I was asked to do a blood test this morning, the result is "I have a secret I cant share yet". J
On ET+5, we were told only 1 of 4 embryos able to
develop to blastocyst stage, again we ended up having no embryos to freeze. Sad. However I want to be grateful as I was still blessed and cherished with our dear only
blastocyst embryo.
Post embryo transfer, I was asked to lie down
for 2-3 hours then I was allowed to go back home. I was scheduled on:
21st Nov – to have a routine Cyclogest
400 mg, Progynova 2 mg per vaginal at 3 pm, 11 pm and 250 mg Proluton
injection
22nd Nov – 3rd Dec –
Cyclogest 400 mg and Progynova 2mg per vaginal at 7 am, 3 pm and 11 pm
24th Nov, 27th Nov, 30th Nov – 250mg Proluton injection
On ET+3, we were told that from total 10 oocytes I
got, 4 were immature, 6 were injected and numbers down to 4 embryos. And due to
15%-20% fragmentation, our 4 embryos are not suitable for PGD testing. Again, I
was so heart-broken. We were asked to wait until ET+5 to see whether our 4
embryos should have reach blastocyst stage. However, the only down side doing a
blastocyst transfer is that there may be some risk that no embryos make it over
the hurdle and survive to day 5.
Post OPU, I was allowed to rest in
the recovery room for an hour or two, I think I was sedated quite deep, because DH said I was put in a deep sleep for quite a time after that.
I don't know why, but I think I react poorly with the sedative, I got a motion sick and ended throwing up for the next three days post OPU.
This 3rd consultation supposed to be our
last scan, and here’s our schedule:
13th Nov - Dr. S having me inject 237.5 IU Gonal-F,
and Buserelin at 10 IU
14th Nov – Inject the balance unit of Gonal-F
at 0.4 ml, Buserelin at 10 IU, and Ovidrel of 6500 IU at night
15th Nov – I was told to have 2 Dulcolax
tablet after my last meal before 11.30 pm, and then fasting at least 6 hours
before the Ovum Pick Up procedure.
16th Nov – Ovum Pick Up (OPU)
Flying
back to TMC early morning at 05.00 am, arrived KLIA, Malaysia around 08.00 am.
When we made our way out from the airport, we saw Shane Filan just landed about
the same time with us. Here’s a snapshot taken by DH at the airport, you can
see SF gets swamped by numbers of his fans. I read somewhere, SF was there for
his Autograph Session at 1Utama, Highstreet and another live performance at the
Shout! Awards, Malaysia. When we looked at him straight in the eye, we think he's quite cute as seen on TV.
***
***
Alright, so on this 2nd consultation, after having my internal ultrasound scan, I naturally got 10 follicles with the sizes varied at 12mm. Dr. S said it takes
10 days for follicles to grow. Thus, after being stimulated with a start dosage of 237.5 IU
Gonal-F for 5 days before, Dr. S top up the dose of my Gonal-F to 262.5 IU for another
4 days, and Buserelin for another 4 days too at 10 IU. We were scheduled to get back here again on 12th Nov.
* Notes, uterus lining at 7mm.
* Notes, uterus lining at 7mm.
On
my day 11th on Buserelin injection today, I understand it is better to avoid strenuous activities
such as running, jogging and lifting heavy weights while doing the meds.
However, I just need to challenge myself to finish this 10k race. My endurance.
A great way to maintain motivation by picking the correct goals.
.jpg)
My
treatment involves a series of daily injections for 4 weeks and 3 clinic
visits. I was asked to be seen every 3 to 5 days until egg collection and
subsequently embryo transfer 5 days later.
For today, I was prescribed with Buserelin at 50 IU to inject from 17th Oct until 30th Oct, and another 10 IU from 31st Oct - 8th Nov. We were scheduled to get back here on 8th Nov.
For today, I was prescribed with Buserelin at 50 IU to inject from 17th Oct until 30th Oct, and another 10 IU from 31st Oct - 8th Nov. We were scheduled to get back here on 8th Nov.
It has been raining on and off for 3 days here. Tell you what, rainy days always made feel very serene in a way and a simple beverage of ginger tea is just what you need on a cold rainy days.
I brewed a pot of ginger honey lime tea today, which is very easy
to make. What you need are ginger (here I used a lot of ginger), smashed them
open like you smashed garlic for sauteed then add up honey and lime suited your
needs. I really love the real kick from the soothing ginger, it gives you a lovely
extra warmth on rainy days while you sit back and relax on the couch.
My 22nd June appointment was cancelled due to Dr. I's
business trip. Another ultrasound scanned today was alright. I obviously do not
need any Provera or Progynova anymore to bring on my next cycle. So really
crossed fingers, my next cycle will be on time naturally. Take note here:
uterus lining was at 7.6 mm, break for a cycle or two I am allowed to enter the
2nd IVF.
By the way, when DH went to the cashier desk, I also noted there’s an
increment of Dr. I's consultation fee, almost 60% rise in rates, so one shot
consultation becomes IDR 400.000,- now from normal rates. Hmmm....60%
rise, its not an up-tick increase anyway huh?
.jpg)
Alright..so
here I am again, flashed back a bit..I did my D&C on 24 March, and I still
have got no period even after getting all period symptoms such as dull, throbbing, cramping, bloating, weight gain. I went
checked my b-HCG levels which has already down to <5, so I am perfectly clean.
DH scheduled me to meet Dr. I today - by means my period has been absent
for almost 2 months and 2 weeks, err… a red light as they said. After an ultrasound
that showed no bad news, Dr. I prescribed Provera 10mg and Progynova 2mg for
10 days to bring on my period and said I’ll probably get mine between 16th
– 22nd June. He also mentioned about Asherman syndrome which scared the
heck out of me. However, I was asked to see him again on the 22nd
June.
I
prepared these blueberry pancakes for DH past weekend. He took so much joy
when having this breakfast, not to mention the approving smiles when I added a
sunny side up egg. These pancakes actually taste better when you crisp the edge. He would then went back for the second slice and so on.
 |
| The Truth About Fruit |
Proverbs 18: 21 says, “Death and life are in the power
of the tongue: and they that love it shall eat the fruit thereof!
 |
| morning always gives me hope in time of trials |
As I’ve gotten older, the joy of a sleep-in has become a thing of my
past. Now I used to get up before the sun and spend a little quiet time being
thankful for the fresh day ahead, not the least of which is bear witness a
magnificent beautiful sunrise.
My mundane routine would be step outside basking
myself in the warm sun and lingered over my lukewarm green tea. I always full
of wonder at this amazing sight. Who could ask for a better
beginning for such a blessing?
A missed miscarriage can be an extremely traumatic experience for a couple. A missed miscarriage is the term referred to when a woman has a miscarriage without any symptoms. This typically is something that’s discovered when there’s lack of a fetal heartbeat at a check-up, when a woman sees the doctor due to lack of pregnancy symptoms that were previously felt or when this is discovered as a result of an ultrasound. Missed miscarriage can be a shock to a woman who believed her pregnancy was average and did not suspect any problems.
While most women experience bleeding and/or cramping while
having a miscarriage, a missed miscarriage is when the fetal simply dies but is
not expelled from the body. This can be extremely shocking to the patient who
was not aware of any problems in her pregnancy and can be difficult to overcome
on an emotional level.
Miscarriages are difficult at any time. Whether the woman who
was pregnant discovers she’s had a chemical pregnancy, a blighted ovum, a
missed miscarriage or a miscarriage that occurred as most do, with accompanying
bleeding and cramping and a lot of waiting, it’s going to be a traumatic
experience that will take some getting over.
When a woman experiences a missed miscarriage or any other type
of pregnancy loss, she needs care, rest, moral support and reassurance. When
the majority of women become pregnant, they instantly become attached to the
life within them and that loss is as grievous as losing someone that you have
already met and loved. There are support groups and books on this subject that
can help a couple work through the associated emotions.
It’s important to realize that miscarriages, including missed
miscarriages occur more often than you might think. General statistics indicate
that one in five pregnancies ends in miscarriage through no fault of anyone. A
miscarriage is most often due to the embryo being unviable due to chromosomal
defects. While the pain and loss associated with miscarriage makes it feel
anything but common, it truly is part of life for many women and most of the
women that have to suffer this loss do still go on to have successful
pregnancies.
When a woman has recurrent miscarriages such as three or more, a
doctor will more closely examine the reason for this. It could be due to
uterine problems within the woman or other medical reasons that might be able
to be worked on. While miscarriage can be an extremely difficult and
frustrating thing to deal with, there are specialists that can help couples
successfully succeed in many cases.
Source: Online Pregnancy Info
04.00 am I woke up and passed blood clots with mild cramp. DH packed up and took me to the hospital then I was admitted to One Day Care for D&C. I was so nervous. I have laid in bed completely awake for 3 days by now, when I got a chance to have a small talk with Dr. ARS (anesthesiologist) and his assistant, I wish they can sedate me deep enough for maybe 1 or 2 hrs after D&C.
The D&C procedure performed
by Dr. I only taken about 7 minutes as confirmed by DH. But the worst part
(besides feeling rotten emotionally) was waiting for what seemed like an eternity. Post
D&C, I was wake up in bits and pieces, feel groggy and thirsty. Alive but a corpse inside.
At 2.30 pm, I was released
and they let us take the remains home. I am so over.
[01.30 pm]
Get my ultrasound today.
No luck. Our little one started to bleed and my gestational sac started
to collapse and shrinking. Dr. I told us it would only be a matter of couple days for me to have miscarriage. He presented both sides of what we can do but
suggested us of having D&C. I was so crushed. I really don’t know what to do, I have been on
such an emotional roller coaster past few weeks in this waiting miscarriage
game.
[04.00 pm]
We finally decided and agreed to book for D&C
tomorrow at 10.00 am.
Medication Lists:
Gastrul, 1 to be taken orally at 10.00 pm tonight and
another one to be inserted vaginally at 07.00 am in the morning (3 hrs before
D&C)
 |
| Lisa Faulkner & Billie |
By SIMON CABLE
PUBLISHED: 22:30 GMT, 6 March 2013 | UPDATED: 21:31 GMT, 8 March 2013
For years, Lisa Faulkner tried everything to conceive the baby she so badly wanted. Round after round of costly IVF treatment wiped out the actress’s savings and left her ‘a walking mess’ – all for nothing. The 41-year-old, now the proud mother of an adopted daughter and dating MasterChef host John Torode, has spoken of her struggle to start a family and the heartbreak of failed IVF.
Miss Faulkner said: ‘It’s a really, really tough process. I don’t
think people have any idea until they go through it. ‘It’s not just the
physical stuff – it’s the emotions and the hormones that are pumping through
your body. ‘You’re on this whole trip of desperation for a baby and you’ll
do anything. I was determined that I would be a mother.’
She underwent four rounds of treatment, at a total cost of
£35,000. In an interview in The Lady magazine, she added: ‘I said I’d give IVF
three goes, and I ended up doing four. I spent all of my savings. But also
mentally, I couldn’t go through it again.’
Miss Faulkner, who starred in BBC show Holby City and won
Celebrity MasterChef in 2010, married actor Chris Coghill in 2005, three years
after they met on the set of the drama Burn It.
They began trying for a child, but she suffered an ectopic
pregnancy at six weeks which left her with only one working fallopian
tube. Miss Faulkner decided to seek private fertility treatment when she
was in her early-30s. She would have been eligible for free NHS treatment but
chose to pay to avoid long waiting lists.
During IVF, an egg is removed from a woman’s ovaries. It is
fertilised in a laboratory and returned to the womb. Private treatment can cost
£10,000. Miss Faulkner said: ‘Every day I was injecting myself [with
medication]. I was a walking mess of hormones – crying all the time. I was
emotional, sad and just desperate for it to work. It was
horrendous.’ Exhausted, the couple researched surrogacy before adopting
their daughter Billie in 2008 when she was 15 months old. She is now six.
Miss Faulkner, who presents a daily Channel 4 food show, What’s
Cooking?, added: ‘I wanted to be a mum for a very, very long time and I feel
very blessed that I finally am. ‘I love Billie so much and I want her to
have everything that she could possibly have.’
She and Coghill split in April last year and she began dating
Torode, 47, in October after they met on MasterChef.
She has spent time working at his Smiths of Smithfield restaurant
in London, and they appeared together on BBC1’s science series Food Factory.
IVF
wiped out my life savings and left me a mess, says TV star Lisa
Faulkner. Actress, 41, spent £35,000 on four rounds of unsuccessful
treatment. 'I was a walking mess,' said former Celebrity MasterChef
winner. Adopted daughter Billie in 2008 when she was 15-months-old . 'I
feel very blessed that I'm finally a mum' she said.
I should be 9 wks today. My ultrasound showed baby's CRL at 0,284 cm. Dr. I told us it’s not an ideal pattern, our little one was measuring weeks behind in growth and again we decided to wait for another 2 weeks to get another ultrasound done. I am clutching at straws here – hoping to see baby and heartbeat then.
Starting from 11 Feb – 02 Mar, I did my blood test of our own will, sometimes to make sure that my b-HCG levels would increase at the appropriate levels. However, below is the breakdown:
11
Feb 2013 – b-HCG went up to 279.79
20
Feb 2013 – b-HCG reached 2024.00, slowly increased.
23
Feb 2013
We went to see Dr. I today for internal ultrasound and
showed him my b-HCG results. The ultrasound showed my gestational sac at 0.72
cm and gestational age at 4w5d. Dr. I said the numbers were not increased significantly.
However, he asked me to remain positive and keep the benefits of all these doubts. Dr. I suggested us to come back again on 9 Mar for ultrasound.
2
Mar 2013 - b-HCG went up to 4867.55. The numbers were still slowly
increased.
I am wondering if anyone ever experience b-HCG
rise-drop and rise again in this way and able to go full term with a healthy
baby? I am really hoping against hope that things will turn out well.
09 Feb 2013 (CNY-eve)
It seems my happiness didn’t last long. My b-HCG level dropped
from 169 to 128. Dr. A texted me to stop consume Duphaston and Ascardia, and
ask me to consult with Dr. I when I am ready. They said things about embryos do not grow
properly, and it will be a miscarriage waiting to happen.
Totally shattered!
Totally shattered!
The two weeks wait is one of the most longest weeks of my life. I was incredibly tensed after a few usage of Crinone. There’s nothing much I do, I was put on total bed rest. DH did everything he could do to help me at home.
Some of my reading lists:
- IVF-2ww
Day 6 – 21 Jan 2013 (PMS Day 16)
Btw, on 19th Jan (PMS Day 14), we received a
text from Dr. A – from total 10 oocytes I got, 2 were immature, 8 were injected
and numbers of oocytes down to 5.
On PMS Day 16, we were scheduled to see the
embryologist on 10.00 am, we found out that – from total 5 oocytes only 2 can
survived. I shocked and my tears started to welling up. I thought I will end up
with many embryos. Our embryologist started to comfort us try to explain we
actually have a good embryos condition, a semi-compact and a 10 cells embryos.
However, I still feel numb and feel like a total
failure…, we ended up having no embryos to freeze.
My 2 embryos transferred lasted for 15 minutes only.
This procedure was performed under ultrasound guidance and was no more
uncomfortable than a pap smear. My bladder was almost full when the procedure
about to get started. They said full bladder provides an acoustic window that
allows the doctor to see the uterus more easily.
I didn’t get into so much details about the procedures,
but as far as I know once the catheter tip was in place, the embryos were
deposited and the catheter was removed. The embryologist then checked the
catheter to ensure that the embryos have been released. Sometimes, the embryos
could stick inside of the catheter.
After the transfer, I was taken to recovery room to
rest for about 30 minutes. Then, a nurse came by and helped me administered
Crinone vaginally. Later on, I was transferred to regular patient room to get a
bed rest and asked not to mobile until 05.00 pm. I was instructed to take
Dydrogesterone (2x a day), Acetosal and
Progesterone Vaginal Gel.
Medication Lists:
Dydrogesterone, Acetosal
Dydrogesterone, Acetosal
Day 5 – 18 Jan 2013 (PMS Day 13)
That night at 10.00 pm on PMS Day 11 which was 48 hrs
before egg retrieval operation, I was asked to inject Ovidrel which was 250mg
to induce ovulation.
Pre-OPU, we faced a scene as Jakarta floods due monsoon
soaks, heavy rains bring this capital to a standstill. The hospital remained
open but the access roads leading to it were reportedly blocked. The traffic
was brought to a near standstill by waist-high floodwaters, and overflowing
with cars. By midnight when we heard the access road to hospital down to
knee-high floodwaters, DH packed up and took me to the hospital where I
was admitted to ICU then transferred to regular patient ward.
Home truths about ovum pick up…
Before operation, the nurse gave me a surgical gown to
wear, I was asked to change my clothes and shown to a bed and a cannula ( fine
plastic tube) was inserted into my vein in the back of my hand. It was used to
make me feel sleepy and sedated throughout the procedure. Once I got into the
OR, Dr. I already inside the room. The room was freezing. It was medium and
white. I was instructed to lie on the operating table. Later, they tied each of
my arms to the boards. They also slapped sticky heart monitors onto my chest
and plugged them in. An assistant came
by and did a complete medical history on me. Another anesthesiologist asked me not
to worry and started to sedate me via cannula inserted in my vein before.
That’s the last thing I remember.
An hour later, I have been taken down to recovery room to
rest and DH was eventually brought back to see me. I found myself given
oxygen throughout the procedure via two short plastic tubes that sit at the
base of my nostrils. DH told me that out of 15 follicles retrieved, 5 were
empty so I got 10 oocytes in total.
I was prescribed with Cefixime 200mg taken once a day
and Asam Mefenamat 500mg 3x a day with no end date provided. After having lunch
about an hour and so in recovery ward, I was released home.
Post–OPU, I bounced back fairly quickly. I was pretty
much feeling completely normal.
Medication Lists:
Ovidrel 250mg, Cefixime 200 mg, Asam Mefenamat 500mg
Ovidrel 250mg, Cefixime 200 mg, Asam Mefenamat 500mg
Day 4 – 15 Jan 2013 (PMS Day 10)
PMS Day 10 – 4th consultation, another
ultrasound and blood test, my follicles’ sizes are growing. Some of them have
reached 17mm and the smallest at 10mm. Dr. I hopes the 10mm follicle would
catch up. He prescribed me with Gonal-F at 150IU. So, in total, I had 9 days of 2 Gonal-F pen at 900 IU
each dosage and additional 150 IU Gonal-F.
Dr. I explained Ovum Pick Up will be executed as
scheduled on 18th Jan. He ordered us to go for another blood test on
PMS Day 11 in the morning and Ovidrel injection at night around 09.45 pm also a
total rest on PMS Day 12 plus fasting 6 hrs pre-OPU.
Medication Lists:
FSH (Follicle Stimulating Hormone) is used
in IVF cycles to stimulate your ovaries to produce multiple mature eggs. FSH is
taken as subcutaneous injections daily. Ie. Gonal-F
2 x 75 IU
Sharing some insight about estradiol levels.
Estradiol: What It Is and What It Tells Us.
The level of estradiol is measured in almost every blood sample taken during the monitoring of almost every type of assisted pregnancy. It is arguably the most informative of the three tests. Because of this, we will spend more time and space on estradiol. Don't worry-- the other two won't be nearly as long.
Estradiol is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo arrival. (This is not estradiol's only function, but for us, it's the important one). Estradiol is tied into pregnancy by it's method of production: oocytes (eggs) contain follicles. These developing follicles contain 'granulosa cells'. These granulosa cells synthesize the estradiol and release it into the blood circulation.
This means that more follicles produce more estradiol. This helps measure how many follicles are actively developing. The longer they continue to develop, the longer the estradiol level continues. As they develop, the level continues to rise. This rise can further indicate that the oocyte within the follicles is reaching its maturity.
An example of the use of estradiol level is when it is measured during down-regulation cycles. In down-regulation we expect low levels of estradiol: below 30pg/ml. If levels are not this low, this suggests that the ovaries are not yet suppressed, and that the down-regulation should continue a little longer, until they actually are suppressed.
Estradiol And Ultrasound Scans
Blood estradiol is also used in combination with ultrasound scans. Taken together they help indicate how (and if) the ovaries are responding to stimulation. Is there a response? Is it adequate? Is it excessive? To tell us this, the blood level has to be viewed in relation to the stage of pregnancy and the day in the cycle in which the level is being taken.
For example, a level of 1500 pg/ml on day eleven might be considered acceptable in a stimulated cycle, as reflecting the presence of a reasonable number of mature follicles. However, if this level were present on day eight, it would be considered unacceptably high. It would almost certainly reflect the presence of an excess of follicles. At this stage (day eight) they would still be Immature ones. Their quantity, however, would suggest that continued stimulation would carry an unacceptable risk of developing OHSS-- ovarian hyperstimulation syndrome.
Don't Expect Easy Comparison
Before we continue, one important point: levels of estradiol are not the same from person to person. They cannot simply be compared from one to another. People vary-- everyone is slightly different, and everyone responds to a different degree. Some more so than others. A level that is dangerously high in one person-- or dangerously low in a second-- might be normal and healthy for a third. This is why blood levels can't just simply be compared. It's also why blood levels can't always be interpreted with complete certainty in the first cycles. Without prior cycles to 'calibrate' the levels, the meaning of a level can only be determined as to what it usually means-- what it 'probably', or perhaps even 'almost certainly' means.
Despite individual variation, estradiol level does provide very useful information.
A Rough Rule-of-Thumb for Good Estradiol Levels.
Exact figures are not possible. As a rough guide, however, a level in the range of 150 to 500 pg/ml is generally considered reasonable for the eighth day of a stimulated cycle. An approximate doubling of this level every 48 hours is considered promising, as a sign of continued good follicle development.
When the Estradiol Level Stays Flat or Begins to Fall.
Occasionally, the level of estradiol fails to rise during a cycle, or even falls. If this happens it strongly suggests that the follicles are not responding appropriately, and that the oocytes within will not be of good quality. Under these circumstances our advice is almost invariably to cancel the cycle, because a change in stimulation protocol may yield more oocytes-- and healthier ones-- in a later attempt.
Low Estradiol Not Always a Problem
A more common situation is when the level is low in the early part of the cycle. The choice then is to either carry on with the same amount of stimulation, to increase the amount of stimulation, or to cancel the cycle. This decision has to be based on a number of factors. These include:
the previous response to stimulation chronological age how low the level is
the ultrasound appearance of the ovaries is there a pressing need to ensure that an optimal number of oocytes are obtained, as in the case for couples with male factor infertility?
How It All Comes Together with Estradiol.
It should be clear from all of the above that estradiol levels do not tell the entire story by themselves. One level leads us to advise a couple to cancel. The same level in another couple leads us to suggest continuing.
We've already discussed levels that are low. When levels are high, we have the same choice: change the stimulation (reduce it), or cancel the cycle. The criteria to consider are the same as for low levels. The one additional factor is that with high levels we also think carefully about OHSS (ovarian hyper-stimulation syndrome). When assessing the risk of OHSS we look to previous cycles, if there are any. Any suggestions from these cycles of OHSS problems would quite definitely weigh heavily towards cancelling the cycle.
When the decision is to proceed, levels of estradiol continue to be monitored. If they continue to exceed acceptable levels, even with reduction in stimulation, we might reassess the cycle, and once again advise cancelling. If however they do return to normal levels, then the cycle will continue.
What is the limit of acceptable estradiol level? Acceptable levels vary-- it's not possible to give a definite, absolute number. However, any level of 4000 pg/ml or above does require careful consideration. Levels that are much in excess of this usually do lead to cancellation, though not always.
What about the lower limit? This too involves many factors. However, if the estradiol level has not reached a minimum of 600pg/L (**** beth-- should this be per liter, or per ml?***), then our usual policy is to discontinue the cycle. In practice we usually don't proceed unless the ultrasound shows three or more mature follicles. Since estradiol levels and the total number of follicles are related (as discussed in the beginning of this essay), this by itself eliminates most of the possibility for levels at or below this lower limit. Three or more mature follicles will, under most circumstances, secrete enough estradiol by themselves to give a level in excess of this minimum.
Do bear in mind that the above are only a rough, rule-of-thumb guides, however. They can and do vary depending on individual circumstance.
Luteinizing Hormone, or "LH": What Is It and What Does It Do?
Before the introduction and widespread use of drugs such as Lupron, assessment of luteinizing hormone was at least as important, if not
more important, than estradiol levels. It remains an important test for anyone undergoing any cycle where Lupron or Synarel (GnRH agonist) is not being used. This is because, without Lupron, an early unwanted LH surge may occur.
LH Surges (note: the next entry implies that an LH surge is desirable, and necessary. This entry implies that it isn't. How do the two reconcile? is early=bad, but near end=necessary?)
A surge in the level of LH may cause undesirable changes in egg quality, or cause early egg release. Both of these decrease the chance of pregnancy. Regimens such as Clomid, Clomid/Pergonal cycles, or "straight" Pergonal, Metrodin or Humegon cycles all must include urine LH testing (for instance, Ovuquick, or ClearPlan Easy). If a sudden rise in the level of LH is detected (often termed "an LH surge"), this indicates that the process leading to ovulation and release of the oocyte has begun. It is this process that is blocked, in the vast majority of cases, by the use of Lupron. Unfortunately, there is no way of knowing when a rise in the level of LH actually begins, except for testing blood or urine every three to four hours. This makes it virtually impossible to accurately time egg retrieval. This timing is necessary to be certain that the oocytes are mature. Because of this problem, the cycle is usually canceled if an LH surge is detected.
