If your first thought is, “What’s a Fertility Hot Seat?!” Then let me tell you!

I go live every other Monday on Instagram and YOU have the opportunity to join me live to get my take on your case. I set a timer for 15 minutes, you ask your question/s and I give you my answers.

Whether you’re chosen to go live with me or not you’ll learn from these lives twice a month.

If you’ve ever thought about coaching with me or my team but weren’t sure if it would be a good fit this would be a great opportunity to test it out!

SEE FULL TRANSCRIPT BELOW OR CLICK ON THE IMAGE ABOVE FOR THE FULL VIDEO.

Aimee Raupp:

Hello, everyone. How are you? I am here for another fertility hot seat, our fertility hot seat. Oh, people are already asking to join. You guys are great. Oh my God. That's amazing. This is how it goes. Fertility hot seat. I pick one of you to join me for a free 15-minute consult on your fertility case and the rest of you get to watch, learn, listen, support.

Now, keep it in mind that this advice is based on my almost two decades of clinical experience helping women get and stay pregnant based on the information in my books that are above me. It is not medical advice, because I am not a medical doctor. Anything I tell you about, I want you to really talk to your established team about this information.

Yeah. Oh my God. People keep rolling on. You're just going to request. I'm going to go on and look, let's see. You guys are amazing. Oh my God. I don't know how to pick. This is the fastest, if you will, that people came on. I'm going to go with Framer, I think is your name. Oh, it was amazing. Oh, I just did the Ignite Fertility. Oh, thank you.

Megan:

Hi.

Aimee Raupp:

How are you?

Megan:

Good. How are you?

Aimee Raupp:

Good. Good. I like the ship lamp in the background. We're going to do our basement in that I think.

Megan:

Can you hear me okay?

Aimee Raupp:

I can. I can.

Megan:

Okay. Hi.

Aimee Raupp:

You're clear that this is not medical advice, right? This is advice based on my experience. Yeah.

Megan:

Yes. Yeah.

Aimee Raupp:

Tell me how I can help. What's going on?

Megan:

Okay. My name's Megan.

Aimee Raupp:

Hi Megan.

Megan:

I'm 36. My wife and I have been trying to have a baby for over two years now. When we started, she was 39, I was 33. We started with IUIs with donor sperm, and on our fourth IUI… We started with her because of age. Our goal has always been two kids. Our plan was for her to carry, then me to carry. Our fourth IUI, we had success. We got pregnant.

Megan:

Unfortunately lost the baby at nine weeks. Then we tried several more times, wasn't working, decided maybe it was time to switch to me.

Aimee Raupp:

Did you do any genetic testing on the loss? Did we know anything? No.

Megan:

No, we didn't know that was an option at the time. By the time she was pregnant, she was 40. I mean, we just thought it's maybe genetic. Then we started with blood work with me. At this point I was 35. This was the end of last year. My AMH came back at 0.25, which was concerning. My FSH was 11.1, but everything else was normal. My estradiol, normal, all my blood levels normal. I had full panels done.

Megan:

My thyroid's normal, insulin normal, had thyroid auto antibodies done, normal. Normal BMI. We decided, instead of trying IUI with me, that we would do IVF because we were worried if I did get pregnant, we would only be able to have one kid. Started IVF. We've had two retrieval so far and then one round that was canceled due to poor response.

Megan:

My first round was in January and we did a microdose Lupron protocol. He had me on 150 Menopur and 425 Follistim and Omnitrope and AM/PM Lupron. During our retrieval, we got seven eggs. I mean, that's the weird thing is that my follicle count has always been normal. I range between lowest has been 12, but the highest has been 22.

Aimee Raupp:

Wow.

Megan:

I mean, it's never been low. Going into this cycle, I had 22, but then after I primed with birth control for eight days, going back in, I think we started with 14. Then stimmed, only seven were responding. We were pretty much just monitoring seven follicles the whole time. The numbers were looking great going into retrieval. On trigger day, my estradiol was 2036. We felt good.

Then we got seven eggs, but only three were mature. Two fertilized. We ended up with one blast. It was a good quality blast. We haven't tested it yet. We want to do PTT testing, but we're waiting till we get more embryos because they charge per batch we send.

My next round was in March and our doctor wanted to do the same protocol, but he wanted to up the Menopur to see if that would work better. Then I was on everything the same, primed with birth control, but we did 300 Menopur and 425 Follistim. I got to day eight of stims and I had started with 16 follicles and then only two were growing. I just wasn't having the response. I think on day eight, my estradiol was 400.

We decided to cancel because our other limitation is we are running low on our donor sperm. We are just very cautious on how we use it. We canceled that. Tried again in May, but what's odd after that canceled cycle was it screwed me up. My period was super late. It's always been very regular, very normal, healthy flow. It was about 10 days late and spotting. Then so when I went back in to start my next cycle, I had two ovarian cysts. I had to have those aspirated.

Then our doctor said, “You can continue the next cycle. This shouldn't affect it.” Going into the next cycle, my follicle count was the lowest we've had yet. It was at nine. We decided to go forward anyway. This round we wanted to more try a mini approach to see if I would respond better because my AMH is low. We did a mini antagonist protocol.

It was priming with birth control again for eight to nine days, a hundred milligrams Clomid, 150 Menopur, Omnitrope and dexamethasone in case I'm having some sort of autoimmune that I don't know about. It was going okay. I mean, we knew to expect less eggs. I had nine to begin with. There was four follicles that were growing really nicely. By day 10, I had four that were 18, 18, 23 and 24. My estradiol was 1305.

We're like, “Okay. Let's go for it. If we can get these four and they're better quality, this will be good.” After retrieval, it was three eggs. He said one of the follicles, one of the 18s was empty. I don't know if it was sick or-

Aimee Raupp:

[inaudible 00:07:40]. Yeah.

Megan:

… or I don't know why that happens. Then so two are mature. Two fertilized. We're still waiting to hear. Actually, hopefully today we'll hear how it turned out. Yeah. That's my story so far. I'm just confused as to why my follicle count seems to be normal, but I can only get like two to three eggs to mature per cycle. Also, my estradiol is normal. Then why is there not mature eggs when we get there?

Aimee Raupp:

Yeah. I mean, a lot of times that can be the meds. It's almost like looking at this cycle versus the first cycle, I think you got the same rate but I think a much less intense protocol. We would hope that this one… I mean, if you're going to test them, this will render better quality. But it's also like, just because we see that many follicles doesn't mean every single one of them's going to mature and turn out.

That's how I would look at it too. It is a bit of like a learning curve. That's what they're doing with you, because it's been a different attempt at medicine each different time. It's like we're learning. I mean, I feel like you're still young enough that it's not what I always see that the high-dose meds compromise the quality, but to me, and you could tell me, was this easier on your body, this cycle than the first cycle or about the same?

Megan:

Well, it's hard to say because the first cycle I was just very nervous and stressed. I also had stopped working out because COVID was really bad in January. I stopped going to the gym. I hadn't made a lot of positive changes that I've made since then in terms of diet. I've cut out all caffeine, alcohol since January. I just have felt better in general

Aimee Raupp:

In general. Okay.

Megan:

I would say felt better, but I don't know if it was the meds or-

Aimee Raupp:

Yeah. If it's all the things combined. That's where I would shift focus of like… I mean, it's so easy to just be like, “Don't get caught up in the numbers.” I don't mean it like that in a dismissive way, but it's like, I would try to just shift the game. I mean, understanding obviously you guys have to do fertility treatments, you're running low on donor sperm, all of that.

Understanding that level of stress and pressure on you, that we're going for quality over quantity, but that less is more typically I think with some of these protocols. To think, okay, maybe… And I also think it's good to step back and gauge like, “Okay. How many more cycles like this do I have in me?”

Maybe even counting that out with the sperm and then shifting focus to all the things you're doing of like, “Okay. How can I best support my body?” If you're not doing acupuncture, I think that's a smart thing to add in to get-

Megan:

Yeah, I've been doing acupuncture.

Aimee Raupp:

Okay. Get more bang for your buck, if you will. I would consider… I'm sure the dietary shifts, if you're following me on Instagram, you probably are following some of the things I say to do. I support that. What about sleep and digestion and overall health? I mean, I know all your numbers look good, but do you feel good?

Megan:

Yeah. I mean, this is literally the healthiest I've ever been. I mean, really since January, I've really dialed into… We already ate healthy, but I've just really focused on adding more veggies, adding more protein. We already don't really eat a lot of carbs. If we do it's brown rice, quinoa, that type of stuff.

I'm doing all the supplements that's recommended in It Starts with an Egg. I'm doing green smoothies with peptide collagen powder. The liver capsules.

Aimee Raupp:

Okay. Are you taking DHEA or anything like that?

Megan:

I'm sorry?

Aimee Raupp:

Are you doing DHEA?

Megan:

I take fish oil that has that [inaudible 00:11:35].

Aimee Raupp:

The DHEA, you know how she talks about the DHEA and It Starts with the Egg.

Megan:

Oh, I'm sorry. Sorry. Yeah. I was going to ask you about that. I've never had my level tested. I know you should check that before starting, but I'm curious, is that something that I just ask my doctor to do my test on or?

Aimee Raupp:

Yeah. DHEA-S, you want to get… It's the S, so DHEA-S, the sulfated version. That's what you want to get tested. Then C because C if you could use a little more support that might help with how many you're getting. I was asking too, because sometimes girls take the 75 as per recommended in that book without getting tested. It can actually cause follicles to hide. It can actually do the opposite.

You want to be really cautious when you take it. Then I would… The prenatal, the quality fish oil, I would even think about increasing fish oil, if you're not taking upwards of like 3000 milligrams. That can be helpful too with the essential fatty acids in there for the eggs. You're doing all the protein and all the veg and all that. Are you doing liver?

Megan:

Yeah. I just recently added liver capsules. I can't really stand the taste. I've also been doing spirulina capsules. I've been doing that for a while. Yeah. I mean, I eat a lot of protein.

Aimee Raupp:

Yeah. Okay. Good. Then exercise, and your BMI's not too low. What is your BMI? Do you know?

Megan:

I think 24. I mean, it's… But I feel super healthy. I wouldn't consider myself overweight.

Aimee Raupp:

Yeah. No, 24 is perfect. I think 24 is perfect for fertility, especially. Okay. Yeah. I mean, I think… So what's your plan? How many more cycles do you feasibly have with the sperm you have left?

Megan:

I mean, we have three vials left, but financially we are hoping to be able to be done with retrievals in two more retrievals. But I-

Aimee Raupp:

Okay. I think that's a good number.

Megan:

Yeah. I just am worried that if we keep our statistic that we have already, which is one blast per cycle with four, for two kids after PTG, it's-

Aimee Raupp:

The other thought process, I'm just going to throw that out there, is that if you bank a handful of embryos and then what if you went to an IUI with you, you know?

Megan:

Yeah. I think that is also a possibility for us that we'll do that and we might have to be pregnant at the same time. Because I feel like we won't have a lot of time to wait, but-

Aimee Raupp:

Well, you could do… That'd be fun. I think that'd be fun.

Megan:

We'd both breastfeed, so there's benefits, I suppose.

Aimee Raupp:

Yeah. That could be fun and interesting, but it's like… So right now there's one blast on ice and then we're waiting for these two to see that we made to blast. Hopefully we did, right?

Megan:

Mm-hmm.

Aimee Raupp:

Yeah. I mean, I think you want to have ideally four to six on ice to get two babies out of it. I mean, it sounds like you're doing all the things to me stay the course. I also think it's like when the pressure's on, I think it's easy to want to just stim the shit out of your ovaries to get as many as you can. It's like think about that too, of like, okay, is that the best for these growing eggs versus doing a mini?

Megan:

For me, it's hard because I have that normal follicle count that I just see them there and I'm like, why aren't you growing? It's like if we were to have few-

Aimee Raupp:

Have they ever talked about a luteal phase retrieval? Because sometimes they do two retrievals in one cycle in a sense. Have you ever heard of that?

Megan:

The DuoStim? Yeah. I asked our doctor about it. He says he doesn't do it because it's too new.

Aimee Raupp:

Yeah. Yeah. Because that's what happens is some of them just aren't there, but they'll be there in a week or two. They go back in for them, you know?

Megan:

Yeah.

Aimee Raupp:

But it's also like… Yeah. I mean, I guess it's more like the time of the pressure and going through the retrievals, but you still have a really good count. It's like each cycle you'll get those, but I think it's normal that you'll see maybe nine growing, we get… You know what I mean? Four to six and then how many fertilized?

The attrition isn't that far off. I mean, I don't know what you found in your own research, but I don't think the attrition's that far off.

Megan:

Yeah.

Aimee Raupp:

The things I feel like can help is sure, you could look into the Ozone Sauna. I feel like that helps with blastocyst rate. Acupuncture. I love the castor oil packs when you're not cycling, that kind of stuff really for circulation and blood flow.

Megan:

I did just buy supplies to do castor oil packs. I was just wondering how often? When's the best time to do it? What is your usual-

Aimee Raupp:

Yeah. I mean, right now you're not doing anything. You're just going to wait for a period basically. You could do them now like every day, about 20 minutes a day. I have a video on all the ins and outs, but it's like… I have my hot water bottles on the floor right now, but I did it earlier. I just put castor oil on my tummy and then I just sit. I'm at my desk doing work.

I stick it into my pants, the hot water bottle and keep it on for like 20 minutes. For you, I would do it in the off time. When you start stimming again, we don't do it. Right now you could do it leading up to the period and then once you start stimming again, stop. Then the same thing, once the retrieval's done, you can go back to it.

Megan:

Okay. Then another question I have is, do you have any opinions on estrogen priming versus birth control? I'm just wondering, is the birth control oversuppressing me?

Aimee Raupp:

Yeah, I think it did. I think it suppressed too.

Megan:

Our clinic is very large and I know they prefer birth control because you can schedule everything. I'm just wondering if we did estrogen priming, if I'd have a result.

Aimee Raupp:

Yeah. I would try it because the birth control can definitely suppress. I mean, you see it a hundred percent.

Megan:

Okay.

Aimee Raupp:

Obviously it did do that to you in that cycle.

Megan:

Yeah. I mean, they have us go in for a baseline to check everything and then you go back in after you're done the birth control and every time my follicles drop by like a third. I've asked about it and they just said, “Oh, that's normal.” I'm just thinking if I really do have such low reserve, maybe that drop-off is okay for people with more eggs, but it's going to be detrimental for someone that doesn't have very many.

Aimee Raupp:

Yeah. Yeah. Your antral follicle count isn't saying you don't have very many, I would say that. AMH, they both jump around a lot. It's like try to work on that story a little bit too, of like, “Okay. I have all the eggs I need, I have all the eggs I need.” But it is. It's a real art. It's not truly a science like the IVF and figuring out what's right for each girl.

Aimee Raupp:

You might do just much better with just starting fresh and not doing the pill so that they can time you, but that might be tough if that's the only clinic that you can use and your insurance and things of that nature. You could push your doc. That's what I would do. I would push back.

Megan:

Yeah. I mean, my other concern is that I've had these ovarian cysts that have popped up and I know you can control them a little more with birth control. I don't know if that's something that we should also be concerned about when deciding what to use.

Aimee Raupp:

Yeah. I mean, the cysts will really more delay the period. I think they're kind of normal to pop up when we're doing IVF because we're stimulating so many follicles to grow. I would worry more about the suppression than the cysts, personally.

Megan:

Okay.

Aimee Raupp:

That's where the castor oil packs can really be helpful too, right?

Megan:

Yeah. That's… Yeah.

Aimee Raupp:

Is that can help process that.

Megan:

That's [inaudible 00:19:50].

Aimee Raupp:

I like the Wobenzym too for the cysts. It's like a digestive enzyme. Well, it'll say on the bottle for joint pain, but it's really just a powerful anti-inflammatory, the proteolytic enzymes. They help break up cysts. You could do the same. You could do that. The same time you do the castor oil packs, like in the off part of the cycle. That could get you in better position for when you start stimming again.

Megan:

That's just like a pill or what? What is-

Aimee Raupp:

Yeah.

Megan:

Okay.

Aimee Raupp:

They're like digestive enzymes. You take like three on an empty stomach. The bottle says three, three times a day, but I usually just say, start with just one dose.

Megan:

Okay. What's it called again?

Aimee Raupp:

W-O-B and then the letter N and then Z-Y-M.

Megan:

Okay. Okay. My other question. Myo-inositol, is that some… I know that helps PCOS patients, but I've also read it can help poor responders, but then I'm finding mixed answers [inaudible 00:20:52]-

Aimee Raupp:

I know. Then some say it'll lower AMH. I did a live. You can go back and find it with the guy from Theralogix. We talked about inositol and I asked him that question specifically too. He was just like, it's very anecdotal. We're not seeing that necessarily in the data, but what myo-inositol does do, it does help regulate blood sugar, which so it'll help with PCOS patients.

Aimee Raupp:

But the research is that it's showing improvement in egg quality. If you haven't tried it, I think there's no harm in it at like 2000 milligrams a day and you could see, if you will, how you respond. I would also get the DHEA-S tested and see if maybe you need a little help with DHEA because maybe that could make a bigger difference with the recruitment.

Megan:

Okay. Okay. I think the last question I had was for vitamins. Is it better to take all your vitamins once in one day or spread them out through the whole day?

Aimee Raupp:

I think it's better to get them in than not get them in. If you can spread them out, yeah. I think like the Wobenzym is better on an empty stomach, probiotics better on empty stomach. Your fish oil, your vitamin D, anything fat-soluble valuable, you need to have food in your stomach. It is pacing them a little bit.

Megan:

Okay.

Aimee Raupp:

I think it does, it help improve absorption rather than just taking them all in one shot, but sometimes that's how I do it personally, too, because it's just like, I'm just going to get them in versus not get them in. If I can plan it, yeah, I'll break it up, kind of just to two doses basically.

Megan:

Okay. Okay. Moving forward, would you recommend that I stick with the mini protocol or should I-

Aimee Raupp:

Well, let's see what you get. Let's see what you get. I think if you get the exact same results that you got with the high-dose protocol, which you could, I'd stick with the mini. You might get two blasts and then I would definitely stick with the mini, right?

Megan:

Yeah. I guess it's just confusing because the first protocol had the Lupron and I'm just wondering if the birth control and Lupron suppressed me. If we did the antagonist protocol and added a lower dose of Follistim would I be able to recruit more follicle?

Aimee Raupp:

You could potentially, but low dose, like 150, not 450. The one clinic I work with, I see that. He has a rule of thumb that if there's less than three follicles, antral follicle count, only Clomid and letrozole. If there's more than three, he still does a low dose, 150, and some clinics, and they have great results with it, they taper up.

Aimee Raupp:

They start like 150 of Follistim and then they taper up to like… And watching estrogen, watching everybody grow. It's like a little bit of magic in there. That could be a good approach for you if your doctor… It sounds like your doctor's pretty open to trying different things. I would bring that up.

Megan:

Yeah. Yeah. He-

Aimee Raupp:

I think it's called the ladder approach. The ladder is what they call it with the Follistim or throwing in… Because you did birth control prime, a hundred milligrams of Clomid. What else?

Megan:

I did Omnitrope and dexamethasone.

Aimee Raupp:

Yeah. Yeah. I would try the Follistim next time, but low dose.

Megan:

Okay. Okay. Yeah. Because it's hard for me to have good follicle count and go in with mini like, “Okay. We're going to try for three.” I want to be that overachiever. You know?

Aimee Raupp:

I know. I know.

Megan:

But it's like each round that we spend so much money because our insurance doesn't cover anything, these trial and errors they just kill you.

Aimee Raupp:

Exhausting.

Megan:

Yeah. Okay. I mean, I think that's all the questions I had.

Aimee Raupp:

Okay. Well, keep me posted.

Megan:

I will. Thank you.

Aimee Raupp:

Sending you love. Good luck.

Megan:

Thank you.

Aimee Raupp:

Hopefully you get a good call today. It'll be so great to get two and then you're at three. Yeah. Then just I think it's smart to maybe go back to the mini, but with adding in the Follistim and let's see too, because of course quality is important. Then to consider of maybe we have enough, maybe we do a transfer in her, an IUI in you. Let's see how it goes, you know?

Megan:

Yeah. Yeah. Okay.

Aimee Raupp:

That'd be fun.

Megan:

Thank you.

Aimee Raupp:

If you are both pregnant at the same time, I'd love a picture.

Megan:

Yes. Definitely.

Aimee Raupp:

I know. Dreams. Dreams.

Megan:

That was never our plan, but it might have to be so you know?

Aimee Raupp:

Yeah.

Megan:

We'll see.

Aimee Raupp:

Well, and that's it too. I mean, again, it's so easy for me to sit here and say this, but it's just try to trust the timing a little bit too.

Megan:

Yeah.

Aimee Raupp:

Life doesn't always go according to plan, we all know that, right?

Megan:

Absolutely.

Aimee Raupp:

It's like, they're going to come through when they're meant to come through. You're on this path. You're determined. You'll do it, so just surrender a little.

Megan:

Okay.

Aimee Raupp:

Okay?

Megan:

Okay.

Aimee Raupp:

Okay.

Megan:

Thank you so much.

Aimee Raupp:

All right. Thank you. Thank you. All right. I will talk to you soon. Thanks so much. Bye.

Megan:

Okay. Bye.

Aimee Raupp:

All right guys. That was a good one. There's a couple of questions. It's not really a Q&A but I think there was a question about castor oil. I'm so glad you loved the Ignite program, Meg. Thank you. Coming on again in two weeks, Megan. I will pick you. There were so many that jumped on today. Thank you for that. My team is not on managing, so I want to just make sure.

There was something about castor oil packs. Can you use the castor oil in the two-week wait? No. Not in the two-week wait. Her case was different because she's just doing retrievals and then they're not trying at home. Her two-week wait is different, so she can do them. If you could be pregnant, no, don't do them in a two-week wait. Oh, you did the Ignite as well. Well, thank you, guys. Thank you. Okay.

I have a whole video on castor oil packs. Just Google Aimee Raupp castor oil. It's on YouTube. There's a blog post that goes with it. All the information is there. You're going to go and watching it. I say that not to be lazy, but to empower you, okay? Then I'm not going to answer any more questions because it's not a Q&A. I am doing a Q&A this week on my live. I'll see you guys there.

It's about The Egg Quality Diet, so anything and everything, okay? Love you guys. Also, you Arban with Hannah. Just keep requesting to join because now people are coming on at once and so I will pick you guys. Your names are in my head, okay? Sending you-

END TRANSCRIPT.

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Disclaimer: Please keep in mind that I am not a medical doctor. I have been a practitioner of Traditional Chinese Medicine for over 17 years and I will be speaking from my clinical experience helping thousands of women conceive. The office of Aimee E. Raupp, M.S., L.Ac and Aimee Raupp Wellness & Fertility Centers and all personnel associated with the practice do not use social media to convey medical advice. This video will be posted to Aimee’s channels to educate and inspire others on the fertility journey.