After our first IVF cycle resulted in an early miscarriage and our first FET cycle did not result in a pregnancy, we had two remaining embryos from our egg retrieval. We previously discussed the benefits of a medicated vs. natural FET cycle, and decided that we wanted to try a Natural FET for our remaining embryos.
Although pregnancy rates in natural FET cycles are equivalent to that of medicated cycles, these cycles are much more difficult logistically to perform. We were also a little concerned with monitoring ovulation, since I ovulated prematurely during our initial IUI. In order to monitor for ovulation, we began using home ovulation predictor kits on cycle day 10. However, as anyone who has ever used these kits knows, it is sometimes difficult to read them accurately.
Our RE strongly encourages patients to use the ClearBlue digital ovulation tests with the smiley faces (not the Advanced OPKs) and recommends testing in the morning and evening. Instructions that come with the kits normally tell you to use your first morning urine. Our RE actually instructed me to test after FMU. I tested twice daily, between 10:00a and 12:00p and then again between 6:00p and 7:00p.
Our first ultrasound was on cycle day 12. I actually had two follicles that were developing (16mm and 17mm) and my lining was great, at 7.7mm. My estrogen level was at 219. Since it looked liked I was pretty close to ovulating, our RE opted to have us do an HCG trigger shot the following evening.
Medication in Natural FET Cycle
Our HCG trigger shot was the first medication (other than prenatal vitamins) during this cycle – what a change! Five days after the HCG trigger, I started using progesterone supplements to help thicken my uterine lining further.
There is considerable uncertainty in the medical literature concerning which type of progesterone is the best for FET cycles. One thing most experts would agree on, however, is that progesterone given by mouth is unreliable. For this reason, even if progesterone pills are prescribed during a medicated FET cycle, your RE will most likely instruct you to insert the pills vaginally. This can be just a little confusing!
Since we still had Crinone (progesterone gel) from our previous cycles, our RE had us use this for our Natural FET.
In my experience, transfer day is pretty much the same for IUI, IVF and both medicated and natural FET cycles. I love that I’m awake and my hubby and I can actually see the embryos as they are transferred (they look like two little air bubbles as they are transferred). Due to our history, our RE opted to transfer both of our remaining embryos during this round.
Unlike our previous embryos, our remaining two had actually started to hatch, and looked like little aliens
Once we leave the office, transfer day always means pampering by the hubby, which is also always a bonus!
Two Week Wait
Frozen embryos are typically day 5 blastocysts, meaning they are already 5 days old on transfer day. This helps your embryologist ensure that the embryo has continued to grow and divide. If your embryo has not started to hatch naturally, your embryologist may assist with the hatching process. As you can tell, our little embryos didn’t need any help with the hatching process during this cycle!
Since our embryos were already day 5 blastocysts, our two week wait is only 9 days instead of the typical 14 days. Thank goodness, since the two week wait can feel like an eternity! Although I really don’t like taking home pregnancy tests (which is the exact opposite of most women trying to get pregnant!), I gave in and took two home pregnancy tests before my beta. Both were negative, but we were still waiting for my beta, since I had few symptoms… We were cautiously hopeful that this round was the round.
Unfortunately, I knew as soon as our IVF coordinator called. The tone of her voice told me before the words came out… we weren’t pregnant. We were back to square one with no remaining embryos.