Yoga and the flare cycle w/o BCPs

Lately, I never actually go out to a yoga class. I've been practicing yoga for 12 years and teaching for a little over 4 and when we moved to Central New York, I had a hard time locating a yoga studio that I liked...which made me happy, thinking I can finally open my own studio...but then fertility got in the way. Well, today I made a trip out to a yoga class locally at the only studio in town. I generally avoid it b/c if any of you have been to several different yoga studios, you know that some are more open and friendly than others...unfortunatly, contrary to the very basis of yoga itself, some studio owners and teachers approach their work and practice with an air of superiority and snottiness. This particular studio seems nice but you kind of get this feeling from it. But, dammit, I wanted to go to a yoga class where someone else would actually teach ME. So I went, and within the first 5 minutes, regretted it. Oh yes, the teacher was pregnant and at the end of her first trimester. At first I was like, this is going to ruin my practice but then I realized it is an opportunity to learn and to practice some of the philophophy of yoga that I have let slip since I've become obsessed with the whole IF thing. It actually turned out okay. I wasn't crazy about the class itself, but she taught it well, I felt a sense of peace when I left, and I feel very happy for her and her healthy pregnancy:-) Yay, me.

The other thing I wanted to mention was that alot of people have been asking me why I think my former RE kind of screwed me in the baby department. The answer is the flare cycle without BCP's. When I first went to his clinic I was only 32 with no known problems at all. We did 3 chlomid IUI's which were a disaster. He told me to take the chlomid and come in on day whatever for the IUI. Well, on all 3 cycles, about 2 days before I usually ovulate, I felt a sharp ovarian pain (indicating ovulation) and I'd call them to tell them I ovulated and they'd tell me not to worry, I probably didn't, just come in at the regular time. The third time this happened, I actually checked my LH and my LH surged, oh, 4 days before the scheduled IUI...so I wonder why these didn't work....but moving on. We finally moved on to IVF. They immediately told me I have normal ovaries and I could do either a long lupron protocol or a flare protocol. They encouraged the flare. So I did it...they never recommended BCP. it was a miserable failure. Second cycle ended in an ectopic pregnancy. Then cycles 3-5 were all okay, stimulated well, flare protocol with no BCP's (even though I begged to be changed to long lupron) and all BFN's. Then I read an article that SIRM (the number 2 fertility center in the U.S.) doesn't do flare protocols at all...saying in a recent Q & A session, "We do not use “micro-flare protocols” for the same reason. With such protocols, Lupron is started virtually with the gonadotropins. This causes an immediate outpouring of both FSH & LH by the woman’s pituitary gland, While the FSH can improve ovarian response, the LH reduces egg quality and, indirectly (by ovaries), hinders endometrial growth in response to estrogen." (found at http://forums.haveababy.com/lofiversion/index.php?t3579.html ).

Then I received an email form a fellow IFer this morning with an interview with Dr. Schoolcraft in which he says, " we don't use BCP's with an antagonist protocol, but they are essential for micro-dose Lupron flare." (found at http://www.resolve.org/site/PageServer?pagename=cop_ch_poorresponder&JServSessionId_form=login)

Finally, here is a great answer from a fellow IFer on the Fertility Community boards, she posted, "If you take BCP's before the MDL cycle, then you do not ovulate, and you do not have a corpus luteum (ruptured follicle). Everything is ok. But if you skip the 2-3 weeks of BCP's, then you probably did ovulate on the cycle just before starting the MDL protocol. Therefore you still have a corpus luteum present. When you start taking the Lupron, it activates your pituitary gland which "rescues" the corpus luteum and reactives it. This causes you to start making progesterone too early in your cycle. (The corpus luteum is what tells your body to make progesterone in a normal cycle - you ovulate, the egg is released, the corpus luteum triggers the body to make progesterone which prevents your period from starting. If your egg hasn't fertilized and implanted and started to create its own progesterone by the end of the next 2 weeks, your corpus luteum fades, your progesterone level drops and your period starts.) The too-early progesterone messes up the formation of your lining preventing implantation of your transferred embryos." (http://forums.fertilitycommunity.com/vitro-fertilization-ivf/2020175166-anyone-done-lupron-flare-no-bcps.html)

Isn't this shocking? And, after all this, my old RE had the nerve to tell me that my embryos really looked good and I obviously have an implantation problem so I should find a gestational carrier! So, as I go about this cycle half lupron-crazed and concerned that we will fail again, I am realizing that there is a little light at the end of the tunnel. In fact, my prior cycles were very likely destined to fail from the start. I keep forgetting this (or, essentially, deep down, I don't believe it). But, if your RE ever suggests a lupron flare cycle without BCP's tell them NO. It wasted an entire year of my life, made me a way more serious person, strained my friendships, and really hurt me emotionally. Tell them to come up with a better plan!

As a result, I've been angry at my old RE about this (well, more resentful) but I've decided that the past is the past, I am who I am today because of trials in my past and I just have to let it go and move forward with optimism and hope. But, I also wanted to write this post and put the cycle details in the title because I hope that if any woman is googling for info about this protocol, my blog comes up and she reads all of this!