e4d?

[CodeViolet]

Hello, I'm been through a lot trying to get my girl. My daughter was conceived with bd twice during the cycle. Each attempt was 7 days apart. I had a 3 day cutoff. She sadly passed away when she was 5 months old. I was lucky to get pregnant quickly after her passing. Her brother (boy #5) was conceived with 2 attempts as well. They were 5 days apart and had a 3 day cutoff. Since he was born I have done 5 rounds of IVF in an attempt for another girl. All of my levels are great, no clotting issues, rpl done, uterus is "textbook". None of these rounds produced a viable embryo after testing-- male or female. I then tried one round of donor embryo transfer, but the embryo didn't implant. I'm a bit frustrated because before the transfer I was told the odds of conception would be over 70% and then duing the follow-up call I was told the odds were actually 50% with pgs tested embryos. It is so much money and I feel a bit manipulated. We are now in a holding pattern because we have huge loans from the ivf and donor cycles. I did a round of clomid (50mg) in November, but only did one attempt at positive opk. My opk and ovulation day, according to bbt, were likely the same day. I think I missed the egg. This past month I just tried without clomid because I couldn't get into my doctor in time. We did the e4d pattern with a 76 hr difference. I don't think it worked. My doctor is willing to try one more round of Clomid. She will not prescribe more, but did up it to 100mg. I'm 41 and my husband is 45. Should we try e4d or is that a bad idea? I want a girl so badly and am afraid I will end up with boy #6. Of course, given my history, nobody needs to tell me how precious any baby is. I totally get that, but given the loss of my daughter and the ivf failures, I'm thinking it would hit pretty hard. Suggestions?

[ksmom]

I don't have any advice but I wanted to say I'm so sorry for your loss and the trials you've been through. I really hope you get your girl. Best of luck to you!

[CodeViolet]

Thank you!

[Slingers]

You have gone thru a lot Code Violet. So sad to read about your daughter. Wish you all the best.

[Shenanigans]

I am so sorry for your loss. I have 5 boys and finally 1 girl. I had 3 losses in a row after boy# 3. Just wanted to give you hope that baby number 6 could definitely be your girl. ❤ Also, I used clomid for my first 2 boys but the doses had to be upped multiple times. Femara, though worked even better. I used it at 5mg days 3-7 and it always made me ovulate (with pcos and never having a natural cycle) and brought me my girl. Good luck and I pray 2021 is your year!

[atomic sagebrush]

OH NO I'm so sorry I set this aside because it was so important I wanted to answer uninterrupted, and meant to come back to it, and then I think I shut down without replying. HUGE APOLOGIES.

I think I speak for everyone when I say I'm so sorry for the loss of your daughter. I believe we've talked before and I would love to help any way I can.

The overestimating odds for people with IVF seems to be endemic; you're the third person I've heard from in a month being told it was a sure thing when it wasn't. I'm so sorry it didn't work out.

Let's talk about the Clomid. Now, most docs don't prescribe Clomid to those over 40 or so because it can raise your FSH really high and basically cook your eggs. Most older moms are given Letrozole (Femara) instead, even though it's technically an off-label use, it's very common to use that instead. So the question is, should you take the Clomid at all this month? It's your call to make, and some people do have good luck with it even over 40 (just like everything there's a wide swath of reactions to it). We could consider splitting the dose. if you ovulated on 50, there's really no reason to go up to 100. You likely just didn't get pregnant for whatever reason (bad egg, bad sperm, they didn't find each other for some reason) and in that case there's no reason to go to 100 and a lot of reasons not to, like multiples, and making it harder for you to conceive at all due to no cervical mucus and uterine lining. So you could end up with 2 more months of Clomid.

The 72 hour e4d does not need to be to the hour. So 76 hours vs. 72 is irrelevant. That's just how we count the days. Wanted to be sure you understood that. (we also say "monday/thursday" but then people get mixed up and think it has to be that day!)

When you say your daughter was conceived with 2 BD, we actually consider what you are describing (separated by 7 days) one attempt since sperm isn't viable that long after. So I'd consider that one attempt. Even 5 days apart is likely one attempt. But you can get a boy or a girl with one attempt, it's not a guarantee of course.

What kind of diet are you following?

[CodeViolet]

I'm a vegetarian, so it limits things. Right now I'm doing a 16/8 fast mainly for weight loss. I'm 155 at 5'4", so not severely overweight, but could lose some. The IVF made me gain weight and it's been hard losing it. I did so much swaying for ttc a girl over the years. The advice has changed a lot since I first started. My diet with boys 1-4 was likely higher in calories. My diet with boy 5 was non-existent. I lost a ton of weight after my daughter passed (wasn't overweight then either) because I had no appetite. My provider will only prescribe Clomid and will only do two rounds. Fortunately, my lining is really good. It is always thick and has the striped pattern. I was told my odds of having take home multiples would be really low (because of my age). My provider says to have sex on days 10-12-14-16-and 18. I didn't share my hopes for a girl with her.

[atomic sagebrush]

Can you run down an average day for me?? We may not need to change much. People do the PCOS-type diet all the time as vegetarians.

The bigger concern with the Clomid is the high FSH and poor egg quality but like I said that doesn't necessarily affect everyone. You may want to split the 100 mg pills and end up with 2 months instead but that's not something everyone is comfy with.

Some of the stuff they say is exaggerated silliness. It is entirely, entirely possible for an older woman to have multiples on Clomid (older women have a higher rate of twins to start with). It's completely fine to take but I just wanted you to know that is a wee bit questionable a reason to give someone too much Clomid.

What days are you taking the Clomid?

[CodeViolet]

I'm taking it days 3-7. I usually don't eat until late morning or lunch. I eat whatever we have available so it could be left overs or sometimes fruit and peanut butter. Dinner could be lentils, Texturized Vegetable Protein, tofu, beans, or quinoa. Usually mixed with a veggie. Sometimes I eat unhealthy processed foods like cheese pizza or cream cheese wantons. My total calories are probably between 1500-1800 a day. I usually am big on walking/ hiking, but right now it's pretty cold and snowy where I am. I'm planning on doing Walk Away the Pounds this cycle to make sure I get something in. I think what my doctor meant was more that I could get pregnant with twins, but it was less of a concern. Overall twin rates are about 8% with the Clomid, but less for those over 40. I do worry about egg quality. The doctor doesn't get into that. She does 2 cycles and then does a referal for a RE. I've already done IVF, so this is my last hope with meds, I guess. I feel torn about going all out or splitting the dose to get an extra cycle out of it.

[atomic sagebrush]

Let's err on the side of eating more full fat dairy and whole grains, less unhealthy processed foods for now. I won't put you on the full alternate LE Diet since we're going ahead here and now but that's the change I'd make.

I think you should split the dose for the sake of egg quality and your ability to get pregnant. It's your choice, but as long as you're ovulating on 50, there is no legit reason to go up to 100. It doesn't help anyone get pregnant as long as you're ovulating. The higher dose is needed to trigger ovulation for some people, but then has all those side effects that I was talking about.