I got my meds the other day. I have a million little Estrace pills, more needles and syringes than I care to count, and a fully stocked pile of my favorite, Progesterone in f***ing oil. I might start calling it PIFO instead of PIO… Can’t wait for that again. It’s not like I’m still sore from a month ago or anything. Whatev, I’m not really complaining, I’m so thankful for the science, and my health insurance, and our ability to do this. I’m just really not looking forward to those particular shots again.
I did notice the absence of trigger drugs, which I was expecting to see. My Dr didn’t go over exactly what happens, just in general terms. This is what I know: I call on CD1 and then they have me come in (I assume on CD3 for blood and maybe the dildocam, like a regular IVF cycle). Then I know that I will be on Estrace and PIO and have several blood and ultrasound appointments to check on how things are progressing. When it’s the right time, they’ll thaw one of our embryos and we’ll go in and they’ll transfer it into me. Then we wait however many days and go in for a beta.
I had assumed they would trigger my ovulation at the right time, and then my 5 day blastocyst would go in 5 days later. So my uterus timing would be matched up with the age of the embryo. The absence of the trigger drugs has me thinking they don’t force it? They just watch for the appropriate time and keep an eye on things? That gives them less control, no? But maybe better for nature to have a hand? Ladies with FET experience, please let me know how it worked for you. I’m curious about the process I’m about to embark on. Specifically, about ovulation timing and transfer timing.
Who knew we’d have to deal with so much to have a baby? (And I have a relatively easy “issue”!) Other people always made it look so easy. haha
Unplanned Infertility 
So you are doing a natural FET? That’s what I had and it went like this for me:
Started OPK’s on CD 10, when I got a positive I went in for monitoring to see if I was about to ovulate. If I was, then i got the trigger shot to ensure ovulation. The transfer was done 7 days later
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Thanks for responding! Umm, I guess? What’s the alternative to a natural FET? If I’m going to be doing OPK’s, I’m surprised they didn’t tell me I’d need some (although I have plenty left over from before we found out sex wouldn’t get us pregnant!). And did they do the trigger for you then? With our regular IVF cycle, I had the trigger meds and we did the shot ourselves. This time I have none.
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The alternative to a natural FET is a medicated one, where you are on Lupron and your cycle is controlled through Meds. Every clinic is different in how they approach a natural FET, if they aren’t having you do OPKs to monitor ovulation then you should be going in for ulta sounds to see when you are about to ovulate. I do find it interesting that they aren’t doing a trigger for you. Your body can gear up to ovulate but then can stop, or can ovulate a day late. The way my RE explained it to me, you do a trigger so they know 100% that ovulation happened. That way they know they are transferring on the correct day.
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Oh ok, I thought this was considered medicated because I’ll be on some stuff, but I see the difference of using meds to control the timing. I suppose it’s possible that they’re doing the trigger for me and that’s why I don’t have it, although that would be really strange… Maybe ordering that particular med was overlooked. I’ll have to check in with them when I go in to find out if that’s right or not.
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Yeah I was sent the trigger, and it was done in office. Definitely check in with them about it! Good luck! 🙂
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I will for sure! Thanks for the info!
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I had the exact same question for my doctor yesterday. I’m not triggering for my medicated FET, they’re just going by lining measurement. I think trigger is to mature the eggs in the follicles so that’s why it’s not 100% needed for frozen cycle. Always good to check with your dr tho. Good luck x
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Maybe that’s what they’re doing for me too. I will be checking. I’m not someone who “goes by” what people online say anyway, I’d definitely check with my own Dr to be sure, hahaha. I was just curious what other people thought. I think you’re right about the trigger, I have read before that in addition to making your body ovulate, it helps mature the eggs. I guess it makes sense that I don’t really need to ovulate, since we’re not trying to fertilize an egg up there. I guess I assumed that you sort of follow the “timeline” of what it would be if it was normal sex leading to pregnancy. I mean, that would be ovulation, followed by fertilization and then it implants 6-10 days later, so I thought that my 5 day blast would have to be put back in on 5dpo for the timelines to match… If that makes any sense to anyone but me!
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yeah makes total sense 🙂 good luck & hope it goes well!
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Thanks so much!
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For my FET, I did not have a trigger. My understanding was I didn’t want to ovulate and they actually commented during my ultrasounds that ovaries were quiet as a positive. I see other people did use a trigger so I guess there are different protocaIs. I used estradiol and PIO or PIFO ( love that!) . During monitoring, they looked at my hormone levels and measured my lining. The estrogen thickens your lining. We added in the PIO shots five days before transfer once my lining was measuring greater than 8. If transfer is successful you have to continue with meds until body starts taking over and making the hormones. I’m not sure once this starts because I haven’t gotten to that point yet but I believe it is around 12 weeks.
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Interesting. Thanks for responding! It sounds like maybe it’s totally normal, either way. I knew the estrogen (I have estradiol too actually) was to thicken. And I think progesterone plays a role in that as well, but I could be mis-remembering. Its It’s been a little while since I looked up what all the meds are for. And yeah, I think you’re right about the 12 week mark. Lucky us! (@$!#&%)
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If you’re on a cycle close to mine, this is what we do: take Estrace starting on day 1, increasing dose every 5 days to match your body’s natural rise in estrogen. Then close to day 14, you’ll have an US to check lining thickness. If your lining looks great, you’ll start PIFO (haha) that day and transfer will be 5 days later. Once you introduce progesterone, your body thinks it has ovulated, no need for a trigger. You won’t be ovulating your own egg this cycle because of the Estrace. If your lining isn’t thick enough, which has happened to me once, they will keep you on estrogen a few more days to let it thicken up. They don’t have to worry about ovulation and they have better control over lining using ‘estrogen priming’, which sounds like what you might be doing. The alternative is a natural cycle, where you wouldn’t take Estrace and you would just let your body go through a regular cycle, then trigger, then transfer. If you have Estrace, it will be a medicated cycle. You’ll feel better after you speak to the clinic and clear it all up I’m sure! Fingers will be crossed!
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Thanks for responding! I actually just talked to them this morning because it’s CD1. She gave me instructions to go in tomorrow morning for blood and US (which I have to drive almost an hour away for instead of my normal 4 minutes because the location I usually go to is closed for the fourth! I’m charging this baby mileage from their allowance! 😜). She said I’d get instructions after that to take 2 Estrace a day, one am and one pm. Then I’d come back for blood and US 10-14 days later to make sure I hadn’t ovulated through the Estrace. As long as I didn’t, then I’ll start PIFO, and have transfer 5 days later. So no trigger. Now that I know, I’m just hoping my body responds to the Estrace properly and doesn’t ovulate on me! Fingers crossed!
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Good luck with the Estrace!!! Fingers crossed for you!!
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