Why Did Lupron Stop? (IVF)

Hope40b

I'm on IVF #3... On my first two IVF cycles I continued to take Lupron while taking Follistem and Menopur.  This time around, they are having me stop the Lupron when starting Follistem/Menopur.  How will they ensure I don't ovulate before ER if I am not taking the Lupron?  Also, I came close to overstimulating on IVF #1 (had to coast for a few days) and I thought the Lupron helped prevent overstimulation. I know it's really a question for my ER, but thought I'd also ask you ladies what you thought. Thanks.

epphd

They may just be trying to switch up your protocol. Lupron will quiet your ovaries before stimming.  When you start stimming, they will likely have you take ganirelix or cetrotide to prevent ovulation - but be sure to ask your doc, of course.  The nice thing about these drugs is that they tend to allow follies to mature without raising E2 as high.  On my lupron protocols, for instance, my E2 was routinely above 4000 by trigger.  On my one ganirelix protocol, it was ~1200 at trigger and we still got 16 eggs.

Lupron can help prevent OHSS if it is used as trigger - but if you take it during the course of stims you can't use it as a trigger (has to do with lupron having both agonist and antagonist effects, depending on the duration of exposure).  Going off of lupron and using ganirelix instead may allow your doc this option if needed. 

HTH!

 

yodasmistress

It sounds like they have put you on a different protocol, likely to increase the yield - how many eggs did you get in your last 2 cycles?

Hope40b

Thanks to both of you!  I am not going to be taking ganirelix or cetrotide....I have all of my meds and they're not in the mix, and I have started stimming and am just taking menopur and follistem.  My trigger is pregnyl.

On IVF #1 they retrieved 30 eggs, and they said that was too many and dialed down my dosage for IVF #2 and retrieved 20 eggs.  My ER has told me that both cycles were "great" (although of course I'm here now going through #3!) so I'm just confused why he's changing things and I don't understand how they'll make sure I don't ovulate early.  

I've put in a call to my ER.  I know it's not a big deal, but I just want to be educated about my cycle. 

yodasmistress

It sounds like you are on a "lupron stop" protocol.  This is akin to (but not the same as) a microdose flare protocol and is for low-responders, which you clearly are not.  Definitely talk to you doc ASAP.

epphd

Hope40b:

Thanks to both of you!  I am not going to be taking ganirelix or cetrotide....I have all of my meds and they're not in the mix, and I have started stimming and am just taking menopur and follistem.  My trigger is pregnyl.

On IVF #1 they retrieved 30 eggs, and they said that was too many and dialed down my dosage for IVF #2 and retrieved 20 eggs.  My ER has told me that both cycles were "great" (although of course I'm here now going through #3!) so I'm just confused why he's changing things and I don't understand how they'll make sure I don't ovulate early.  

I've put in a call to my ER.  I know it's not a big deal, but I just want to be educated about my cycle. 

OK, pregnyl is HCG, so that's what they play to trigger you with but of course, that can change.

Having you go off lupron w/o any antagonist on board seems incredibly risky - you are right to ask questions, and when you get an answer, please update

GL!

Hope40b

OMG!!!! Thank god I asked. Turns out I am NOT supposed to be stopping the Lupron!  My ER just said it was a "clerical" error and I am to take 5 units Lupron every night.  Jeez. 

Thank you so much ladies!  Without your responses, I wouldn't have started googling "Lupron stop protocol," freaked out at what I found (based on my situation), and called my ER so quickly.

yodasmistress

epphd

WOW! That's quite an error on their part!  Glad it's sorted out GL!!