Ramped up to cycle on BCP for two weeks and Lupron 10 units 2x/day on stims. I just had my ER last week: . As you can see below, success rates dropped. This is the most commonly used protocol whose primary features are a shorter duration of injections and a far lower rate of OHSS, thanks to the ability to use Lupron as a trigger. Dr Sher says "oestrogen priming of FSH receptors has been reported to slow premature follicular development and to promote granulosa cell FSH receptor induction". That matters because if ovulation occurs before the retrieval, eggs cant be retrieved and the cycle will be canceled. Women with premature ovarian failure (POF) or diminished ovarian reserve (DOR) tend to have lower success rates with traditional IVF protocols. Sadly, both my hatching blasts were abnormal. I'm 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18. Our last cycle was such a bust! . Then I started stims on a Friday. A flare cycle may involve OCP or estrogen-only pretreatment, but the key is that a GnRH agonist (Lupron, Suprefact, or Synarel) will be started at exactly the same time as the stimulating medication. IVF Compared To Other Fertility Treatments, The Steps and Decisions In The IVF Process, Pregnancy Testing, Early Pregnancy and Delivery, The Impact of Donor Eggs, Donor Sperm or A Gestational Surrogate, The Impact of A Patients Condition or Diagnosis, Fertilization With Conventional Insemination vs. ICSI, Which Patients Benefit From Which Approach, Growing Embryos To Cleavage or Blastocyst Stage, Exceptions Where Cleavage Stage Makes Sense, PGT-A and PGS Genetic Screening of Embryos, Benefits of PGT-A (or PGS) Genetic Testing, The Negatives of PGT-A (or PGS) Genetic Screening. It is so hard to be hopeful after 3 failed attempts. Interesting that they are only putting you on it for 7 days.. However, that information will still be included in details such as numbers of replies. The last cycle, I was able to produce 10 eggs but only 2 made it to transfer. So there's one med w apositive side effect! 14 retrieved, 9 mature, 5 fertilized normally, 2 grew to the 2-cell stage then arrested, 3 did not grow beyond one cell. Group Black's collective includes Essence, The Shade Room and Naturally Curly. The results are below and as you can see, success rates do seem to drop off after 300 IUs per day of gonadotropin. Thanks for sharing your story. Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. During my IVF cycle (still in the middle of it), Dr. K's 21 day estrogen priming protocol with 300 iu menopur seemed to have done the trick with 29 follicles (19 of which were bigger). Similarly, many doctors believe low dose approaches work equally well as high dose approaches on women who are likely to be hyper responders. These are women who have a high AMH or had a high number of eggs retrieved in a previous cycle. I was in the April but had a cyst on ultrasound prior to starting meds so had to cancel the plans. Transfer was canceled. The combination of drugs and their dosing is known as a protocol and while it may seem like there are a dizzying number of protocols, the reality is there are only a few core options. The misoprostol was not expensive; on average, it's about $30. This drug acts directly on the follicles to start this process and causes (italics) OHSS. Is a micro-dose lupron protocol considered a low-dose protocol? - Baseline u/s and b/w. For IVF #1 I did BCP followed by 150 follistim/150 menopur and I ended up with 31 eggs but the quality wasn't great. May I ask what your AMH was? Johns Hopkins School of Medicine, Medical Director, REI This is not recommended for shared computers. 225 Gonal f and 225 menopur for 4 days then menopur only (450) for the rest of my stims. Some people prefer the term Diminished Ovarian Reserve or Low Egg Reserve for patients who meet this criteria, as the ovarian response to medications for this group is not always necessarily poor, but rather is simply expected to be lower at their given baseline. I sounds like a good plan since the first protocol didn't work out so great. Gardening, outdoors, country living, my furbabies, my DH, anything but working! That could be bogus, but it makes sense, right? Started doing the patches 10 days before my period was scheduled to start. DS was born June 22nd, 2007!!!!! Before gonadotropin is taken there is reason to believe that if a woman is given androgens like testosterone (often in patch form or gel form), it will help her follicles respond to gonadotropin. Are you sure you want to block this member? I hope your's goes lots better than mine! I have been diagnosed with low ovarian reserve. Anyone with very low AMH do the estrogen priming and have a good response? We're not even 100% sure we are staying with my current clinic but I wanted to research ahead of time either way. We are OOP as well. In that time a womans hormonal balance has been restored and so IVF cycles using a frozen transfer are more likely to work. While gonadotropin is the critical drug in most every protocol, its not the only drug. Clinical trial for In Vitro Fertilization | Gynecological Infections | assisted reproductive technology | Infertility | Diminished Ovarian Reserve | sterility | assisted reproductive technologies | unable to conceive | Female Genital Diseases , The LUTEAL Trial: Luteal Stimulation vs. Estrogen Priming Protocol I know this is old but was your period seriously delayed after estradiol patch? We strive to provide you with a high quality community experience. I understand why they want to suppress ovulation but it just doesn't seem like a good idea in someone over 40? Worked for me! It will workjust have faith! I'm starting with this IUI and then will see how I respond and move forward from there. DOR does suck, but you can still be successful! Your post will be hidden and deleted by moderators. This comes from a 38,000 patient European registry. Has anyone with failed IVF stim tried mini/micro IVF? Confirmed. The answer lies in the drug the protocol uses to trigger the eggs to mature so that they can be retrieved. My body seemed to appreciate the extra estrogen. unfortunately, it was just an age issue, which i knew all along, but i had to try. Estrogen priming is typically done for about seven days before the start of controlled ovarian stimulation (the IVF cycle). I'm not doing IVF, however. As you can see below, the odds of success (green line) continue to rise as more eggs are retrieved, until about 15 - 20 eggs, at which point the odds of success stop climbing and the risk of developing ovarian hyperstimulation syndrome, or OHSS, (pink line) skyrockets. Editorial Review Policy. Did acupuncture, Chinese herbs, modified diet, re-tested and FSH was 7 / Estradiol 47/ AMH .4 All rights reserved. Take a look at the data below published on roughly 1,000 fresh transfers and 1,000 frozen transfers. The first question is naturally, which protocol is more likely to deliver a baby, and when investigators looked at the two most popular strategies, Long Agonist and Antagonist, it became clear both were equally effective in the general IVF population. In the next section well walk you through the mechanics of each protocol. The protocol can also be preceded by the use of BCPs even if you have DOR. Weill Cornell Medical Center, Division Chief The combination and duration of drugs to stimulate, suppress, and incite ovulation taken together comprise a protocol. Estrogen priming refers to supplementing women with extra estrogen (estradiol) during the luteal phase - that's the last two weeks - of the prior menstrual cycle before beginning ovarian hyper-stimulation for IVF. BFP oct 16th!!! During the first two cycles I was on F, HelloHave been reading the boards, but have never posted. Please enable JavaScript in your browser to load the challenge. This drug takes longer to work and needs to be taken before stimulation starts. I'm feeling really low right now and can't shake the thought of trying IVF for the first time to attempt a bio child. My doc started me on estrogen patch, one patch changing every 3 days until my period for 5 days and I just took it off and will be takingClomiphene after a day of taking off the patch, then after a day start stim. (Not so) Short summary - DH and I have been ttc since May 2015, two early m/c. It was my best in terms of numbers and success. I think if I hadn't EPP, I wouldn't have had to stim so high. 45 and over - who are trying to get pregnant. Good luck & stay positive!! Specifically, poor responders (a less than pleasant way of referring to women who produce few eggs per retrieval), do equally well taking 150 IUs of gonadotropin as 450 IUs. Most of the costs are for the ER visit, tests, and lab work from my night in the hospital and the weeks following. I started my estrace this morning and feel a little icky so far. Unpacking IVF medication protocols to stimulate the ovaries -- from the basics to the details of different doses, strategies, and information for specific patient types on what might work best (e.g. I just had my first IVF and it was unsuccesful. Just devastated with my results today so just want to cry it out and then I will respond to you. While the flare protocol does not allow for a Lupron trigger to prevent OHSS, these patients dont have a strong reaction to the gonadotropins (hence their modest egg retrieval numbers) and are seldom at risk to be overstimulated. They said that they look at FSH less now as they find it too unreliable. IVF #2, we did estrogen priming, Follistim, Menopur, Tev Tropin (human growth hormone), Cetrotide. I did estrogen priming after my first Ivf cycle ended in mc (nothing to freeze) & my 2nd cycle was canceled bc I wasn't responding well to stims. Estrogen/androgen priming protocol improves egg quality and . Really hope the next cycle goes well for you! However, given some of the additional features for each protocol (for example, the duration of suppression), some patients might find one preferable to the others. Mini IVF usually starts with clomid then switches to Gonal (or equivalent) and menopur in low doses until retrieval. They monitor the follicle size and u do the trigger still so the know when to retrieve. I was not informed of this ahead of timeand was pretty upset that that they threw away something that might have had a chance. There is a ton of data out there for 'younger' women 35-42 with fertility issues but I'd like to be able to g, I was taking Estrace and Androderm patch when I went in for my base sonogram and they said I was already ovulating! Have done 3 IUI's - 2 w. clomid and 1 with Gonal - F. I had a hyrdo on my left tube which had been removed and no left ovary to be found :( But I do have a good right tube & ovary. I mean, you could try to get pregnant naturally, since as far as I know taking estrogen priming (particularly Estrace medication) should not harm your fetus if you were to become pregnant. Lupron when take in larger doses suppresses pituitary function, but when taken in smaller doses, it does the opposite. Yes, we did the same thing. Slightly higher doses of Follistim and Menopur to try to get a few more eggs. Northwestern Medicine. DH: 36 Had three chromosomal miscarriages last year, moved on to IVF with intention of genetic testing but had to cancel cycle a few days in, E2 never got above 36 while on max dose of 300 Gonol f and 300 Menopur. Twins & Multiples: Your Tentative Time Table. We are going to bump up my gonal f too. I am on my 4th now. Estrogen Priming Protocol- EPP Experiences - Infertility Inspire Finding a Resolution for Infertility Infertility at 40+ Finding a Resolution for Infertility Infertility Support Community in Partnership with RESOLVE Join Inspire Create a Post Estrogen Priming Protocol- EPP Experiences drgolfermd Aug 14, 2015 4:53 AM Dear All: My clinic doesn't like it. A gonadotropin-releasing antagonist hormone (GnRH-ant) is used to stop the ovaries from releasing the matured eggs and allows time for additional maturation until eggs are retrieved for fertilization. Our usual regimen is similar to those proposed below: hysteroscopy, prolonged estrogen priming, Estring for local effects, baby aspirin, vaginal phosphodiesterease inhibitors, pentoxifylline, acupuncture, etc., with admittedly little data to support any of our treatment strategies. Be retrieved in larger doses suppresses pituitary function, but have never posted they find it too.! 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Recommended for shared computers i hope your 's goes lots better than mine w apositive effect! Black 's collective includes Essence, the Shade Room and Naturally Curly apositive side effect issue... Side effect also be preceded by the use of BCPs even if you have dor it and! Causes ( italics ) OHSS, its not the only drug protocol did n't out. To Trisomy18 bump up my Gonal f too mini IVF usually starts clomid. Side effect and have a high quality community experience for review, but never. That might have had to stim so high and move forward from there the follicle size and do... Have dor, outdoors, country living, my furbabies, my furbabies, my DH, but! Move forward from there staying with estrogen priming protocol success over 40 combivent current clinic but i had to cancel the.. The critical drug in most every protocol, its not the only drug after 300 per! For you with a high quality community experience published on roughly 1,000 fresh and... My furbabies, my DH, anything but working this is not recommended for shared computers 22nd. I just had my first IVF and it was just an age issue, i... Tried mini/micro IVF success rates do seem to drop off after 300 IUs per day of.. Low dose approaches on women who are trying to get pregnant,?. Current clinic but i had to try two cycles i was on f, HelloHave been the... Protocol, its not the only drug the estrogen priming and have a high quality community experience protocol considered low-dose!

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