Creating my own injectables protocol...need help; would someone please take a peek?

esrejic · 12-10-2006, 02:00 AM

Recently diagnosed with PCOS ... have one beautiful 2-year-old son conceived without meds, having a hard time conceiving #2.

Been through two failed cycles of clomid and recently figured out that I have luteal phase defect. I've decided to move to injectables. Unfortunately, I don't have access to a fertility doctor ... I have to design my own protocol without the benefit of medical expertise and ultrasound monitoring. I hope that I don't give myself OHSS in the process.
I'm unsure of dosage amounts and timing--would someone please share their own injectables protocol? What did you take, how many IU and on which cycle days? On which cycle day did you get your HCG shot?
I have four 75 IU vials of repronex, 900 IU of Gonal F, tons of clomid, progesterone suppositories and Provera.

My tentative protocol:
clomid CD3-7, 100 mg/day
Repronex CD3-4 150 IU/day
Gonal F CD3-8

Since I have no ultrasound machine and don't have any way of assessing whether my follicles are ready or not, my plan is to simply estimate the right time to self-administer the HCG trigger shot (10,000 IU) ... I plan to do it on CD12.
Following the HCG shot, I plan on taking progesterone suppositories (they're 50 mg apiece) and Provera to help keep my temps high and my uterine lining suitable. I'm unsure of how much of these to take.
This sordid plan is reckless, dangerous and irresponsible, I know, but at least I know how to give myself injections

I'm desperate for a BFP.
Is there a kind soul cyster out there who would please give me some advice, based upon her own experiences? Do I have enough meds? Too much meds? Does my protocol sound like the one your doctor gave you? Thanks so much.

SnowFlower · 12-10-2006, 10:00 AM

Wow. First of all I was one who was going to self medicate using Clomid or Femara but then found a Dr who was willing to help. I wouldnt even think of doing injectables on my own. Last cycle it took me over 30 days to trigger and I would have never known what dose if it wasnt for my ultrasound and E2 blood work. This time when I felt pain and thought I was ready to trigger I wasnt and then the next appointment when I felt nothing my follies had went crazy and I was ready to trigger. I dont really do anything until I get to 200 and then I start responding and usually go up to 250 IU which is a ton. Without the ultrasound and blood work you will have no idea when you have follies ready to trigger and if you are getting close or anything. I seriously would spend the money and go to someone anyone who will at least moniter you via ultrasound and blood work. I know its expensive as we are paying out of pocket but there is no way I would have any idea what was going on with my body and follicles without my RE, ultrasounds and blood work. Clomid and Femara there are set doses and I would if I had to self medicate with those but never injections just bc there is no set dose and you wont know when to do what. I am sorry I couldnt help more and would really try and find a Dr for some help with this. I understand your need for a BFP but you could end up killing yourself or at least being hospitalized with OHSS and you will waste your time money and sanity without knowing whats going on and not knowing wheather you should up the dose or down it or coast or trigger..

esrejic · 12-10-2006, 02:32 PM

Thank you for the input!

wombat woman · 12-10-2006, 08:03 PM

Oh yeah that should work. I could not agree more with KimberlyHeidi. I don't think you are going to find one single lady here who has experienced an injection cycle to agree with you and your "tentative protocol" or who will offer you medication, dosage or cycle day advice. By your own admission you have no idea what you are doing. I hope you are posting this for shock value. In my opinion you are

Take it from someone who has done 3 rounds of Clomid, 7 rounds of injections, 3 fresh and one frozen IVF cycle. You are playing with fire.

PBLayzod · 12-10-2006, 08:19 PM

My first injectable cycle we did 1 1/2 amps for 5-7 days. I had 40+ follicles and then had an early LH surge before they were mature. The 2nd cycle we did 1 amp for 5-7 days and I had 1 follicle the matured. The 3rd cycle we did 1 1/4 amps and I had 2 follicles. My point is that without monitoring there is now way to tell how your ovaries are responding and when. Unless you are getting these drugs for free, this could be a very expensive (and possibly dangerous) shot in the dark. A cycle with clomid and the trigger might be a safer gamble. The progesterone supplements should help with the LP defect. Will your OB/GYN not monitor a medicated cycle?

esrejic · 12-11-2006, 03:17 AM

OK, everyone--thanks. I hear you. There's no way to tell if my eggs are mature without monitoring. It seemed worth the risk.
The "insane"/"coo-coo" icon was especially lovely. I feel just grrrrreat. I'm at the end of yet another failed cycle and practically every female I know is pregnant.

Since posting allows a certain degree of anonymity, I'll add one final thing ... there's a reason I never speak up: it's because whenever I do, I always regret it and wished I'd stayed true to my introverted nature. Most of what runs through my head shouldn't be shared with the rest of the world.
On that note, I'd love to take my original post down but it appears that I can't.
Thanks again.

wombat woman · 12-11-2006, 09:51 PM

I'm sorry but you said yourself that "this sordid plan is reckless, dangerous and irresponsible", I'm agreeing with you!! It's a crazy plan!! I'm sorry about your having another failed cycle. I've been playing this game (using fertility drugs) for 3 years with no luck so far so don't think I don't know where you're coming from. My TTC days are fast coming to an end and it scares me to death. You know this plan is ridiculous. What I think you need is talk about your sadness with the women on SC who understand your frustrations. Don't do something dangerous and reckless out of desparation. Tell us more, get advice about your other options. I don't know much about American Medical System, except that I've gathered you need insurance if you don't want to pay through the a$$. Is that why you want to avoid being monitored during your medicated cycles? Maybe other cysters can help there. Please don't leave because of me, and please don't risk your health out of frustration and dispair. You shouldn't regret that you posted here, maybe someone just saved your life, or saved you from making a mistake that could render you unable to conceive ever. It's not just about not knowing when your eggs are mature enough, the other sisters are right when they say you could die from doing what you're planning, now is it still worth the risk??

esrejic · 12-12-2006, 12:25 PM

WombatWoman, Thanks for replying again. I'd LOVE to be monitored--but I'm having trouble finding fertility clinics in my area (Phoenix, Arizona) and I'm not sure how much monitoring would cost (undoubtedly a lot). I'm going to be a full-time student for the next couple of years; we're living off one income while I go through school. At any rate, I think I need to search a little harder for clinics and investigate the cost of monitoring. In addition, I need to ask my OB/GYN about the possibility of beginning an injectables program ... she doesn't really see many patients for infertility and so far she's just been giving me Clomid, which is not working. I haven't been honest with her because she delivered my son, she's very no-nonsense, and I don't want to offend her. I do have the number to another doctor who might be able to help (although I don't know if he does ultrasound monitoring)--I should give him a call.

PBLayzod · 12-12-2006, 07:01 PM

IVF Phoenix (602)765-2229
Arizona Reproductive Medicine Specialists (602)343-2767
West Valley Fertility Clinic (602)993-8636
Arizona Associates for Reproductive Health (480)946-9900
Advanced Fertility Care ?

These all appear to be in your area. Because of the cost of treatment and complicated insurance policies, these types of practices usually have an insurance specialist. They should be able to tell you exactly what your particular insurance will and won't cover. Good luck!

wombat woman · 12-12-2006, 07:19 PM

Great info Pam, thankyou for taking the time to look this up. There's your starting point esrejic, keep us posted and

I hope your sadness fades and you look to the future with positive thoughts of success! Now all I have to do is follow my own advice.

SnowFlower · 12-12-2006, 08:27 PM

Hope one of those works for you. Just an idea if you dont have insurance I paid I want to say $350 for my inital appointment which was a talk, baseline ultrasound and thats it. I pay $150 everytime I need an ultrasound. I pay my RE $90 to do the IUI and the lab bills me $350. For blood work I get billed anywhere from $30-$100 depending on if its just an E2 or what it is. When my lining was thick and they had to do the saline ultrasound I was charged a little over $400 and they found a polyp in my uterus. And lastly my meds are around $750 for a 900IU of Follistim and $35 for the HCG trigger shot. This cycle we used 2 1/2 cartridges so a little over 2 boxes of the medicine. That is just to give you an idea of what it costs totally out of pocket for me.

esrejic · 12-13-2006, 11:16 AM

Thank you very much, WombatWoman, Pam, and everyone else who responded to my post. I will contact these clinics. Again, I appreciate it--thousands of thanks. E

*Clarissa* · 12-13-2006, 04:54 PM

If you cannot afford the treatment and monitoring, what in the world makes you think you can afford to provide for another child?

PBLayzod · 12-14-2006, 10:17 PM

Paying thousands of dollars for a a couple of months of treatment is entirely different from paying for the day to day expenses of another family member. You could pay for an entire year of college for what some of us spend on a couple of medicated cycles. One cycle of IVF could pay for a college education at a public university.

*Clarissa* · 12-15-2006, 12:44 PM

Maybe so, but when you have your child you will see how expensive that they are. It is not just diapers and drs appts.

It is very risky to do this without monitoring. A very BAD idea!

Cost of IVF: http://www.ivf-et.com/financial_ivffees.html