I have a dilemma. I need to decide sometime in the next week whether to use a fully-medication, suppression-based FET protocol that relies upon oral contraceptives (OC) and Lupron to suppress ovulation and precisely time the date of transfer or to skip the OC and Lupron and go with an estrogen protocol in which ovulation may have to be monitored if it is not suppressed by the estrogen treatment.
There are pros and cons to each and I am having trouble weighing out which is better for me as my past experience was with a natural FET protocol in which the only medications I took were Ovidrel to ensure precise timing of ovulation and accurate pinpointing of transfer day as a result and micronized progesterone for luteal phase support. Both of the medicated protocols I’ve outlined below include progesterone support in the luteal phase and for 5 days before transfer.
Maybe you lovely folks can help me decide? I’ve included a poll at the end of this post, after the descriptions of each protocol and their respective pros and cons from my perspective. If you have personal experience with either or both, I would be especially keen to hear from you, including whether your FET was successful. Even if you have no experience but thoughts on what might be best given what I’ve described below, I would be very grateful to hear from you, too.
On this protocol I would start oral contraceptives or OC on the third day of my next cycle (which will likely be around the end of next week). I would take OC for two weeks and it would be overlapped with Lupron and followed by estrogen priming, an end to Lupron and start of progesterone supplementation (while estrogen would also be continued). Immune meds would begin around the same time as estrogen priming. I do not yet know how many days of estrogen priming Dr. Braverman suggests generally.
The OC/Lupron protocol has the added convenience of reducing the number of monitoring appointments and in my case would allow me to book flights without risk of expensive changes as well as allowing me to book a very limited amount of time away from work, at least in principle. If all goes as planned, I would only need to travel to New York the day before transfer and stay there for about 2-3 days (depending on return flights, time of transfer and if I wanted to wait until the day after to return home).
It would allow me to miss the minimum amount of time from work, assuming all goes according to plan.
I would know our date of transfer well in advance, assuming all goes according to plan.
I start the immune meds after two weeks on OC.
There is some evidence to suggest Lupron helps with implantation.
Slightly lower travel costs.
If I cannot get quality images of my uterine lining while on the estrogen priming portion of this protocol to send to Dr. Braverman, I would still need to travel earlier than transfer day (on day 8 of estrogen priming), making this very similar to the Estrogen Priming Protocol though probably still slightly less time missed from the office.
I bleed through on OC and feel quite sick to my stomach, bloated and generally lousy.
I get bad headaches on Lupron even when I drink buckets of water and take supplements to support liver function.
The monitoring appointments would be done by ultrasound technicians who are not trained to do what I would be asking of them because I do not have a RE where I live. This makes me nervous but perhaps unnecessarily.
Two more needles per day for about 3 weeks while I am on Lupron. I’m not super fussed about needles so this is a pretty minor “con” (hence it’s place at the end of the list).
The estrogen protocol would have me start estrogen supplementation on cycle day three (again, late next week or next weekend, most likely). I would be monitored through ultrasound and blood tests to track for ovulation (which my last two cycles was on day 15 and 16 respectively). I do not know when immune meds would start but I suspect it would be the same time as estrogen, given that is when they are started in the OC/Lupron protocol.
I would allow my body to function somewhat normally (i.e., I will be permitted to ovulate rather than suppressing it), which could assist in my body producing its own progesterone rather than relying entirely on supplementation.I avoid the Lupron headaches.
The RE at Dr. Braverman’s Manhattan clinic would be doing the critical monitoring appointments, as opposed to the less skilled technicians in my local facilities (because I do not have a RE here and the wait to get into one is > 12 months so I’m not going to try now).
I avoid the OC nausea and bleeding.
I would take additional hCG injections to assist with implantation (replacing the possible implantation support Lupron would provide).
Two less needles per day for the approximately 3 weeks I’d otherwise be on Lupron.
I will need to book more time away from work.
I will be unable to precisely predict my travel dates to return between when ovulation is triggered (I am assuming Dr. Braverman would trigger it to ensure precision in timing the transfer and I would want this).
Increased travel costs unless I can couch-surf in the Big Apple for part of my stay.
Here it is, your chance to participate! What do you think? Feel free to comment as well as or instead of taking the poll. Thank you!