Monday, August 06, 2012

Hypothalamic Amenorrhea BFP update


I posted a summary of the stats I've been tracking for HA pregnancies from the Fertile Thoughts Hypothalamic Amenorrhea thread last year.  Figured it was about time I updated!  So here are the data including the additional year.  The overall percentages haven't changed by much. However, when you look at just the pregnancies since my last update (109 in total, see below), there are some interesting trends. 

First, the grand totals:

Pregnancies:  361

First post-HA pregnancy: 279 pg
Natural: 72 (26%)
Clomid: 82 (29%)
Clomid + injectables: 6 (2%)
Injectables: 68 (24%)
IVF: 45 (16%)
Other: 6 (2%) - GnRh pump (2), adoption (3), zoloft (1)

HA vets - subsequent pregnancies: 82 pg
Natural: 63 (77%)
Clomid: 4 (5%)
Injectables: 7 (9%)
IVF: 7 (9%)

m/c rate: 19%

Total pregnancies in the past year: 109

First post-HA pregnancy: 83 pg
Natural: 14 (17%)
Clomid: 31 (37%)
Injectables: 19 (23%)
IVF: 19 (23%)
GnRH pump: 1

HA vets - subsequent pregnancies: 26 pg
Natural: 20 (77%)
Clomid: 1 (4%)
Injectables: 1 (4%)
IVF: 4 (15%) - three with first from IVF, one with first two natural (that would be me!)

19 miscarriages, for a m/c rate of 17%. 

So there are a couple of interesting points in comparing the overall data with those from this past year.  First, Clomid usage seems to have increased quite a bit - perhaps because people have seen that it does work quite well with HA and are more likely to try it?  Second, that the number of people doing IVF has increased quite a bit as well.  My impression is that it's due at least in part to the high cost of injectable cycles, with people thinking they'll get more bang for their buck (higher success rate) with IVF.

It's not statistically significant, but in this past year the miscarriage rate (per cycle) from IVF was 27% (6/19), as compared to right around 15% for pregnancies that were natural (5/34), from Clomid (5/32), or injects (3/20).  Of those who miscarried after IVF (four women), one became pregnant naturally, one with Clomid, and one on a combo natural/FET cycle (with twins so both the natural and FET originally implanted, but subsequently lost one).

Notes:
1. First post-HA pregnancy is not necessarily a first pregnancy as some develop HA after having a child already due to overexercise / underfueling.
2. I have grouped Femara and Clomid (including the extended clomid protocol) together in these stats
3. Due to miscarriages, some people are represented multiple times
4. Injectables is usually Menopur as with HA we need LH in addition to FSH to have the best response to injectable cycles. Some people have used FSH + hcg or Luveris. FSH alone is more likely to lead to cycle cancellation.

6 comments:

KK said...

Nico - I like seeing these stats (I love data just like you!). I was a natural after clomid extended. Hoping to be in the natural category again for the 2nd, but good to see other options too if that doesn't work out.

Lisa said...

It's crazy the amount of miscarriages people have these days.

Hinkle said...

I am on the four cycle with injectables; becoming very discouraged! After reading this I think maybe I should of tried clomid first.

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Anonymous said...

I haven't tried any yet but my doctor suggested trying cloned first just because it is so much cheaper than injectables. He said if it doesn't work the first time then it prob wont ever work for me and to move on to injectables after that.

Nico said...

Anon, you should check out the extended clomid protocol. And hopefully you've been working on getting your weight, exercise and stress to a good place? :)