u/basilbelle

I’m hoping to start a transfer cycle soon after canceling a transfer in April due to uterine fluid. That was the second time thats’s happened and the fluid appeared after starting PIO both times so we’re switching to modified natural for the next try.

My doctor has given me the choice of letrozole or a low dose of an injectable FSH like Follistim to get things growing before trigger.

For context I did two months of suppression before the canceled medicated cycle and am currently on birth control so the last time I ovulated was in January, and the last time before that was July because I did suppression to canceled transfer to successful transfer then miscarriage followed by the January ovulation.

Letrozole is obviously cheaper and I even have some left over from my suppression months, but I’m nervous my cycle will be wonky and I won’t ovulate properly and maybe the Follistim would be a surer bet? It’s so hard to know! I appear to have pcos/pmos but usually ovulated regularly prior to all the suppression. Also suspected endo (elevated bcl6) and chronic endometritis (will be on doxy for this). If fluid recurs again, we’re going to do a lap.

Anyone have experience with either meds in a modified cycle?

This process has aged me so much in two years. I am so tired. My doctor today gave me a referral for a fertility wellness program since I’m so mentally and physically exhausted. Then I open Facebook to see my college roommate posting about her daughter’s 21st birthday. And here I am, 44 and still trying for number 1. I don’t know weather to laugh or cry. Probably both.

I tested positive on Receptiva last summer (3.2) and then did two months of suppression (Orilissa, letrozole, norethindrone).

Immediately following suppression we went into a fully medicated FET cycle. Lining check was great, but a few days after starting progesterone, I got crampy and had some spotting. On ultrasound the day before transfer, they saw fluid in the uterus so we canceled.

The next month we repeated the same protocol with a slight estrace dosage change, and I had a successful transfer. Unfortunately I miscarried after a few weeks due to a chromosome abnormality.

Following the mc and d&c, we did two more months of suppression. Then jumped into fully medicated protocol again. Lining check was great, but then once again a few days after starting PIO I had a little spotting and a lot of cramping. Did a repeat ultrasound and once again saw fluid. Transfer canceled.

What to do next?

My doctor is concerned there could be a hydrosalpinx leaking fluid, or that there’s something endo related that’s not responding to suppression, and has brought up surgery to repair/remove and excise any endo. I’m torn because I wonder if I try another transfer cycle if I could have success again. Like, is it just something about the first cycle after suppression that my body doesn’t like or was my successful cycle a fluke? Has anyone else had issues pop up specifically after starting PIO?

I did have a clear HSG but that was almost two years ago now. However this is the first time hydrosalpinx has come up as a possibility.

What would you do?

If you’ve done a lap, how long did it take until you were ready to transfer again? What was the recovery like?

I’m scared of losing several more months - It’s already 5 months since the last transfer. I’ve been at this so long I’m now 44 and every month lost feels like a crushing defeat. I don’t get to talk to my doctor for another week so any input is appreciated!