CD7: A bit of understanding about my cycle
I stayed up late last night, until 2AM, reading and digesting. I've read a number of his articles before but I hadn't tried to find any that spoke to the sort of protocol I was on because, well, I didn't understand what sort of protocol I was one! However, I found a few articles of the Dr's online which helped me understand what he's going after.
So. In a nutshell.
The estinyl estradiol (EE2) forces your FSH down and gets your granulosa theca cells to do create more FHS receptors.
Think of it this way: you cut off the FSH but your granulosa theca cells WANT FSH. So they make more receptors to capture whatever FSH comes their way. It makes them very efficient with whatever FSH they can find and capture with their "receptors". They become hypersensitive to FSH and therefore act like cells from a younger person!
So you stick with this oral EE2 until the FSH tanks (becomes normal) and the E2 rises to above 50. He notes that EE2 doesn't cause your blood E2 values to change. Different chemical. So the EE2 gets the FSH into the normal range, gets the granulosa cells primed for FSH. The body's own FSH helps to mature the follicles but if it slow you can add in extra FSH (150 to 220iu of FSH the latter amount if you're using ganirelex or cetrotide).
It's a very low dose cycle - but it's interesting how he's making the body use it's own FSH here and then helping out where necessary. I did see one article where he said that this is not only successful with older patients, but that it helps to really save on costs for IVF drugs.
Brilliant.
It's too bad that his nurses, after a few years of nursing school, and probably multiple years of working for him, don't understand his protocols enough to help calm patients' nerves.
I can guarantee you that he and I will have a very long talk next opportunity. I think he is an utterly brilliant man who is doing studies that aren't what universities consider "lucrative" or those that would entice big pharma funding. In other words, pharmaceutical companies wouldn't want to fund his research because his work shows that 900iu pens of gonal-f aren't exactly necessary. Imagine spending $500 for your cycle meds rather than $10,000? His research money is probably not huge, despite his working a university IVF clinic outpost, but he persists on doing work that is really insightful and meaningful. Seriously, ladies, from what I read last night, I can that this man is one of the few that is truly on our side.
Maddy: Maybe you need to be cycling with Dr. Czech? :-)
Postscript: I just realized that in one month I will be 46 and it'll be time to update my age on my blog headline. I hope to one day edit that headline to speak to a success.
Labels: IVF9, Low Dose Protocol
Comments on "CD7: A bit of understanding about my cycle"
Hi Linda,
Yeah, I hate to come across as judgmental or a know it all. Her RE sounds like he truly cares which is HUGE, and I know he is doing the best the he knows for her. However, some of the things he says and done have made he scratch my head and wonder. I went through four REs myself until I finally found the one that could really help me. My first stop was at a world-renowned place, CCRM in Colorado, who told me donor egg and kicked me out. Second one told me donor egg too. I've learned to be VERY skeptical of anything an RE says and always run it through the filter of what I have learned over the last three years and what I know to be true of my body. Collaborating with other women and reading blogs like yours is such a help too.
I guess the winning difference this time was the my fourth RE is very experienced and knowledgable, really listened to what I had to say, tweaked his protocol based on what I knew to be true about my body, and then carefully monitored me and adjusted as necessary. Coupled with a great lab, it was the winning combo. I just wish everyone could get this kind of help because I know RE quality varies wildly.
Anon,
Wow, you went right to the "top" (some would say) by STARTING with CCRM! My first RE (Dr. Moustache near SF) "fired me" and told me to go to CCRM but I didn't have insurance back then and I wound up going elsewhere.
I'm shocked that they told you donor egg - I always thought that they were the last bastion of hope for women. :(
Yes, I scratch my head a lot when I read other blogs. I've seen a lot of doctors that just do "cookie cutter" protocols. I used to joke that Dr. Moustache was a one trick pony as all of his patients seemed to be on MDLF protocols. LOL.
That's fabulous that you found a clinic that worked for you. I've got to ask: which clinic???
I have to say it's a very strange feeling to read a discussion about me on another blog.
Linda, I will definitely look into this low-dose protocol - it sounds very promising and I hope it does the trick for you.
And Anonymous - I really appreciate your following my blog and your wish for me to have success. I have heard a lot about Dr. Check on the FSH Support Board and if money weren't such an issue, I would love to hear what he has to say - so I'll just put it out there in case there's some wealthy philanthropist reading this who would like to pay for my travel and medical expenses so that I can get a consult...otherwise, I'm pretty limited in my choices right now and am doing the best I can with what I have to work with.
Maddy, no offense and I apologize if I have offended you in any way. I am cheering for you to find your happy ending and wish all the best for you.
Linda, about CCRM, they are great IF you are perfect and have nothing obviously wrong. For me they were great until they told me my FSH was 20 and even though I had 13 antrals at the time I was told DE with an FSH that high. They also told me I should have 25 follicles. They are VERY protective of their stats and will kick out anyone they think might be hard to stimulate and lower their stats, because they want to keep their prices sky high. I don't like them, but they did figure out what was wrong with me when no one else did, so I am grateful for that.
(cont.)
My hero RE was Dr. Jimmy Gill at Houston Fertility Institute. I was lucky to find him after moving to Houston last year. On the high FSH board a 45 year-old woman who also lived in Houston and had thoroughly investigated every one of the six or so fertility clinics in town recommended him (and when I say research, I mean she met with every RE, interviewed them, interviewed their lab directors, and really did her homework).
She sent me to Dr. Gill because she was convinced he understood how to deal with high FSH and low follicle count, would be open to doing so (his wife only had two follicles but had success through IVF) and has a kick-ass lab. His consultation fee is only $50 and after looking at Check's protocol he said he thought it was basically a good protocol but suggested three tweaks. He also LISTENED when I said I did not want to do any prior suppression and cancelled BCPs when I said I feared oversuppression because of past experience. Everything he said made sense and we agreed together on how the cycle would go.
I think his protocol tweaks helped because I produced twice as many mature eggs and ended up with four blasts (two transferred, two on ice). With Check I only had thee 3 day embryos and nothing to freeze. Dr. Gill's office also monitored me very closely after transfer and caught that my E2 had dropped in time to help me supplement. They are just really good with the details.
Anyway, I think Check himself is brilliant and you clearly have some weird implantation/immune issue going on. If you want to try to carry yourself he is probably your best bet. Good luck; I am so pulling for you!
Hi Maddy,
I think Anon brought you up because I put a message to you in my post. I am truly sorry to make you feel odd. I hope the best for you as I know how hard you are working for this!!
:-)
Love,
Linda
Linda, I am so sorry to have started all this controversy. I have apologized to Maddy personally through email and on her blog. Is there a way for you to edit out or delete my comment? Thank you, and again, I apologize for being so inappropriate.
Hi Anon,
Sure...I'll edit your post for you if you wish. :-)
Cheers,
Linda