estrogen priming protocol (epp)

ngokli

Hi Ladies,

Has anyone heard of epp and if so, when is it used?

07may07

I used the EPP last cycle and will be doing so again this cycle.  My RE recommended it b/c I am a poor responder.

ngokli

I am a poor responder as well. How is it different than an antagonist protocol?

STL34

It is done various ways.  I did this with an antagonist cycle for IVF #2.  They had me start ganirelix two days before starting stims and I start estrogen supps the day before starting stims.  Other than that, it was pretty much the same.

The EPP protocol that Dr. Sher and Dr. Fisch do at SIRM - Las Vegas (and many of the other SIRM REs do) is an agonist antagonist conversion protocol.  Basically you start out on lupron before AF like a long lupron protocol.  You stop lupron at some point, I  believe about the time you start stims.  You start estrogen (usually injections; sometimes patches at my clinic supps) the day before starting stims.  Then you start ganirelix when indicated.  I may not be explaining this exactly correctly.  I have been trying to get my RE to let me try this protocol but for some reason he is resisting it.  

EPP is supposed to be used for poor responders or those that have problems with lead follicles. 

Good luck! 

kekis

Ditto the other pp.

ErnieH

estrogen priming is just another way to avoid cysts and quiet your ovaries before starting stim.  sometimes a bcp is used for this same purpose.  some people think that a bcp suppresses some women too much and so a epp is used instead. it is used with an antagonist cycle.

 

caityr

hope u don't mind my response...i did epp with antagonist and with microdose lupron cycles. Its typically offered to women who have dimished ovarian reserve.

Temp935838312504158

I am in the process of doing an estrogen priming protocol right now & have been taking Estradiol for 7 weeks. I have one more week of the Estradiol & will start BCP on Mar 3rd, microdose Lupron March 10th & stims March 13th. I too have DOR (diminished ovarian reserve) & my RE thought this might work better for me this next IVF cycle. 

Ginger71

I've done it twice. It really helps for those of us who have a lead follicle that likes to ruin everything. Estrogen is  taken before the cycle...after you ovulate and during you period to help the follies grow close to the same rate. It is used a lot for AMA. It helps you produce more follicles and supposedly it helps with quality since they stim you for a long time. I did it the 1st time as part of an antagonist protocol and the 2nd time with the microdose flare protocol. There is basically just a difference in the supression  drugs used. I have both cycles documented in my blog...link in signature. If you have any questions, feel free to page me.

Good luck!

njohnson1972

I hope you don't mind me posting.   

STL34:

The EPP protocol that Dr. Sher and Dr. Fisch do at SIRM - Las Vegas (and many of the other SIRM REs do) is an agonist antagonist conversion protocol.  Basically you start out on lupron before AF like a long lupron protocol.  You stop lupron at some point, I  believe about the time you start stims.  You start estrogen (usually injections; sometimes patches at my clinic supps) the day before starting stims.  Then you start ganirelix when indicated.

This is the protocol I did and it did get me my BFP.  I made the most eggs (6 at retrieval) and they were the best quality I ever had.  I even made it to a 5dt.  I also took DHEA prior to cycling. 

I brought up EPP to my RE and he did research.  He found Dr. Sher's paper on this protocol and we decided to try it.

Good luck! 

ngokli

thanks, ladies!