IVF #3 – My IVF Calendar – Antagonist Protocol

We switched clinics several weeks ago. Not because I didn’t like my last clinic, actually I loved it and tried extremely hard to stay with them, but their policy is to require the 6 month quarantine for sperm from a known donor, also called a directed donor. You can read more about that quarantine here in my post about FDA regulations for directed donors.

Anyway, so I chose our new clinic based on their policy to allow us to use sperm that has only been quarantined for 7 days. Their success rate isn’t quite as good as our first clinic, but it’s still good.

As our new doctor said, there’s a certain amount of “voodoo” that goes into fertility treatments. Sometimes even if there’s no study that shows an absolute improvement in outcomes with a certain addition to the standard protocol, for example taking a baby aspirin everyday, the clinic will still have you do it because it’s part of their protocol. They don’t want to “mess with the voodoo” if it’s not causing any harm.

At the new clinic, there’s several differences in my IVF protocol that I chalk up to “voodoo” but might actually have some clinical benefits. One of them is taking the baby aspirin everyday starting 3 weeks before stim day 1. There’s some evidence that taking a baby aspirin thins the blood and might allow the ovaries and eggs more blood flow and therefore help produce higher quality output. There’s even some evidence that taking it at night is better at preventing heart attacks than taking it in the morning. So I take mine faithfully every night.

Another voodoo is having me and my husband both do a Z-pack antibiotic starting 8 days before stim day 1. I thought they made a mistake by asking my husband to take the antibiotics because we’re using a sperm donor, but they said since we are sexually active with each other they don’t want to chance him getting sick and then infecting me. I guess that makes sense. We start our Z-packs today.

The third voodoo is the brand of stimulation drugs. Not a single one is the same as our previous clinic! I’m a little nervous because this clinic seems to want to use the brand name of everything instead of a generic. For IVF#2 we spent $5,000 on just the meds! And that included a couple generics (leuprolide and cetrotide). We’re supposed to find out tomorrow the cost for 10 days of stim meds. I had pretty good results last time using the generics and the supposedly “less pure” Repronex instead of Menopur. Hopefully this clinic’s brand voodoo will be worth the extra cost.

The last voodoo is the timing of the stim shots. With our first two rounds we did all our shots at the same time in the morning. But this new clinic wants the Follistim and HGH in the mornings and the Menopur at night. This is much less convenient than doing all the shots in the morning and, again, I don’t see the point since we had pretty good results last time, but this is their voodoo so we’ll do it.

IVF #3 Antagonist Protocol with Dual Trigger

(Learn about antagonist vs. agonist protocols)

Baseline ultrasound and baseline blood work on day before starting stims

Daily stimulation injections:
Follistim 300
Menopur 1 powder
HGH 50 units

Start Ganirelix after 1 follicle is greater than 14-15mm

Blood work on stim day 3

Ultrasound and blood work on stim day 6

Ultrasounds on stim days 8-10

Dual trigger (Lupron and HCG), probably on day 10

Mrs.E’s Voodoos

I have a couple of voodoos myself. I have my regimen of vitamins we take every day, including special B vitamins for our MTHFR mutations. And last time we had such good results, that I’m going to continue with the DHEA 75mg and CoQ10 300 mg. And of course, our grounding sheet which, I swear, really helps me sleep better at night.

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7 thoughts on “IVF #3 – My IVF Calendar – Antagonist Protocol

  1. I’m not sure if you want to answer this in a comment or if you would prefer to email me. But were you at the U and changed to a different clinic? If so, we are going to be going through the same thing as we will hopefully be using donor sperm as well as the few they found from my husband. I’ve been seeing Dr. Peterson at the U. We spoke to him briefly last week and he said that the 6 months was optional if you feel comfortable without doing the testing if you are using a known sperm donor. I’m really hoping that’s the still true. If you’re not at the U do you mind telling me the new clinic?

    It’s really interesting the differences you have stated between the two clinics. It will be good to get more updates from you and read more about your process. It’s always great when I get an email telling me there is a new post from you!

    • Annie – thank you SO much for letting me know this! If this is true, I will take all the credit for making it happen. Or at least for getting the ball rolling there 🙂 I spent many, many hours over several weeks going back and forth with them about the quarantine and directed donor sperm. I have a call in to see if they’re updating their policy. Which might mean I’m going to delay this IVF cycle. I would LOVE it if Dr. Carrell’s Andrology Lab team was taking care of my embabies. I have total confidence in them. Will keep you updated!

      • Well thank you for your hard work! 🙂 Definitely keep me posted on what you find out. I have an apt Friday, so I’ll keep you posted as well if I learn any new information.

        Any suggestions of questions I should be asking about IVF? This is our IVF consult apt. You usually think of things I don’t! 🙂

      • I’ve been thinking and thinking about what questions to ask and the only one I can think of is, “Will I be on an agonist or antagonist protocol and why?” I think some doctors automatically pick the agonist, also called the long Lupron, protocol for people to do first because that’s the standard, not necessarily because it’s the best option for the patient. But that protocol is not necessarily a bad thing, though. I have mixed feelings about it.

        My antagonist protocol went so well that I wonder why they would bother with the long Lupron protocol at all. There’s a major problem with it: something like 10% of women get OHSS on the long Lupron protocol. That’s a lot! And often if you’re hyperstimulated they won’t let you do a fresh transfer, which means all your embryos will be frozen. Not all of those embryos would survive.

        OHSS is much less likely with the antagonist protocol because only a little hCG is used for the trigger shot.

        Anyway, I would ask why the doctor chooses whatever protocol. Not to argue with him, but just to understand the whole thing better.

        Other than asking that, I would do stuff like asking for a printout after every single ultrasound which should show stuff like the number of follicles and how big they are.

        This is all I can think of! I think everything else is something they’ll tell you.

        I’ll let you know if I come up with anything else! Good luck at your appointment!

  2. Thanks for your reply, I didn’t see it until today! Our appointment felt a little pointless as we are still getting the money together and waiting to hear if my husband’s brother will be our donor so we didn’t really get into much about IVF. He did mention that he wanted to work me harder than he normally works others, as he wants to make it so I only have to do IVF once. He said the only problem with that would be that I would be more likely to get OHSS, so maybe he is planning on doing the antagonist? I’ll definitely ask at our next apt.

    We saw my doctor two weeks ago and he told us that we could waive the 6 month waiting period for a known donor if we were comfortable and confident that we didn’t have to worry about any infectious diseases. Then when we saw him Friday, he said that there had been a board or committee meeting where they discussed whether people had the right to waive the 6 month waiting period. Unfortunately, he was not at the meeting and didn’t vote. Everyone else voted against allowing people to waive the 6 month period. He said there will be a meeting on Tuesday and he will bring that up again and see what he can do. My husband and I are really hoping he has as much pull as we think. 🙂

    However, it may not even matter. My brother-in-law and sister-in-law have been deciding for the past MONTH whether he would be willing to be our sperm donor. We have been anxiously waiting to hear from them. Tonight they wanted to talk about it and we spent a good hour and a half discussing every possibility and they still haven’t made a definite decision, although, we are fairly certain that they are going to say no. I feel like my heart is broken into a million pieces. Our doctors don’t want us to move forward with IVF unless we have donor sperm as back up, because the chance of the three of my husbands sperm working are so low. My husband does not feel okay with using an anonymous donor. So they are our only option. It sucks because we feel so good about him as our donor but ultimately it is their decision. I just feel like I am going to have a difficult time accepting their decision if it is to not help us. Anyway, I’ll let you know when I hear from the doctor about the 6 month waiting period. 🙂

    • Have you gone to see Dr Laura Czajkowski yet? She’s the reproductive psychologist. I recommend you get an appt with her right away. In fact, make 2 appts. One for you and your husband and one for your BIL and his wife. And then, I would tell your BIL and his wife to take a break from thinking about it and not to make a final decision until after meeting with her. Tell your husband the same thing. I think she will help you guys feel better about random donor sperm and I think she will help them feel better about being donors. She has a long waiting list, so call today!!

      Re: IVF, the only thing I know is that they changed the rule for sure for IVF with ICSI. They will waive the 6 month quarantine if you do IVF with ICSI.

  3. I’ve been super absent, I’ve been in total denial. We heard back from my husband’s brother and his wife and they gave us their final answer of “no” to being our back up sperm donor plan. Basically it came down to her not wanting her husband to have a child with another woman. They live out of state and weren’t willing to talk to a reproductive psychologist about the situation. I’m pretty sure they still would have said no, her mind was made up the minute we asked. Oh well, nothing to do about it now. I am dreading seeing her ever again, she’s pretty confrontational and I know she’s going to bring it up which will not be a good thing for anyone, especially me.

    My husband and I have an appointment with Dr. Czajkowski on the 20th, man she is hard to get into, thanks for recommending calling her ASAP. I really hope she can make my husband more comfortable with an anonymous sperm donor. We are able to get help paying for IVF with ICSI through a organization at the U and would only end up paying about $3,000, on one condition, we have a back up sperm donor. Otherwise they won’t pay for the IVF. We have already spent $25,000 so this would be a huge blessing! I really have hope that at least 1 of the 3 sperm they found from my husband will work so really it’s just a legality having the back up sperm. But on the chance that we do have to end up using the sperm donor’s sperm we both need to be certain it’s something we are comfortable and okay to live with for the rest of our lives.

    It feels crazy that we even have to think/consider things like this. We haven’t told anyone besides my husband’s brother about finding 3 sperm. We told everyone the surgery was successful, because they did find something. We didn’t really want anyone else’s opinion’s about sperm donors getting in the way of making a very personal, very difficult decision. So glad to have your blog so I don’t feel so completely alone. 🙂 P.S. I can’t remember which post you talked about being a redhead, but I’m one too.

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