Who has used low dose hcg in their protocol and not menopur?

panda100

Hi I have a problem getting immature eggs despite using menopur and I am thinking of suggesting low dose hcg to my doctors. To anyone who has used it, what was your response to it as far as egg maturity? Why did your doctor suggest you use this and what is super expensive? Thanks in advance

tweetyknicks

I'm about to start a cycle with low-dose HCG. I paid about $90-100 for a vial of novarel and my RE's office diluted it for me. In the scheme of things, not expensive at all.

As for the rest of your questions, I can't say much. My RE's office is not terribly communicative -_-

Good luck!

Marissa6609

I used low dose HGC. I have low AMH, and my Dr uses low dose HGC for poor responders. Of my 6 eggs retrieved, 5 were mature and fertilized. My Dr (and I) were happy with the quality of the eggs, even though we didn't have many. I don't recall the cost, my insurance covered it. Good luck!!

Marissa6609

@kaly75. ... very interesting. My dr never measured my post retrival or transfer progesterone, but I was on crinone 2x/day. Next cycle do you think asking to have my progesterone monitored makes sense? (Due to my chemical).

Marissa6609

@kaly75 thanks so much for the info. I have my consult this afternoon so I'll see what he says.

KM721

@panda100--Thanks for starting this thread. My RE added low dose Hcg to my next cycle as well. I have not used menopur before, so I can't speak to that. I spoke with the pharmacy today and she gave me the copay for it, but I'm imagining you want the full ticket price. My RE added it because my initial jump in estrogen at my first checkup is not getting high enough, although by the end of my last cycle it was plenty high. He explained that it can help to get the follicles going in that early stage. Thanks for posting this and getting the discussion started! 

Marissa6609

One thing I want to mention - if your low dose hcg is premixed by the pharmacy make sure you keep refrigerated. I had a pharmacy that forget that detail so I had to toss it and get a new dose.

KM721

Good tip, @Marissa6609. It also has a 14 day shelf life after it is mixed. So, my pharmacy is doing a separate shipment of it so it comes after everything else. Also, they are going to do a second shipment which is complimentary just in case I need more after that first 14 days. I don't know if I have an awesome pharmacy or if this is common practice, but something to keep in mind! 

tweetyknicks

@KM721 I had not heard of the 14 day shelf life. I'll have to ask my clinic about that. They are not doing terribly well with communication  :-w

ddvj79

panda100

I will be starting stims Oct 9th with low dose HcG. My RE recommended Stroheckers Pharmacy in Oregon. THey compound it there with a longer shelf life (refrigerated ofcourse). It cost me $80.00 & they give all the paperwork to submit to insurance & I know couple people who got a 100% reimbursement for it from their insurance.

Also, I am on it because of I am a poor responder as well.

Hope this helps...

tweetyknicks

I just talked to my nurse (for other reasons) and she said the low-dose HCG they gave me is good for 30 days. I was going to worry about the 14 day limit because I picked it up a week and a half before I even start stims.

Any idea why your pharmacy said 14 days, @km721 ? Maybe they did it in a different way.

tweetyknicks

@kaly75 That's awfully nice! I wonder now if it's just my clinic that says 30 days. I ordered novarel and the clinic diluted it. Maybe that's the difference?

Marissa6609

I had diluted/premixed Novarel too, but my Dr. told me it had a 9 day (!) shelf life - the pharmacy didn't mention anything to me about the shelf life. 

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erbear84

I'm on micro dose HCG right now.  Can't speak about egg maturity yet (I'm on day 7), but it cost me $4 through my insurance.  I had to get a second dose shipped because it only lasted a week.  I got it through Walgreen's specialty pharmacy pre-mixed and it has to be refrigerated.

blueeyes233

My first cycle I was on Bravelle and Menopur and had a 37% maturity rate.  My second cycle we dropped the Menopur and added micro dose hCG and I had a 62% maturity rate, so a vast improvement.  I also responded to stims more quickly as my first cycle I was on stims for 12 days and the second only 8 days.  

I've since switched clinics due to moving out of state and my current RE has never done the micro dose hCG before.  I requested it since I had a much better response on it.  She is consulting with another doctor in the clinic who does use it regularly.  

With my first cycle I had a bottle of Novarel which I diluted myself (just like lupron, no big deal).  This time around the RE is ordering the premixed hCG and told me to wait to have it delivered until the day before I start stims due to the short shelf life.  She didn't mention how short just that I couldn't pre order and keep it on hand.   

blueeyes233

Oh and it doesn't really save any money on stims since you will still be on the same amount of FSH, its just all going to be Bravelle, Follistim, Gonal F, etc instead of a split between them and Menopur.  

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tweetyknicks

I started hcg the same time as stims.

Marissa6609

I started with 25 iu hcg when I started stims. When my follicles were about 12-14mm, my hcg dose increased to 200 iu.

erbear84

I stayed on the low dose HCG the entire time of stims.  Gonal-F and low dose HCG.  

I'll know how mature my 25 eggs were in about an hour or so!

erbear84

20/25 were mature!

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erbear84

No issues with LH or progesterone; my estrogen got high but those levels "looked good" according to my RE. I was on 50 iu or 0.1 mg. my RE originally had me on 100 iu/0.2 mg but decreased it before I started.

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erbear84

13 of the 20 were fertilized. I get my next update on Saturday!

KM721

@kaly75--that's the same pharmacy that I use and they also offered the complimentary second delivery if needed. 

My RE has not identified me as a "poor responder," but he wants me on it to increase the initial jump at the first checkup. I'm with others--I'll try anything if it works! 

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tweetyknicks

41 retrieved

35 mature (or 37... can't remember)

32 fertilized

2 transferred, 14 frozen

possibly increased risk for OHSS

erbear84

13/20 fertilized, 1 transferred on day 5 and 7 are frozen.

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erbear84

I did 100 units and it was eventually decreased to 50.

RunCC37

I don't know how much it cost, but I uses LD HCG in IVF #3, which was by far my best cycle.

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RunCC37

@panda100 - I'd say it was my best cycle because it was the only time we got a blastocyst. I don't recall the dosage, but we did a freeze-all and had a BFN for the FET.

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RunCC37

I'm so glad that you found my blog & the information you were seeking! I forgot that I was so thorough about documenting all of my instructions - good thing I was! Thank you for your condolences about Ninja... I'm still so sad that it didn't work out, but I'm hoping that my ninja will come back to me in another way soon

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RunCC37

@panda100 - yes! I'm going to be a Tiny Turkey, woohoo! Though I'm not blogging about the DE part of the story because my DH would like to keep that information private (I have some IRLers who stalk my blog).

przemosbabe

@panda100‌ this thread is awesome. I too was considering low dose hcg but i am paranoid because I also had a problem with rising P4 before trigger, and immature eggs , and I have seen a few things that say that that a rise in P4 not only throws off the uterine lining, but can cause immature eggs to boot. I think everyone is different as to the way their cycle will be affected by this, but this rise in P4 does mean premature lutenization has occurred. That causes other hormones, mostly testosterone to rise and in turn cause immature eggs & other eggs with abnormalities that are unseen unless you test them. Premature lutenization is not so disastrous for all women who get it because we are all different, but it can and does cause serious problems. With IVF - you have to try to mimic what happens in a natural cycle. And in a natural cycle progesterone does not rise until you ovulate. I hope more ladies join in and we can all learn from each other. Again - awesome thread.

@RunCC37‌ I too read about frosty ninja when I was searching about these protocols. Made me cry too. I'm so sorry you lost him