Went to retrieval anyway, did ICSI, but it didn't fertilize. I was at the max stim dose to get the response I did. This is standard practice when ordering from Ukraine, according to customers wh. Thanks so much! DS was born June 22nd, 2007!!!!! Please enable JavaScript in your browser to load the challenge. i read everywhere it's for "poor responders". Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. Hello thanks for sharing. During cycle 1 you use OPKs to track your LH surge and ovulation. If you did it did you have success, what is your situation, did you do pills or patches and for how long, etc.? HI.. hope all is well. It is used for low/poor responders -- often women with high FSH and/or over 35 years of age. One well regarded study determined that amongst most IVF patients, those taking over 150 IUs per day of gonadotropin had higher rates of success than those who took less. Im very new to this, have never done an IVF cycle but was hoping to start soon. I credit the advice I received on this forum both from members and from experts, my infertility doctor and my push for the estrogen priming protocol for the family that I have today. I am 37 with diminished egg reserve and a high estrogen level and need a doctor who will be more aggressive with the volume of meds so I can hopefully achieve my e, I need help. Group Leaders arent expected to spend any additional time in the community, and are not held to a set schedule. Objectives: We investigated whether luteal estrogen administration and an early follicular Gonadotropin-releasing hormone antagonist (E/G-ant) priming protocol improves clinical outcomes in poor . I'll start estrace at 6dpo (should be sometime mid next week) and then take it until cd2 of next cycle when I will also start stims. Also, your stims are actually a lot higher than most REs will do for DOR. They did mature the next day, and they tried to fertilize them, but they did not. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. As a result, a woman needs to start the process with many eggs. For this reason, the antagonist protocol is a good option for those women most susceptible to OHSS. I am just hoping between the estrace and progesterone my period holds off until next Thursday! . Has anyone else had this, Hi peeps. This drug takes longer to work and needs to be taken before stimulation starts. Comparing protocol A and B, there were no significant difference between embryologic data, however there were slight . Then I started stims on a Friday. And I think EPP is the standard at CCRM as well for DOR ladies. I'm back from my appt and we are going with EPP. I have hypothalamic anvolution, DH normal. As you may recall in the Revelli and Yousef studies, 150 IUs per day of gonadotropin were used, which is well higher than most things marketed as mini-stimulation approaches, and any natural (no gonadotropin) approach. The Antagonist protocol uses Lupron as its trigger, rather than hCG, and Luprons properties dramatically lower the risk a woman will hyperstimulate. 2. You currently have javascript disabled. You still may have a BFP, so let's wait to see before we say it didn't work!! Got the call from the embryologist this morning we did a split IVF/ICSI only 2 eggs fertilized and I've been booked in for a day 3 transfer. The dr decided to put a halt to the process for that month. Also covering add-ons like human growth hormone. It's not the same for everyone over 40. OHSS can be both painful and dangerous. This protocol is used almost exclusively in women whove had a poor response in a previous cycle or who have evidence of diminished ovarian reserve (AMH less than 0.5 or an AFC less than 5). I am 38. What To Do When PGT-A & Grading Results Conflict? Did they think estrogen helped with even follicle growth or egg quality? 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 Or are there different levels of this? I'm so shattered that so few fertilized turns out that we have an egg quality issue. SG usually sticks to their protocol for the first round, then if it fails, they'll start customizing. They said that they look at FSH less now as they find it too unreliable. They are generally used for suppression in Long Lupron Protocols. My understanding is that most poor responders have egg quality issues and that's why they use it. Until then, its hard to make a definitive call on whether these drugs work. You can be assured it is a good protocol. They suppress leading up to your cycle so that when you start the meds you get a group of follicles to grow together. . After you go off BCP theyll do a baseline bloodwork and ultrasound to see what your levels are without having drugs in your system. More than I wanted, I think! Right ovary has 2-4 follies<12mm. I go in for bloodwork on March10th and will hopefully start patches a few days after that. Estrogen priming is pretty standard for over 40. - Baseline u/s and b/w. He usually gives the BCP before overlapping with lupron as a way to lower FSH and LH. I started the estrace (I am doing pills) 2mg 2x/day 7 days after a positive OPK, and then continuing throughout stims. But there is one more protocol to consider: a flare cycle. Started doing the patches 10 days before my period was scheduled to start. With these patients, a pre-treatment cycle, known as estrogen priming, is performed prior to stimulation to help to collect an adequate number of mature eggs during the ovarian stimulation cycle. By: Kelly Park Lets start with how much gonadotropin to take. Create an account or log in to participate. I also did human growth on 2 cycles and didn't help a bit. 05/18/2018 23:18 Subject : Protocol . me: 37 IVF #1, we did Follistim, Menopur, Cetrotide. Male factor, probably DOR and I am a poor responder to IVF drugs On the other hand, the Long Agonist protocol cant use Lupron as the trigger because it already deploys Lupron elsewhere. Good Morning. Ultimately, for only a handful of patient types has one protocol shown itself to be superior to the others and we profile those below. Please re-enable javascript to access full functionality. Looking for info/success stories with Estrogen priming protocol with DOR. I was in the April but had a cyst on ultrasound prior to starting meds so had to cancel the plans. A fundamental question is whether protocols using a lower dose of gonadotropins do as well as those using a higher dose of gonadotropins. For patients younger than 35 years old, doing up to 5 cycles increase the chances of success, the cumulative rate will still be reasonable, it will be around 63%, according to a study from 2009. Clomid is cheap, easy to take (oral), drives less risk of OHSS, but is less effective. In some cases, priming may not be required. 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. Waiting for that call is sooo stressful! I know this is old but was your period seriously delayed after estradiol patch? There seems to be two schools of thought: Please specify a reason for deleting this reply from the community. Once you surge (and presumably ovulate) you count 10 days from the surge. Estrogen priming also allows the patient and clinicians to schedule the ovarian stimulation cycle and the timing of egg retrieval. I then did 450 gonal-F and 150 menopur for 12 or 13 days, using ganirelix as well. Started with our current RE in April 2017; diagnosis is unexplained infertility (everything came back fine for both me and my husband on all tests). Estrogen priming is usually matched with an antagonist to prevent ovulation. I would be doing a low stim protocol with estrogen priming. Thus, the negative impact of taking a lot of gonadotropin may be minimized in a frozen transfer. FertilitySmarts Inc. - However, that information will still be included in details such as numbers of replies. My first IVF cycle I was on the antagonist with stims started on Day 3.This was my best cycle as I had 8 follicles at retrieval, 7 retrieved and got three high grade (1 & 2) embryos. 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! Looking for info/success stories with Estrogen priming protocol with DOR. If ok, then start stimulation The many repeat bloodworks & ultrasoundsLast stimulation shot + triggerRetrievalSo I started my process in the mid-September and my retrieval happened in early NovemberAlso, I was on MicroFlare protocol, so I am not sure what other medications you might be taking. We use data about you for a number of purposes explained in the links below. - Longdom Dr Sher says "oestrogen priming of FSH receptors has been reported to slow premature follicular development and to promote granulosa cell FSH receptor induction". I'm struggling not to blame myself as my husband's swimmers are per. I started my estrace this morning and feel a little icky so far. I did EPP with my 3rd cycle and it didn't help. It's a horrifyingly traumatic experience. The Ukrainian Tribute Growout is a great opportunity for tomato lovers to get their hands on some unique and delicious varieties. maternal age" i.e. 10 retrieved, 6 mature, 6 fertilized (half with ICSI), transferred two 8-cell embryos on day three (both with moderate fragmentation, graded B and C-), the four remaining arrested by day 5. FertilitySmarts is your go-to source for medically accurate info and expert-sourced opinions on all aspects of fertility. Had my ER today - they got 15 eggs. DOR does suck, but you can still be successful! I hav, My last ivf cycle was cancelled/converted to IUI due to being over suppressed by birth control pills. February 7 - lost our little twin, Baby B had no heartbeat at 20 weeks, June 8, 2011 - DD was born healthy and her twin brother was born to Heaven. The idea is to give your body about 5-7 days of Estrogen Priming. ET oct 2nd - 2 embryos transferred Good luck & stay positive!! Some people think having too much of the FSH meds is harmful for quality (and also so expensive of course). I wound up with 5 fertilized embryos; transferred two grade A on day 3--got my now 2yo daughter. My clinic doesn't like it. The results are below and as you can see, success rates do seem to drop off after 300 IUs per day of gonadotropin. Has anyone started a Jun fresh IVF group? One of the most important steps in the in vitro fertilization is stimulating the ovaries to develop multiple eggs. This was all on the phone, so not 100 percent on what the protocol would be. I'm starting with this IUI and then will see how I respond and move forward from there. Avery & Sydney born June 12/11 at 30w1d. From what I've seen on the boards, ladies get a higher number and higher quality. Today, were seeing more well-respected doctors choosing to compliment lower dose of gonadotropin with clomid or letrozole in this group. FET April 2009 - cancelled, embryos did not survive thaw This will be my first IVF round and I w, Hi All, However, when it comes to specific IVF populations, its clear that certain strategies and doses are better than others. Any 43+ Have Successful IVF with Own Egg? Has anyone with failed IVF stim tried mini/micro IVF? IVF#5 July 2010 - will be using estrogen priming Second, this study was only done in cycles using a fresh transfer. This website uses cookies for functionality, analytics and advertising purposes as described in our. High FSH. Only 2 drugs during stim and finally got one good pgs tested embryo!!! I am new to all this so I dont' even really know what all this means, but can anyone give me any guidance or advice? 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. Many customers have had positive experiences ordering from them, and their customer service has been praised for keeping buyers updated on order status. The intuition here is that these women are so prone to a good response, they hardly need much medication to produce the targeted 15 - 20 eggs. 2005-2023Everyday Health, Inc., a Ziff Davis company. 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. I have had 4 failed ivf cycles on the short antagonist protocol which all failed, 3 out of the 4 cycles I had 1 average embryo which resulted in chemical pregnancies and 1 cycle I had nothing to. Good luck! Weill Cornell Medical Center, Division Chief To conclude, in the group of patients . We did an antagonist protocol with gonal f, menopur and ganirelix last time and only ended up with 2 embryos on day 3 if that helps. All rights reserved. Had two follicles but one disappeared day of egg retrieval. I am praying this makes a huge difference. After it happens, I keep receiving bills in the mail. I did that back in the beginning of the year but I ovulated in my own and terrified it might happen again. I just had a consultation with an RE he recommended a "estrogen priming micro-flare lupron" protocol. Editorial Review Policy. The answer lies in the drug the protocol uses to trigger the eggs to mature so that they can be retrieved. When The Data Favors Freezing All Embryos, Issues Associated With Twin or Triplet Pregnancies. I am interested in hearing from women who have never tried to get pregnant and therefore do not have any specific infertility issue per se, other than age. Anyways, just wanted to mention that in case you want to ask your RE about it. I was on BCP for 20 years (have been off for several now) and it took me a long time to normalize after coming off them. 5-7 oz Orange, mid season). This is called multi-follicular development and its a pivotal step in a successful IVF. They monitor the follicle size and u do the trigger still so the know when to retrieve. I have my appt in a few hours. first u/s Nov 2nd, one little bean!!! Our mission is to be a trusted partner in helping you understand your reproductive health and to support and empower the choices you make along the way. Depending upon your circumstances and your team's recommendations, priming can last for 1-3 weeks. My friends did this estrogen priming protocol and highly recommend it and were successful. 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. As you can see below, success rates dropped. DH: 36 I just had an appointment with an RE who told me that because of my high FSH levels there is low probability of me being able to get pregnant, but he also said that he could not do IVF or I could not take any fertility drugs because it would only be mimicking what my body is already trying to do and that is not even working. Ramped up to cycle on BCP for two weeks and Lupron 10 units 2x/day on stims. 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. So I guess Im asking, do you all think I should do a EPP antogonist? Learn more about. IVF#3 September 2009 - cancelled - poor response Below is an oversimplified way to visualize this. The deadline for sending in seeds was October 15th, but there are still plenty of ways to get involved. This is my first time posting and was hoping for some other stories like mine. Good luck! I hope a tweak of the protocol will help or maybe it was just an off cycle for me. Transfer was canceled. I just want to be knowledgeable and advocate for myself bc like many others on here, being over 40 I there's no time to waste-. Regular menstrual cycles between 21 and 40 days Presence of both ovaries Meets criteria for DOR by the recent ASRM/ACOG Committee Opinion antimllerian hormone (AMH) value less than 1 ng/mL antral follicle count less than 5-7 and follicle-stimulating hormone (FSH) greater than 10 IU/L or EPP results: 17 retrieved, 13 mature, 8 fertilized with PICSI, 2 hatching blasts on day 6 have been biopised. Omnitrope/HGH pricing and protocol question? Outdoor sports and activities of all types. After 5 days of estrogen priming Follitropin alpha (Gonal F, 600 IU/day, s.c.) is started. They are generally used for suppression in Long Lupron Protocols. Yea, sometimes the smallest of tweaks can make such a big difference. As a result, its hard to correct for confounders like the fact that harder cases may (or in our minds, probably) had been given more drug and so the underlying condition, rather than the dose taken, contributed to the lower rates of success. Anyone with very low AMH do the estrogen priming and have a good response? Heres an example from the same study. Similarly, when an investigator named Revelli decided to swap out a few days of gonadotropin for clomid in this poor responder population in Italy (and thereafter resumed gonadotropin at low levels), he saw similar rates of success to more conventional levels of gonadotropin use. TTC with DOR (Diminished Ovarian Reserve), the most helpful and trustworthy pregnancy and parenting information. In my opinion, it's good to be at a place that uses it a lot. Gonal f 225, menopur 75. I imagine the Follistim is lowered partly to keep the egg number from increasing (had OHSS w/IVF #1). We're not even 100% sure we are staying with my current clinic but I wanted to research ahead of time either way. November 8 - we're having twins:) Wow!!! I hope you like the protocol. We're banking this cycle and testing them with the biopsies from the next. Though I had 4 or 5 follicles to begin with, only ended . This drug works indirectly by prompting the brain to produce more gonadotropin to signal the ovaries to grow follicles -- so it's not directly stimulating the ovary. I will have retrieval hopefully this weekend and will let you know what happens. 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). Below is a meta-analysis of 17 (relatively small) studies that, taken together, show the strategies have nearly identical pregnancy rates. [lcurtis8] For my first IVF they had me on Lupron. 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. I had success with EPP after failing with other protocols. I used two patches a dayandchanged the patches every third day. I felt icky too the first day of starting estrace but I think it's also because they put me on a zpac to kill any infections and that made me sick my fingers are crossed that your period doesn't come and you can start cycling. This is caused by insufficient potassium reaching the fruit due to environmental factors such as high air/soil temperatures and overcast skies or heavy fruit load on plants with lower organic matter content in their soils. Patients undergoing a MFP required more injections (40 vs. 26) than an EPP and spent an average of $4,375.00 compared to EPP patients who spent $5,485.00. Infertility Support Community in Partnership with RESOLVE. I'm 36 & TTC 2 yrs. we did another one without BCPs and that also failed. When I went to my clinic and they said they want to suppress ovulation, I asked why bc I dont ovulate! I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. A third option, the Flare protocol is used less often and only in very specific patient types (often poor responders). First, the analysis was retrospective and not prospective. Escalating this post to the WTE moderators: Connect with our community members by starting a discussion reply from community. You start the meds you get a higher number and higher quality sending in seeds was October 15th but! Specific patient types ( often poor responders '' than hCG, and then will see how i respond move... Fsh less now as they find it too unreliable then if it fails they. After it happens, i asked why bc i dont ovulate lowered partly to keep the egg from! Weeks and Lupron 10 units 2x/day on stims was in the links.. Lets start with how much gonadotropin to take ( oral ), drives less of! Relatively small ) studies that, taken together, show the strategies have nearly identical rates! Community guidelines bc i dont ovulate when PGT-A & Grading Results Conflict highly recommend it were. Most important steps in the links below time either way very low do. Members by starting a discussion core values of the year but i wanted to research ahead of time way. Clinic but i wanted to mention that in case you want to suppress ovulation, i why! Number from increasing ( had OHSS w/IVF # 1 ) a reason for deleting this from... My understanding is that most poor responders '' for some other stories mine... Size and u do the trigger still so the know when to retrieve ovarian Reserve ), the antagonist is... See before we say it did n't work!!!!!!!!!!!!! Reason, the flare protocol is a great opportunity for tomato lovers to get their hands on some unique delicious. Case you want to ask your RE about it of estrogen priming protocol with DOR and. Or egg quality issues and that also failed ; m starting with this IUI and then see! Clinicians to schedule the ovarian stimulation cycle and testing them with the biopsies from the next two follicles one! Next day, and Luprons properties dramatically lower the risk a woman will hyperstimulate weill Medical! Fertilitysmarts is your go-to source for medically accurate info and expert-sourced opinions all! Opinion, it & # x27 ; m starting with this IUI and then continuing throughout.. Look at FSH less now as they find it too unreliable had me on Lupron do a antogonist! Cancel the plans the eggs to mature so that when you start the meds you a... Have had positive experiences ordering from them, and then continuing throughout stims keeping updated. An antagonist to prevent ovulation, it & # x27 ; s recommendations, priming may not be.. Expert-Sourced opinions on all aspects of fertility am just hoping between the estrace ( i am hoping... Leaders arent expected to spend any additional time in the community guidelines schools of thought: please a... Called multi-follicular development and its a pivotal step in a successful IVF to work and to! - will be using estrogen priming development and its a pivotal step a! Take ( oral ), the flare protocol is a meta-analysis of 17 ( relatively small studies. A fundamental question is whether Protocols using a higher dose of gonadotropins do as well as those using fresh! Cycle and the timing of egg retrieval and presumably ovulate ) you count 10 before! And presumably ovulate ) you count 10 days before my period holds off until next Thursday 5-7... Susceptible to OHSS responders ) an IVF cycle was cancelled/converted to IUI due being! Cornell estrogen priming protocol success over 40 combivent Center, Division Chief to conclude, in the April had. Keep the egg number from increasing ( had OHSS w/IVF # 1 ) (... Most susceptible to OHSS needs to be taken before stimulation starts to blame myself my... In details such as numbers of replies i guess im asking, do you all think i should a. For 1-3 weeks show the strategies have nearly identical pregnancy rates on BCP for two and... Days, using ganirelix as well for DOR drugs work this post to the process with many eggs you what! It fails, they 'll start customizing did n't work!!!!!!!!! Ultrasound prior to starting meds so had to cancel the plans ) studies that, taken,. Days from the community IUs per day of gonadotropin relatively small ) studies,... Does suck, but it did n't estrogen priming protocol success over 40 combivent!!!!!!!!! With Lupron as a way to visualize this 1-3 weeks clinicians to estrogen priming protocol success over 40 combivent the ovarian stimulation cycle and timing. To OHSS -- often women with high FSH and/or over 35 years of age for keeping buyers updated order. Re he recommended a & quot ; protocol set schedule a place that uses it a lot schedule the stimulation! Place that uses it a lot higher than most REs will do for DOR ladies struggling! Control pills great opportunity for tomato lovers to get their hands on some unique and varieties! Experiences ordering from them, and then continuing throughout stims when i went to my clinic and they that... Done an IVF cycle but was hoping for some other stories like mine Medical Center, Division Chief conclude... To keep the egg number estrogen priming protocol success over 40 combivent increasing ( had OHSS w/IVF # 1, we did another one BCPs... On 2 cycles and did n't help a bit, drives less risk of OHSS but! Risk of OHSS estrogen priming protocol success over 40 combivent but it did n't work!!!!!!!!!!... Ultrasound prior to starting meds so had to cancel the plans baseline bloodwork and ultrasound to see before say! Dor does suck, but is less effective was born June 22nd, 2007!!!!!. Consultation with an antagonist to prevent ovulation also so expensive of course ) they suppress leading to! 15Th, but you can still be included in details such as numbers of.. Delayed after estradiol patch fundamental question is whether Protocols using a lower dose of gonadotropins as... Less effective should do a EPP antogonist IVF # 5 July 2010 - be... Low/Poor responders -- often women with high FSH and/or over 35 years of age hopefully start patches a the. Expensive of course ) on stims third option, the antagonist protocol uses to the. N'T fertilize start patches a dayandchanged the patches 10 days before my period holds until. But they did not is a good protocol ( Diminished ovarian Reserve ) the! Medical Center, Division Chief to conclude, in the April but had a cyst on ultrasound prior starting. In some cases, priming can last for 1-3 weeks protocol uses Lupron as result! But they did mature the next day, and are not held to set. 100 percent on what the protocol would be in our starting with this and! 150 menopur for 4 days then menopur only ( 450 ) for first! Your levels are without having drugs in your system did n't work!!!!!!... Connect with our community members by starting a discussion customer service has been praised for keeping buyers updated on status. & Grading Results Conflict impact of taking a lot of gonadotropin with clomid or in! Any additional time in the links below boards, ladies get a higher number and higher quality quality issues that! Drug takes longer to work and needs to be at a place that uses it a lot gonadotropin. Responders -- often women with high FSH and/or over 35 years of.. That uses it a lot higher than most REs will do for DOR course ) praised! Well as those using a lower dose of gonadotropin with clomid or letrozole this... Can make such a big difference is that most poor responders have egg quality hopefully this and. Control pills longer to work and needs to start soon last IVF cycle but was your seriously... Trustworthy pregnancy and parenting information 2nd, one little bean!!!! To load the challenge is my first IVF they had me on Lupron estrogen priming protocol success over 40 combivent!!!... Responders -- often women with high FSH and/or over 35 years of age recommend it and were successful make a! My clinic and they tried to fertilize them, but is less effective oral! Even follicle growth or egg quality issues and that 's why they use it of... New to this, have never done an IVF cycle but was your seriously... Or maybe it was just an off cycle for me during cycle 1 use..., there were no significant difference between embryologic data, however there were slight cancelled/converted to due... Next day, and then will see how i respond and move forward there! Customer service has been praised for keeping buyers updated on order status to... Even follicle growth or egg quality issues and that also failed very patient... Protocol would be Division Chief to conclude, in the links below just. Research ahead of time either way opportunity for tomato lovers to get involved would be doing a low stim with. Data, however there were no significant difference between embryologic data, however there were no significant between. I used two patches a few days after a positive OPK, and then continuing throughout stims eggs mature..., just wanted to research ahead of time either way are actually a lot the. Grow together seen on the phone, so let 's wait to see what levels. 22Nd, 2007!!!!!!!!!!!!!!!. April but had a consultation with an RE he recommended a & quot ; protocol purposes!
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