r/InfertilityBabies • u/AutoModerator • Sep 14 '26

Trying Again Monday Trying Again

Please use this space to discuss your journey to conceive (again) or thinking about trying again.

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7

u/breadbox187 Sep 14 '26

Okay everyone......thought on doing unmedicated vs medicated transfers??? Ive only ever done medicated before but my new clinic seemed to think that since my last fresh transfer worked (though it was ectopic) I might be a good candidate for an unmedicated cycle situation? I'm doing a repeat ERA to just cover all my bases but interested if any of you have any insight. She said that it may lower chances of blood pressure of placental issues in pregnancy. I did have gestational diabetes in the past but otherwise no BP issues or anything.

I guess Im just concerned bc Ive only ever done medicated cycles and it seems super weird to just like....throw one of my 2 embryos in to the void.

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u/partygnarl Sep 14 '26

I advocated for an ovulatory transfer to try to circumvent hypertensive issues, but still experienced complications at term (severe pre-e that became HELLP). That being said, my pregnancy was pretty unremarkable until the end, and I made it to term (37w), which may not have happened had I gone the medicated route! My clinic has already said that if I make it to the transfer stage again, we'll do ovulatory once more, to try to mitigate as much risk as possible.

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u/breadbox187 Sep 14 '26

I guess I should trust the experts at this point, eh? She kind of left it up to me but did say that they've had a lot of success w the ovulatory transfers.

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u/Technical_Quiet_5687 Sep 14 '26

I actually jumped on here to ask the same thing. So glad you did! I’ve never done an ERA. Can you explain why that was recommended for you? 

My new clinic (which suggested the unmediated) said they have a lot of success with it. My only concern is I’ve only done medicated and I have zero idea when I actually ovulate! But agree I’m apprehensive about moving to a new protocol.

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u/breadbox187 Sep 14 '26

I'd had 4 transfers that didn't take so we tried an ERA to get more info. I ended up needing extra progesterone. Once we did that I got pregnant the next 3 transfers, but only 1 resulted in a live birth.

3

u/Working-Eye-7252 Sep 14 '26

My understanding is that live birth rates are pretty comparable but slightly more favorable with ovulatory cycles v fully medicated. I think as long as you ovulate and are okay with the extra monitoring, there is no harm in doing it and potentially some benefits. I would love to do ovulatory FETs but I'm a travel patient and there is no same day blood work where i live which makes it practically very difficult.

ETA- one "risk" with unmedicated/ovulatory is if they miss ovulation and you have to cancel the cycle and try again the next month. But if you're being monitored closely I think it's pretty low.

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u/breadbox187 Sep 14 '26

I believe I ovulate regularly but the only time I've ever been checked was my initial bloodwork w my original IVF clinic like 6 years ago haha. And that was just day 21 bloodwork where they said my progesterone was too low to have ovulated (although based on years of tracking and tempting and such, I am a later ovulater).

And I guess youre right! They'll keep track of me and worst case I get pushed a month or so back. I don't work so extra monitoring isnt a huge burden.

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u/intersecti0nal Sep 14 '26

I've only ever done medicated and a clinic that I did a consult with recently also recommended a semi medicated cycle, because of a history of pp preeclampsia. I think that evidence wise there isn't a strong trend towards one having a better success rate. If I were you I'd probably stick with what I know, it does feel like a lot to jump into something completely new!

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u/wydogmom Sep 15 '26

I’ve tried every flavor tbh - and it’s more about what you won’t have regrets about. I might advocate for medicated for you only because if the unmedicated fails, you will 100% wish you had done medicated

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u/breadbox187 Sep 15 '26

Maybe also true haha! She is willing to do whatever option I want. Looking like a December transfer so Ive got time to think it over.

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u/wydogmom Sep 15 '26

My RE published a paper about how outcomes were the same when switching protocols but the mental effect of changing was beneficial nonetheless 😆

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u/breadbox187 Sep 15 '26

I will say, for this retrieval we switched to the only other clinic in town which wasn't an option when we last did treatment and the difference is astounding. Even with just how positive this RE is is really different, haha! Maybe I will leave it up to her and see where we land...

2

u/Secret_Yam_4680 Sep 15 '26

My 1st FET 100% was unmedicated...no e2, no p4, no trigger. Also did an unmedicated ERA, which a lot of providers said can't be done...it absolutely can be done if your doctor is flexible. WOI is wider in unmedicated FETs however there is still a risk of developing pre e. I did along with HELLP and I was on baby aspirin.

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u/isabelledavenport Sep 14 '26

CW 3rd
I requested ovulatory for my 3rd final embryo transfer due to preeclampsia and GDM with the 2nd pregnancy. It’s wasn’t unmedicated - I did letrozole, trigger shot and progesterone, added estradiol when my levels weren’t quite right. But the theory is that the corpus luteum from ovulation is protective from some of the placental complications (preeclampsia). Previous 2 were fully medicated/non ovulatory.
3rd transfer successful, currently 12 wks. I did an era with the first which showed standard transfer timing but never repeated it.
FWIW our fertility diagnosis was severe male factor and have been beyond fortunate with 3/3 successful transfers.

2

u/breadbox187 Sep 14 '26

We also have severe MFI. I did an ERA before my successful pregnancy and it showed I needed longer progesterone exposure. However, that was almost 4 years ago.

Maybe I just need to remind myself that they will be monitoring me still even w a non fully medicated cycle.

Thank you for your input!

3

u/isabelledavenport Sep 14 '26

Yep! Potentially more monitoring with ovulatory cycle.

I’d probably repeat the ERA too, in your shoes, since your previous one was nonstandard and worked.

1

u/Itchy-Site-11 Sep 14 '26

Congratulations ❤️

1

u/reebs___ Sep 15 '26

My first was medicated and this one I’m going to do modified / partially medicated. I don’t want to do PIO again tbh. My doctor was very supportive of it!

16

u/Inno-Guy Sep 14 '26

I had my transfer today. I was feeling optimistic but now a bit anxious because of all the information. I had 2 6 day 4AA and 4AB embryos but instead they transfered the Day 5 3AB embryo. Additionally my lining was 8mm last week wednesday and today when he looked it was 7mm. We still did the transfer. I was already quite in a hurry because I was waiting for 1,5 hours and had to get home to my daughter but now I kicked myself for not asking more questions... whelp.

12

u/tmp1030 Sep 14 '26

That’s a long time to wait!! If it helps, I do think lining compacts after progesterone exposure. It’s interesting to me that they measured again bc my clinic never does! Ours also transfers a day 5 before a day 6 regardless of grade.

Wishing you luck!

6

u/Inno-Guy Sep 14 '26

OMG, that helped sooo much.
Thanks a lot. <3 It makes a lot of sense and makes me spiral less. Now I can get a good night sleep. hahah

1

u/Itchy-Site-11 Sep 14 '26

Good luck Inno ❤️🙏🏼

1

u/Inno-Guy Sep 15 '26

Thanks <3

1

u/Secret_Yam_4680 Sep 15 '26

Have everything crossed for you, friend!

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u/Inno-Guy Sep 15 '26

Thanks a lot <3

11

u/yellow_sun_shine Sep 14 '26

The trial transfer was a success. I’m happy to report. So hopefully things will go smoother for my next transfer. Which will be in the next couple weeks.

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u/Itchy-Site-11 Sep 14 '26

Happy about it! ❤️🙏🏼

9

u/Itchy-Site-11 Sep 14 '26

On Wednesday I have another lining check and bloodwork. I thought the lining would be good on Saturday but nope, only 6mm.
I am getting a bit anxious but have so much to do…

5

u/arcaneartist Sep 14 '26

I'm sorry your lining was not where it needed to be. I hope you get good news Wednesday.

2

u/Itchy-Site-11 Sep 14 '26

Thanks Artist!! One day at a time and hopefully I got this

2

u/tmp1030 Sep 14 '26

Home stretch 🤞

1

u/Itchy-Site-11 Sep 14 '26

Yeah! I got this!!
Still very afraid of PIO

1

u/rbecg Sep 14 '26

hoping for you, itchy! lining stuff is so frustrating.

1

u/Itchy-Site-11 Sep 14 '26

Aw thanks! I hope Wednesday is the day ❤️

1

u/reebs___ Sep 15 '26

It’s really odd to be back in the unknown and the waiting of IVF but now with so many more experiences.. both good and bad