I am four days out from my fourth FET after repeated issues with failed implantation. Prior to starting this cycle, my doctor and I discussed adding an HCG booster to my semi-natural FET prep, as there is evidence that the HCG can help with implantation.

The plan we settled on was to come off birth control, and not start PIO until 6 days prior to transfer, and add estrogen and the HCG booster.

At my last ultrasound and bloodwork appointment on Tuesday, no one mentioned the HCG trigger shot, only that I would start PIO the following day to align with my ERA recommended window of 125 hours. I was also told to start oral Estrace.

My lining on Tuesday was trilaminar and measured at 7.25, which the doctor said was great. My estrogen levels were rather low, having decreased from 113 on 1/20 to 99 on 1/28. Progesterone was .02 and .03 respectively. These levels seems odd to me, on the low end of the ranges for ovulation phase.

I called the IVF coordinator today to ask about the HCG trigger and was told the doctor vetoed using it since he deems my lining and levels are fine.

This goes against what we previously discussed, and I’m confused. I also greatly distrust the IVF nurse; she has given me incorrect information several times and never really seems to know what she’s talking about. But she said that was doctor’s orders and I’m not sure about it to be honest. I don’t trust that she actually spoke to him.

I really am not pleased to be skipping the HCG shot.

So, asking about rogue protocols. If I wanted to secretly take the trigger shot, when would be the right time? I’ve had two doses of PIO (1.5cc) already. I haven’t been keeping track of my temps or LH surge because they told me not to bother.

Has anyone used HCG in a semi-natural FET and if so, when did you trigger?

I don’t necessarily want to go against doctor orders, but at no point was it communicated to me that my own hormones would determine whether it would be used.

I obviously want this transfer to work, and go into with the intended kitchen-sink approach.

Thoughts? Suggestions? Thank you!

Edit to add: I’m transferring a hatching blastocyst that was frozen on day six.