Fertility clinic - IVF?

[Petra]

Hi girls, I need to ask something for my sister-in-law. She has been trying for nearly two years. She has had her laparoscopy done ( they haven't found anything abnormal). Her DH's sperm is fine. They found out that she doesn't ovulate at all. They tried 5 cycles on clomid and nothing. Now her consultant decided to send her to the fertility clinic. Does it mean that her only chance is IVF now or is there any other way of getting her ovulate? Please help me as she is asking me and I don't know what to say

 

[jenna]

(im not 100% sure what a laparoscopy is but...) Have they checked her hormone levels? If there sending her to a fertility clinic then maybe there is more they can do for her? How does she feel about IVF?

 

[Petra]

thanks Jenna. They have checked her hormone levels and they were not satisfied..that's why they gave her clomid to regulate and get her ovu. However, this hasn't happened. She will do anything to have a baby, so IVF is ok. She just doesn't know what to expect. Do you think they will give her another drug or will start with IVF right away?

 

[jenna]

Hmm im not sure. At least if her DH's sperm is ok then they can have a baby together. I think you have to be put on a waiting list for a while before you can have IVF (im not sure though). If shes ok with having it i supose its good that there being looked at... iv heard it isnt very nice though but it'd be so worth it. I hope everythings ok. Keep us updated! When do they go to the fertility clinic?

 

[jenna]

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=460

If you havnt looked on the NHS site before this is quite useful...

 

[Petra]

Thanks, I will double check the website. I need to do some research for her as she doesn't have internet at home Her appointment is at the end of April, so long wait.. She just wanted some simple info.. If she doesn't ovulate, then there is no egg... would that mean that she needs donor egg? Sorry to ask all those questions...

 

[jenna]

I think in IVF they take the egg from the ovaries and then implant it after its been fertilized so i dont think she needs to actually ovulate.

 

[jenna]

The main IVF technique was developed in the 1970s. This involves giving the woman fertility drugs to stimulate egg production, and then surgically retrieving the eggs from the ovaries. She is then given hormones to prepare her uterus for pregnancy, while the eggs are fertilised with the sperm in a laboratory. The embryos are then implanted into the woman's uterus, and if all goes well, a normal pregnancy is achieved

 

[Petra]

I see.. thanks Jenna

 

[chellieboo]

Hi, I can't really help I'm afraid as I do ovulate but we still need IVF and the only drug I know of that induces ovulation is clomid.

Do you know if she's had FSH/LH tests done as these will tell her whether she is likely to have any eggs of her own or not and what their quality might be?

 

[Rachael]

Initially the Clinic will do a range of tests to decipher the cause of annovulation, as it may be corrected with medication before even looking into fertility treatment. If its a hormonal problem, that can be corrected.

Even if medication cannot solve the problem - IVF isn't the only option. As the problem is down to not ovulating IUI (Inter Uterine Insemination) would be offered before IVF, which is less invasive and less expensive. It would be a medicated treatment cycle though, as she would need her ovaries stimulated as she doesn't ovulate naturally - so a similar drug protocol used for IVF would apply.
-IVF is usually used where women have problems such as blocked or damaged fallopian tubes, so IUI wouldn't be a viable option.

 

[Petra]

thanks Rachael

 

[Jollypops]

Hi,
I am afriad that i can only give recomendations as i to ovulated when doing IVF treatment and therefore cant give personal insight.

Medications that are commonly prescribed to induce ovulation include Clomid, Gonal-F/Follistim AQ, Metformin, Bravelle, Menopur and Repronex if they have already tried Clomid maybe try another and see if anything else works for them.

I do think if they went with IVF it would be with egg donation from another person and her partners sperm but am afraid that i couldnt be certain.

If i find anything out them i'll let you know. Good Luck.

 

[Petra]

thanks and congrtulations on your pregnancy Hope everything is going well for you.

 

[Jollypops]

Cheers - After 12 years of trying and failed IVF the last 12 weeks havent gone bad thanks.
I wish you and your sister in law the best of luck.

 

[Petra]

thank you ! Enjoy your pregnancy, you truely deserve it hun

 

[Jollypops]

I've just found this in a book i got given when doing IVF its called infertility The HFEA guide 2007/08. (Theres a website www.hfea.gov.uk)

This is what it says:

Drugs and Surgery
A combination of fertility drugs and surgery are often used to kick start treatment either before or during IVF

For Women
If you aren't ovulating (producing and releasing an egg each month) at all, or only sometimes, fertility drugs - which trigger egg production in much the same way as your bodys own hormones - can help. This is known as ovulation induction. You may get pregnant using fertility drugs alone, but they are more often used with other treatments such as intrauterine insemination (iui) and in vitro fertilisation (ivf). Read on for what to expect.

Ovulation-inducing drugs
Cloiphene citrate, usually known simply as Clomid, is the oldest and probably the most widely used fertility drug. Taken as a pill, it tells your brain that you are not producing enough oestrogen, which indirectly stimulates your ovaries into producing eggs.

What for: Straightforward ovulation failure in woman under 40.

Possible side effects hot flushes, mood swings, nausea, breast tenderness, insomnia, increased urination, heavy periods, spot breakouts, weight gain. Some experts think your risk of ovarian cancer may increase slightly if you take it for more than a year.


Pituitary stimulators
Pulsed gonadotrophin-releasing hormone (GnRH), such as Gonadorelin, kick starts the pituitary gland into action. A small battery operated pump usually worn on the upper arm injects pulses of the drug directly into your bloodstream (hence the term pulsed). This triggers egg production by mimicking your bodys production of a hormone produced by the pituitary.

What for: Ovulation failure resulting from a lack of the hormone GnRH

Prossible side effects Stomach pains, sickness and nausea, heavy periods and headaches

Ovary-stimulating hormones
Drugs containing folicle-stimulating hormone (FSH) and/or luteinising hormone (LH) stimulate the ovaries to produce eggs. These include Gonal-f, Puregon, Menogon, Menopur and Merional. They are injected into a muscle or under the skin by your doctor at the clinic, your GP or pratice nurse. Alternatively, you may be shown how to inject yourself at home. When the eggs are mature, you are given a single injection of the hormone chorionic gonadotrophin (hCG) to trigger the release of an egg.

What for: To simulate ovulation before treatment cycles, or if you have polycystic ovary syndrome (PCOS) and your ovaries are not responding to Clomid. They are also used for infertility caused by failure of the pituitary gland and in some cases of male infetility.

Possible saide effects Over stimulation of the ovaries, known as ovarian hyperstimulation syndrome (OHss), increased risk of multiple pregnancy when used for ovulation induction, allergic reactions and skin reactions.

During treatment your doctor will usually prescribe other drugs for you to take at various times to give them more control over your treatment cycle. These may include:

Cycle suppersing drugs
Drugs such as Goserelin and Burserelin copy the action of natural hormones that block the release of the two hormones controlling ovulation: FSH and LH. These are known as gonadotrophin releasing hormone (GnRH) analogues. You take them as a nasal spray or as a daily or mothly injection before, or at the same time as, fertility drugs.

What for: To stop the menstrual cycle.

Possible side effects hot flushes, night sweats, headaches, vaginal dryness, mood swings, changes in breast size, breakouts of spots, acne and sore muscles.

Drugs that maintain pregnancy
Progesterone for example Cyclogest, Gestone, Crinone or Progynova, can be taken after the injection pregnancy hormone hCG or on the day embryos are returned to the womb. You take them as vaginal suppository, a pill, gel or by injection into the buttock.

What for: to thicken the lining of the womb in preparation for nurturing a possible embryo.

Possible side effects Nausea, vomiting, swollen breasts.


Sorry for it being so long but have just type all what it said!!!

 

[Rachael]

Just because your sister doesn't ovulate does NOT mean she will need donor eggs. Failure to ovulate can be due to a number of factors, such as a hormone imbalance, rather than she has no eggs.
-Even if they can't correct the problem that is causing the annovulation, they can medically induce ovulation so that one or many follicles are released from her ovaries and donor eggs will not be needed.

When she first goes to the clinic, as part of the initial tests they will do a test ccalled an Inhibin B test, which gives an indication of ovarian reserve (Both egg quality and quantity)...if she has a good result, there would be no need to consider donor eggs unless other factors suggested a better outcome with them.

I have undergone IVF ...I had ovulation problems myself as my LH/FSH ratio was out, amongst other problems (PCOS, RPL, Sticky Blood) but was advised to start with IUI ....as you can see from my signature, I went on to have two children, so there is definitely hope for your sister!

Wishing your sister the best of luck.

 

[Petra]

OMG Jollypops and Rachael, you are both so lovely ! Thank you so much for you kind words and advise. I will let her read what you said. I am sure she will be releaved to read that there is a hope for her. I am awaiting my blood results as I am having no period at all.. they suspect PCOS and hormonal imbalance. I have an appointment next week so I am feeling positive again ( hope Cheri22 was right..if so, March could be my month)

Thanks again for your efforts