of course we are all different.

The baths are fine up til transfer - and then I'd take whatever advice your doc gives about it. I don't think flying would be bad if you can take it easy, my doc didn't require bedrest but I laid around for 2 days (didn't help though!)...I think if you don't overdo you'll be fine. Hoping so hard this works for you