What meds/doses were you on?? Tell me about Microdose Lupron.

ChristieH917

Here I am considering a new RE after my first cycle was cancelled and my second was a horrible fail.  

My current RE had me on a BCP prep cycle, then stimmed with 300 Follistim and 300 Menopur (max dosage for my RE).  I added Ganerelix in there along the way. I made it to their target for my estrogen, but it still seemed low compared to what I have seem around here.   After the failed cycle, I called to make a WTF appointment.  The best they could do was almost a month out.  I am still waiting for that appointment to hear what he has to say.  

The same day I scheduled the appointment with my RE, I looked into possibly changing REs.  I called around and did some researching.  I found this clinic with great reviews.  They take my insurance but I have to change medical groups and get a referral (HMO-fun times).  I called them to see what it would cost to get a consultation appointment and pay OOP.  To my surprise, they said it would be free and I don't have to change my insurance for the initial consultation.  The available appointments were only a little over a week out.  

The prospective new RE said that with meds at that dosage I would be classified as a low responder.   I should have never been on BCPs because I was probably over-suppressed.  He doesn't seem to like Menopur from what I gathered.  He said that he would do 300 Follistim in the morning and 300 Follistim in the evening with microdose Lupron.  

So... thanks for reading my book.  I didn't realize that I had that much to say.  

Here are my questions for you. 

What meds/dosage were you on?

How many eggs did you have retrieved?

What is microdose Lupron? Pill? Inject? Side effects?

blueeyes233

I haven't head of a micro dose Lupron protocol: long Lupron, Lupron flare, and agonist/antagonist are the ones that I know of that use Lupron.  Lupron is an injectible medication used to suppress ovulation, it's an agonist.  The needles used are insulin needles so the amount of medication used is small, typically 5-20 units.  Common side effects are headaches, hot flashes, and mood swings.  I had the headaches, no other side effects.  

My first two cycles I did the long Lupron.  My last week of BCP I started Lupron injections at 10 units.  When I started stims I dropped the dose to 5 and continued taking it until trigger.  When used to suppress ovulation, it takes a while for the Lupron to kick in which is why it is usually started before stims.  

Cycle 1: BCP, long Lupron, Bravelle/Menopur (dose between 225 and 300 combined), and hCG trigger.  Stimmed 12 days due to maturity issues.  16R, 6M, 5F

Cycle 2: BCP, long Lupron, Bravelle (300), microdose hCG, and hCG trigger.  Stimmed 8 days.  27R, 17M, 7F

This cycle my new RE will be trying me out on the antagonist protocol which does not use Lupron (except possibly as a trigger if I look like I'll get OHSS) so we'll see how that goes.  

soonihope81

Hi ,

I've done the short microdose protocole but instead of lupron, I was on buserelin (they are both GnRH agonist). This protocol is aggressive and is used on poor responders (I'm one of them). Based on my personal experience, the new RE is right, if you needed 600iu to get things moving, you shouldnt have been on BCP (or at least, for a shorter amount of time).

What meds/dosage were you on?

Buserelin
repronex 450iu (225 in the am and 225 in the pm)

How many eggs did you have retrieved?
none.. I cancelled that cycle because I only had 2 follicles developping. I though it would be best to get back to the drawing board.

What is microdose Lupron? Pill? Inject? Side effects?

The PP already explained lupron, so i wont repeat

If you don't mind me asking, have you considered trying a low dose IVF. Based on my experience and what I've read over the years, poor responders tend to do better on low dosage of meds (slow and steady). Personnaly, I always did much better on 150 (4 to 8 eggs) vs 450 and 600iu (0-2 eggs). I know we are all different and we all respond differently, but it may be worth googling

Wishing you good luck

Justone13

Hey girl!! I agree with the new re. If you are a low or poor responder you should not be on bcp. Being on them has prob over suppressed you. Is this clinic batching ladies too?? That could be a big problem for you too.

I'm on lupron now too. I do 20 a day in the morning. This is my 3rd week of bcp (only because I didn't ovulate they had to put me on it) the last 3 days I've done lupron in the morning and bcp at night. Tonight is my last bcp but I will continue the lupron until Thursday when I start my stims.

So far the best eggs I have had was my 2nd cycle and we made it to day 5. I was on menopur and bravelle with ganarelix in the am and a hcg trigger. I don't know why this worked better than the last cycle where I did the estrogen priming. My re is pretty confused at this point so we are trying the lupron. Idk if it's going to work but worth a try.

Have you read it starts with the egg? I have been using coQ10 and started melatonin. Maybe the supplements would help you too. Do you have an insurance max? I'm cheering for you sweets!!

ChristieH917

@blueeyes233  Thank you so much for all of you info.  That is a great help.  

@soonihope81  I did a low dose for my first one. I was on Follistim 150 in the morning and the evening.  I only had 4 follicles and low estrogen.  That cycled got cancelled.  

@Justone13  I keep hearing about this book.  I am starting to think it is something I should be reading.  I do have an insurance max but it is ridiculously high. 

This is what I found about microdose Lupron.  "The Microdose Lupron regimen uses a very small dose of Lupron just 3 days before the start of stimulation medications to minimize the suppressive effect and to take advantage of a unique property of Lupron to release FSH and LH from the pituitary, which are the same hormones found in the stimulation medications. Thus during the first few days of Lupron, the ovaries are stimulated by the natural pituitary hormones (the flare effect). Medications containing the same hormones are later added to augment the stimulation effect."

My husband said I sound so happy about what the possible new RE had to say that if I want to cancel my appointment with the current RE, he would be ok with that.  

Justone13

@ChristieH917‌ I'm so glad your husband is on board and trusts your opinion! Read the book. Trust me. Read the book. I'm not saying it's gospel but I found so much in that book that has hopefully made a huge difference. I'm bpa free now, I am using only chemical free cleaners in our house. Added supplements. I'm tagging @Carol77B‌ in this because she is one to tell you the supplements and life style changes can make a difference. Her tests are coming back so much better now than what they were. It's like 10$ for the book but worth it I think. Just remember this is your body and your potential child don't let the doctors think they know it all. Research the crap out of everything. It pays off.

ChristieH917

@Justone13  I bought the book!!

ronniesgirl1981

@ChristieH917, are you with SG?  I also did 300 FSH and 300 Menopur...but I haven't seen anyone else with that dosage.  I was terrified of the potential side effects of the lupron, but honestly I didn't have any.  However, lupron shut me down...hard.  My estrogen never rose from baseline despite the high dose stims.  It was a way worse cycle for me than my prior antagonist attempts.  For some women, MDL works like magic, but I was just not one of them.

I do plan to ask my second opinion REs about the high dose of menopur.  I've read that some women (esp poor responders) don't do well on it.  

Good luck with your upcoming cycle!

zeynsom

I want to note an important difference: lupron is different than microdose lupron. Microdose lupron is compound lupron, which is basically diluted lupron. Specialty pharmacies dilute the lupron and they have a shelf-life of 30 days upon dilution (and they need to be refrigerated). I believe the idea is that lupron by itself is a suppressant. But for DOR/POF patients that do not respond very well to stims and who should be suppressed only minimally in order not to ovulate too soon they should be using diluted lupron (microdose lupron).

I was on MDL protocol for my first (failed) IVF. We did BCP for one month and then 300 Follistim in the am and 300 in the pm along with 20unit microdose lupron in the am and in the pm. On CD1 following BCP we started with MD lupron injections and on CD4 we added Follistim. I stimmed for 11 days afterwards. They retrieved 5 eggs, 4 fertilized, 3 transferred on day 3 (failed to implant) and one frozen on day 6.

My RE decided to follow a similar protocol for the upcoming IVF but this time no BCP. We will do MDL with Follistim again but this time we will start without BCP. On CD2 we will start on MD lupron (20 in the am and pm), on CD4 we will start on Follistim 525 along with Menopure 75 and microdose lupron (20 in the am and pm).

ChristieH917

@ronniesgirl1981 I am not with SG.  I'm not sure who or what that is.  I live in the far suburbs of Chicago.

@zeynsom Wow.. that's a lot of info! Thank you so much!

Marissa6609

@christieh917 - i was on microdose hcg, not Lupron so I can't help.
I am curious though, you said you are in the Chicago area - what REs have you been seeing?

ChristieH917

@Marissa6609 I am currently with Dr Binor at Rush Copley in Aurora.  I am considering changing to Chicago IVF.  If I switch, I will be with Dr Tarun Jain at the Warrenville office. 

Marissa6609

Thanks @ChristieH917‌ . I am currently with Dr. Morris in Naperville but keeping my options open

ChristieH917

@Marissa6609  I would recommend checking out Chicago IVF.  Simply because they offer FREE second opinion consultations.  The doctor that I saw is blunt and honest.  It may hurt my feelings but I would rather hear that than have someone blow smoke up my butt to make me feel better.  

LynnLee7

This is my 1st IVF cycle and I am doing Microdose Lupron Protocol. Heres the short version of what I have done:

AM: 20 units Microdose Lupron, 150 units Follistim

PM: 20 units Microdose Lupron, 150 units Menopur

Trigger: 10,000 HGC

Stimmed 10 days/ ER- 5R/4M/4F

My RE explained by doing the microdose you have less chances of having the headaches, hot flashes, and mood swings. It has treated me well and so far has been a breeze. It is 4 shots a day but the needles are so tiny and I hardly bruised, which I am very prone to doing. Also I have terrible Endometriosis and past scarring on my left ovary and we weren't expecting many eggs. So Im not sure if that changes the count number for everyone doing the protocol or if that's just how many eggs I got.

Carol77B

ChristieH917  I'm so glad you bought the book! I am a true believer. After just two months on the supplements, dietary changes, and lifestyle changes (including no BPA, drinking out of glass/ceramic/stainless steel, reduced parabens/phylates in household products) my numbers were vastly better than the year before. For example, at my baseline CD3 u/s they counted 16 follicles, when in 10/2013 I had 12. I can't remember the hormone improvements off the top of my head, but they were all very impressive. Strangely, my RE was pretty blasé about the improvements, but I'm thrilled and more optimistic going into IVF #4. So even if you don't have several months to follow the book, before you cycle again, you could still expect to see improvements.

I tried the Microdose Lupron Protocol (20 units 2X/day) for my second IVF and it was a big failure for me; it had the opposite result of producing more eggs. It over-suppressed me so that we only had five follicles and just got three eggs. They all fertilized, but it was still a BFN. I will say that my RE thought the quality of the embryos was good, but it wasn't good enough to offset the reduced number we got from the antagonist protocol.

From the research I did, some women get terrific results from the microdose Lupron, but from what my RE said, they can't really predict who will do great on it and who won't. Which is the same thing he said about Human Growth Hormone, so he isn't recommending that for me.  I do wonder if I hadn't used BCPs before starting, if I might have had better results. We've since switched me to the EPP.

saratrying

@Christieh917 and @marissa6609 Looks like we have our own little Illinois group going on here. I have friends who have had success with both of your REs, so I think you're in good hands. I'm with FCI Highland Park. 

I just started a microdose Lupron cycle (last cycle was antagonist). The goal here is better quality embryos, but I'm really worried I've over suppressed my ovaries (not that I am a doctor or anything). In the morning I take 10 units lupron, 2 vials Menopur, and dexamethsone. In the evening its 10 units lupron and 300 Follistim.

Unknown

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