Protocol for poor responders (prev. success ment)

[BC-tammylj]

My first IVF was successful. At the time I my FSH was 11.3 and AMH was 0.4. I was a poor responder though. They asked me at one point whether or not I wanted to cancel because the believed they would only retrieve 2 or 3 eggs. I didn't (thankfully) and the actually got 4 mature eggs, but they were not the best quality. My embryos were not the best quality either. It really was a fluke that it worked, not that I'm complaining! But now that we are looking at IVF#2, I wondered if I should ask the RE to try a different protocol altogether, or just increase the dose of the stims.

I did an antagonist cycle with Ganirelex, Bravelle and Menopur. I was thinking of asking about doing a microdose Lupron flare instead to "wake up" my ovaries. My right ovary only produced 1 follicle last time and I'm wondering if we can wake it up! lol

Thoughts?

[KimAtFertilityAuthority]

Looking at the title of your post, I was going to suggest Lupron Flare as well. It never hurts to suggest/ask questions to your RE.

Good luck!

[BC-tammylj]

I've been looking into it more and it seems like microdose Lupron flare may be the way to go. I'm going to ask my RE about it during our consult on Monday.

[heatherfla]

Hello,
I did antagonist with both of my previous IVF cycles and poor response each time even though I have a normal FSH (7ish) I had 7 eggs retrieved each time and 5 mature the first time, 4 the second even though the second Antagonist cycle was more aggressive and did use BCP prior but estrogen priming (both were Gonal F / Menopur cycles). Had I gone forward with another own egg cycle, the three clinics that I consulted with all recommended the route you are thinking of w/ Lupron microflare. Not sure I would recommend estrogen priming.

[heatherfla]

Hello,
I did antagonist with both of my previous IVF cycles and poor response each time even though I have a normal FSH (7ish) I had 7 eggs retrieved each time and 5 mature the first time, 4 the second even though the second Antagonist cycle was more aggressive and did not use BCP prior but estrogen priming (both were Gonal F / Menopur cycles). Had I gone forward with another own egg cycle, the three clinics that I consulted with all recommended the route you are thinking of w/ Lupron microflare. Not sure I would recommend estrogen priming.

[BC-tammylj]

Thanks heatherfla. The more I look into it, the more I want to push my RE to try it. I did my day 3 labs yesterday, so curious what my FSH is now after 2 years. I imagine it's worse than before, so I think the flare would be a good protocol to use.

[cathy25]

Everyone's different but I had much better luck with antagonist. When I did lupron flare I had no response at all. Estrogen priming gave me a small response (1 mature egg retrieved). Antagonist with high a dose of menopur gave me the best result (3 mature eggs retrieved).

[jenga12576]

I have done antagonist and microdose lupron flare, success with antagonist 2 times, and BFn with horrible response from microdose lupron flare......

antagonist 6 eggs retrieved, mature
microdose lupron flare only 3 mature eggs
antagonist 13 eggs/ 12 mature WITH an amh level of 0.5 at age 34

i have found that women are more likely to be canceled long into a microdose lupron flare than an antagonist, i have read alot about the 2 protocols their is negative and positive thoughts on both.

Since antagonist worked for you, i would do it again, maybe try not to use BCP prior and up the dose of stims, also maybe DHEA, talk to your RE about it...... antagonist is a much easier protocol in my opinion

Jen

[BC-tammylj]

Thank you Jen. I have been thinking more and more about it. Last time I was not on the max dose of stims, so maybe I'll just see about doing an antagonist starting out at a higher dose. I see my RE today, so I'll see what he says!

I just started DHEA. Hopefully I'll be taking it long enough to make a difference!

[BC-tammylj]

Just wanted to say too that I can't really do a cycle without BCPs. I get cysts all the freakin' time and I would never be able to start a cycle if I didn't take BCPs to keep a cyst from forming. Last time I was on BCPs for 4 weeks because I had a cyst and had to wait 2 more weeks until it became inactive. Hoping that if I can only be on BCPs for 2 weeks that it may help. I do have a cyst now, just not sure if it is active or not. I found out about it about 3 weeks ago when I went to the ER for abdominal pain. It may be gone now, hopefully! I sometimes wonder even though the cyst I had wasn't active, if just having it may have caused an issue while stimming.