Last Chance

 I did my first shot for my last chance IVF cycle this morning. AFC of 8. I just need one euploid out of this, although selfishly I'd like two! I find myself pep-talking my ovaries, pleading with the universe to let us get a good embryo from this, and simultaneously not expecting anything good at all. I guess the cynical optimist has finally run out of optimism. 

I have a birthday this week. The birthday where my odds of a euploid embryo go from 38% to 29% based on my clinic's data. I've never been sad about a birthday before, but now I am. 

Monitoring on Saturday. Wish me luck? 

I am/have been pretty conflicted about this cycle. After getting 5 mature last cycle, I wanted to do MDLF again, but with artificial occyte activation (AOA) to combat the 20% fertilization rate we had. My RE insisted on another antagonist cycle, since we've gotten blasts from those. I really don't love this plan, and it's the first time that I've been truly unhappy with a plan to move forward. It doesn't feel good, especially since we've "gotten blasts" when having 2 fertilized, and once we only got one blast. So having one fertilized and not reaching blast doesn't seem unexpected. I also don't want to be on extended Clomid for a fourth time, given my lining, although I know that extended Clomid is CCRM's "thing" for poor responders.

All this messaging came via my nurse. In order to discuss with my RE, I'd have to cancel this cycle and wait for a regroup in 4-6 weeks. While I'm usually pretty patient, the thought of another 8+ weeks to cycle again, while having to maintain my diet, was enough to break me. So I'm trusting my RE and going with the antagonist cycle. 

Because I like putting things in one place, here's the history we're basing decisions on.

IVF #1: Estrogen & cetrotide priming. 300 Gonal/150 Menopur/100 Clomid/HGH/Dexamethasone. Cancelled after 13 days, only one follicle remaining.

IVF #2: Estrogen & short testosterone prime. Luteal phase stim due to triggering a lead on CD2. 300 Gonal/150 Menopur/100 Clomid/HGH/Dexamethasone. Cetrotide added around day 10. 6R/3M/2F/2B - aneuploid.

IVF#3: Estrogen & long testosterone prime. 300 Gonal/150 Menopur/100 Clomid/HGH/Dexamethasone. Cetrotide added around day 10. 4R/3M/2F/1B, day 7 euploid.

IVF#4: No priming. MDLF 20 units/2x/day. 300 Gonal/150 Menopur/HGH/Dexamethasone. 5R/5M/1F/0B.

If I include my 6 OI/TI cycles, I can assume that we always had at least one blast, because we always had a positive beta. Based on CL cysts, I always had 1-3 mature. Thus, taking the most conservative assumption, those were: No priming. 175-225 Gonal/75 Menopur/vaginal estrace during stims. 1-3M/1-2B/0-2 euploid.

This does point out that we get euploid blasts with cycles that don't use MDLF. But I should also point out that we never needed Cetrotide on our OI/TI cycles. My LH always stayed low, probably due to the vast amount of vaginal progesterone I was on. Given my cancelled antagonist primted cycle, I really wonder if the antagonist limits follicular maturation for me, despite sizes increasing.