FET Protocols

Now that we have two healthy little frosties, E, Dr. D and I are weighing the pros and cons of a medicated transfer vs natural transfer. A natural FET is an option when you have a regular menstrual cycle with regular, trackable ovulation. The transfer is scheduled around your natural cycle, you don't take any medications to alter it and instead monitor yourself for ovulation. Once ovulation is confirmed, they transfer the embryo back 5 days later just as if you'd gotten pregnant naturally. The pros are no artificial hormones, a completely natural environment, no medications to take etc. The cons are that you could have a less than ideal transfer environment since you're not taking anything to beef it up and scheduling/monitoring issues. Since you're relying on natural ovulation, it doesn't always occur at the best time.

A medicated transfer controls the playing field. You take birth control pills and a little lupron to ensure you don't ovulate too early and have to cancel the cycle, and prep your body with estrogen pills or patches that help grow a nice healthy lining. A few days before the transfer, you add in progesterone suppositories and usually progesterone in oil injections which helps prep the lining for implantation. The entire process is scheduled and controlled, the lining is measured carefully to ensure it's ready, ovulation is triggers so there's no question as to when to transfer. Pros are you know exactly how things are going to go and you're doing everything possible to ensure the best environment. Cons are it's more expensive, more injections, more hormones and it's not necessarily a "natural" process.

I'm leaning heavily towards a medicated cycle since I have a short luteal phase and Dr. D agrees. This is somewhat contrary to my usual preference, I run towards the crunchy, do things naturally, follow your instincts line of thinking, but nothing about the IVF/ICSI/PGD/PGS/FET process is crunchy.  I always ovulate around day 16/17, leaving 11 days for the luteal phase, and that doesn't leave very much time for the embryo to implant and get comfy, especially if it's a late implanter. There's no way I would risk a precious, healthy embryo after everything we've been through to get them. 

The question is, if we're going medicated, what protocol? Birth control, estrogen pills and crinone or endometrin yes, all of that should be fine, but what about progesterone in oil? Those injections, usually in sesame oil, are almost guaranteed to give me hives which unfortunately means an immune response. We want my immune system quiet when we transfer so it doesn't try to attack our embryo. Waking it up with a hivey allergic reaction is a bad idea. It's something we're going to have to mull over more so we give our embryos the best chance to stick.