XP - cancelled IVF - questions

thishappyhouse

Im visiting from the preemie board and hoping some of you can help me.
My 1st IVF was cancelled today.  I have a history of PCOS, blocked tube + possibly damaged 2nd tube, and very preterm birth.  My AMH is 5 and all other labs normal.  My doc wanted to take a very conservative approach as to avoid OHSS and since our goal was to do an eSET.
I was on a long lupron protocol and started stims at 75 follistim / 75 menopur and 5 units lupron.  Day 5 I went in and had 26 follies between 9-10 and e2 of 589.  They immediately dropped the follistim and I went down to 75 menopur and 5 lupron.  
Day 7 there was growth and e2 was up to 715.  meds stayed the same
Day 9 there was a little more growth but e2 dropped to 140 (WTF?!)
They thought it was a lab error and had me come back day 10.  NOT a lab error e2 was 174 with a little more follicle growth - cohort follicles were around 14.  They added back to follistim
Day 11 - e2 up to 280 decrease number of follie - CANCELLED
So- Im pretty sure that the carpet was just completely pulled out from under the cycle since I was on such low meds from day 5-10.  agree?
Anyone know how they will handle the cancelled cycle?  Will I go on BCPs?  Any idea of when we can restart?Those with PCOS, high AMH or high response- what type of protocol or meds were you on?Any other thoughts?  I will go in to discuss with doc either tomorrow or tuesday.  

badrianne

I am so sorry this happened to you! It must be super frustrating and feel like such a waste. I can't be of much help but to explain what happened to me. 

I started on 225 follistim and 75 menopur by day 6 my e2 was in the hundreds and follies were small, so the upped my menopur to 150 which speed up my follicle growth and e2 and I became slightly overstimulated before retrieval. I believe my early menopur was exposed to too much light and may not have been as effected so the increased dose was too much. 

Your med dosages do seem low... but I don't have experience with PCOS. I'd ask over on the IF board because there are a lot of people with PCOS and high AMAs who have made it to retrieval and or may know the next step after a cancelled cycle. So sorry you are having to go through this junk.  (((hugs))). Just do a signature warning in advance. 

ld08271

Oh how disappointing to be cancelled! I'm so sorry. I'm sure it's devastating. I hope you can start again soon. What does your doctor have to say? 

I agree that the dose does seem a little low to start with, but given the concern with OHSS it doesn't seem unreasonable. It seems like the issue was when they reduced your medications and you lost momentum. I was doing an Antagonist protocol with Ganirelix. I started stims after 3 weeks of birth control at 150 Menopur and 75 Gonal-F. However my dose was continuously increased during the majority of my cycle. I think sometimes it just takes some trial and error to find the right dose. Next cycle they know not to decrease your dose in the beginning like that. Also, I was told and have read that the antagonist protocol puts high responders at risk for OHSS.

As for what's next, I think every doctor is different. I was told in the case of a cancelled cycle I would have to wait to have my period. Then do 3 weeks of birth control again before starting stims. Best wishes! 

ld08271

I just read my post. What I meant to say was: "Also, I was told and have read that the antagonist protocol puts high responders at LOWER risk for OHSS."