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  • IVF Protocol

    Hello,
    I have a question about IVF protocols and would appreciate your insight.

    My first IVF cycle was with 225 Follistim and Ganirelix after being on bcp for a little over a month. They were able to get 6 eggs, all mature, 3 of the eggs fertilized, 2 embryos made it to day 3 but were 6 cells and average-poor quality (background on me...I am 30 years old highest fsh tested was 10.2 normal e2 level with 3 miscarriages, 1 stillbirth, and one living child). For my last IVF cycle both embryos were transfered--the cycle did not work. The egg retrieval was difficult as my follicles were extremely hard to puncture, according to the dotor, and my follicles actually dulled the needle so the doctor had to switch needles during the retrieval. This next cycle my doctor wants to add 75 units menopur along with the 225 units follistim and ganirelix.
    I wonder a different protocol might be better? I will have been on continuous birth control for over a month before starting stims. Can being on birth control that long over supress/cause issues? Does your clinic have patients use lupron the last 4 days of birth control to help during the stim phase? Is there something we should consider doing at the start of the cycle to help with stimulation?

    Thank you.

  • #2
    Hi,

    I individualize my IVF patients to stim protocols based on many factors, including, and not limited to, their age, cycle day 3 FSH, estradiol, AMH, and antral follicle count, as well as their height, weight, and BMI. It's impossible (and illegal) for me to tell you what to do, since you're not a registered patient here. Most of our IVF patients conceive on their first IVF cycle, because my philosophy is, "do it once, do it right, and just make it work"....

    If you would like to undergo a consultation here, or want to consider highly advanced, successful, hand-holding care here, please let me know. Frankly, given your age and response, as well as your history, I would be surprised if just adding 75 units of Menopur to your same stim regimen would make a huge difference.

    All my best - Always,
    Dr. Roseff in FL
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    Comment


    • #3
      Thank you for your response. I did question whether adding 75 units of Menopur to the same stim regimen would be effective given what happened during my last cycle.

      Would you be able to provide some information on whether or not, in your practice, you have women go straight from taking birth control pills to starting stims, or do you have them overlap the last few days of birth control with Lupron or a similar medication? I understand if you cannot answer this question. I was just hoping to go back to my RE with some information that I could talk to her about and see if she would be willing to come up with a different protocol.
      Thank you.

      Comment


      • #4
        Hi,

        I only overlap Lupron with birth control pills when I'm doing a Lupron down-regulation cycle, and that type of regimen is seldom used in my practice (ESPECIALLY in a woman who is older, a poor responder, or has DOR). Overlapping pills with Lupron can SEVERELY shut someone down, and that doesn't pertain to most of my patients.

        Most of my patients stop pills and start stim shortly thereafter.

        Dr. Roseff in Florida
        Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
        PERSONALIZED/SUCCESSFUL Specialty care....

        Comment


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