Natural FET #1 Scrapped

Well, my lining was only 6-7mm today, day 13 of my natural FET prep.  My nurse called and said my RE said we can move forward.  Huh?  Come again?  With that lining?  She said he noted that the thickness was similar to what I had in the past.  She started guiding me through the next steps of my FET prep and I somewhat interrupted her.  I asked her what my hormone levels were.  They were E2=316, LH=19.6, P4<1.  My follicle was 16×9.  I have a follicle because we didn’t use Lupron at all.   I am close to ovulating this follicle due to the LH value.  My progesterone is low enough to prove I haven’t ovulated, along with the fact that there is a huge honkin’ follice in there, too.   The lining was trilaminar.

I asked her if we could wait a few days to see if it gets thicker.  She said that I could wait and check on Thursday, but that I’d likely ovulate by then.  She said that my LH is surging and my follicle is a decent size.  I asked if there is anything I could take to delay ovulation and she said nothing other than lupron, and that is way too late for that. 

My analytical mind started to spin and I shared my thoughts out loud with the nurse.  In my standard medicated (with lupron) FET prep, my lining was at 6.5mm with an E2 of 1800 and then a week later it grew to 7.5mm with an E2 of 2600.  This was with two estrace tablets on top of the patches and two extra weeks of prep than the normal patient.   Looking at these natural FET results, my conclusion is that my body doesn’t seem to respond to the high levels of estrogen.  The lower estrogen number from my follicle and the supplemental patches seemed to create as thick of a lining as all that estrogen and extra time in the medicated cycle.  The surplus didn’t seem to help.  My nurse told me that she thinks I did much better on a natural prep than with lupron.  She thinks that the lupron suppressed me too much and contributed to my sluggish lining. 

I asked her, “What would you do in my shoes?  We have 3 embryos left waiting for us.  I don’t want to waste them.”  She said, “If it were me, I’d cancel this cycle due to the sub-optimal lining and try again next cycle with another natural FET using estrace tablets from the beginning.”  She thinks that maybe the increased level of estrogen from the beginning may trick my body and delay ovulation a bit, which would allow a little more time for the lining development phase.  

I can’t help but think why didn’t the RE think this through and come up with these thoughts.  I know he thinks my lining won’t get much better than this due to my D&C after my m/c (that cycle with the m/c was a stim cycle where my lining was 9mm, E2 was high).   I can’t imagine that a D&C would keep you from growing a thick lining.  It’s so disappointing that you pay all this money and get a 30 second review.  I’m not stupid.  I know that I have lining issues.  I know that I’ll never be the 8-10mm person with an estrogen level of 300.  I get it.  I have a physiological issue.  I just think that they can offer more, think more, analyze, consult, commiserate, etc. 

I think I’ll sleep on it and decide if it’s even worth looking at the lining on Thursday.  I’m thinking that, at a minimum, it may give me a piece of information for next cycle.  

If you have any advice or ideas, please comment….I would appreciate your thoughts.  Thanks!

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7 Comments (+add yours?)

  1. LisainSK
    Mar 09, 2011 @ 07:05:57

    hoping4family: My RE says that as long as you can produce a tri-laminar lining that pattern trumps thickness. But of course prefers a minimum lining of 8. He said a 6.5 mm or 7.0 mm lining with triple stripe (tri-laminar) is still better than an 8.0 mm with no pattern. But I can sense the need to want to cancel when you have 3 frosties left to try a different plan for the next round. You’ll know what to do – your nurse sounds awesome BTW. She may not be the doctor but I’ll bet she’s calling the shots anyway with his approval. If you do decide to cancel…so sorry…REALLY hope the next round will produce a better result for you. If you do decide to move forward…best of luck.

    Reply

  2. soulshine
    Mar 09, 2011 @ 08:29:44

    h4f,
    i am really disheartened to read this update. by now you are a professional in terms of knowing how the e2/p4, suppression, and lining all relate, and talking it thru with your nurse was a great thing. but it is always hugely disappointing to have to wait and try again. i would personally want to see what things look like on thursday, just for the knowledge.

    i think your doctor may have a preconceived notion about how he thinks your body may or may not react, and obviously i wish you were able to talk thru things with him rather than with his nurse, so he could have the whole picture (3 precious remaining embryos- um, hello) in order to advise. but i like your nurses idea to begin again with estrace from the beginning, just to see how that changes the timing, or not.

    always thinking of you. hugs for daisy!
    -soulshine

    Reply

  3. elliej
    Mar 09, 2011 @ 08:56:12

    Hi Daisy, I don’t think I have commented before or if I have, not much. Will change that! I feel an affinity to you as we are uni-ovaried; Casssie also said we look alike! (this was one stone ago in my case). Anyway I like your nurse’s suggestion; it sounds thought through which is what you need. I like the thought that if you try it you may not have the ‘what ifs’ than if you transfer now if things don’t go acccording to plan. But at the end of the day it is a personal decision. I think we have the same RE. Sometimes during stim cycles I felt that a one size fits all approach was applied, as opposed to an individual approach, which was precisely the reason I went to his clinic. Maybe he just expected the worst from me, which was perhaps not unmerited and I was lucky that they never kicked me out. Anyways good luck with whatever you decide elliej xxx

    Reply

  4. elliej
    Mar 09, 2011 @ 08:58:42

    PS: I also think you should look at your lining Thursday for informational purposes

    Reply

  5. R
    Mar 09, 2011 @ 10:48:28

    First, I am so sorry…I know the anger and frustration you are feeling due to lining issues. Here are my thoughts:

    1. What about doing a medicated FET without Lupron? This is what I did (although for me, it didn’t make much difference)

    2. I think you have added the Trental and Vit E, are you still taking it?

    3. Have you tried Viagra suppositories?

    4. Have you tried the delestrogen shot? I took the shot instead of the patches, with the estrace and Viagra. Again, no Lupron

    5. REs are so frustrating. My RE (who know who) was always willing to let me transfer with a thin lining and it was usually my decision to cancel (with advise from the RN) and that drove me nuts. He is supposed to be the expert and I felt like I came up with all the game plans. He did tell me quite clearly and I have had this confirmed from other RNs, ultrasound techs and other RE’s that the most important is the pattern and then the lining. My one FET that worked was on an “optimistic” 6.5 and who knows how thin it was this time around.

    I just hope that whatever you decide will bring you peace. I always HATED cancelling as I felt like a failure, but like you I didn’t want to waste good embryos on a subpar lining. I really think it is a combination of hormone levels and lining though.

    Good luck, with whatever you decide. I am always thinking of you and here to support you.

    R

    Reply

  6. Cassie
    Mar 09, 2011 @ 18:44:27

    Ugh. I’m sorry. I really don’t have a lot of advice, since among my many problems, I never really had lining issues. I do agree that a triple stripe is more important than thickness. But I also agree that you should probably wait until you have more optimal circumstances, since your remaining embies are more precious than gold. So I’ll let others give you advice and just send you some hugs!

    Reply

  7. MyTwoLines
    Mar 09, 2011 @ 22:06:23

    I’m sorry I don’t have any advice to add…I think I have somehow forgotten everything ART like…but I agree to wait for more optimal circumstances. What a about a pre-cycle biopsy to help the lining regrow–refluff?

    Reply

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