Difference between Menopur & Follistim?

lizardknitter

SIG WARNING............

 

 

I know that Menopur is FSH mixed with LH, and Follistim is just FSH (or maybe I've got them backwards, anyway).

But my first IUI cycle was just 150 Menopur, had 1 17mm follicle after 4 days of stims.  Ended up a BFN and RE said that a "single, fast-growing follicle is what I would expect from old ovaries."  I am 40 BTW.

This cycle, which is our hail Mary before moving to IVF, we did 150 Menopur and 125 Follistim.  After 4 days of stims, I had 6 follicles.  I did another 3 days of stims and when I triggered, I had one 21mm, one 18, one 14mm, and three 8mm or less.

I guess I'm just trying to see if I can figure out what the difference was between the meds and how the cycles went.  I can't seem to find anything with Google except what the meds are made of.

Thanks! 

BootsOrHearts

**ticker warning**

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The key to preventing one lead follicle from developing seems to be suppressing you early in your cycle so your body doesn't start trying to grow one. I used ganirelix from days 1-3 (I think) to suppress, but there are other meds that suppress also.

For your age, an estrogen priming protocol probably makes sense and worked quite well for me on IVF#1. (I'm 39 and have DOR to boot)

Good luck!

Edwina.McDunnough

True suppression needs to be implemented the cycle previous to stims at the time follicles are being recruited. For IUI this is generally not a consideration since the goal is a smaller number of mature follicles. An RE that wants you to do an IUI with a high number of mature follicles should be questioned.

FSH is like gas and it gets your follicles growing. LH helps mature them along with other hormones, and causes ovulation. The difference in your cycles may or may not be attributed to the difference in overall FSH that was administered. Different REs will have differing opinions about the relevancy of LH during a stim cycle and whether it helps or hurts quality, when it should be administered (if at all), etc. For IUI I only used FSH medications, for IVF I used a varying combination of FSH+FSH/LH products, the most successful being 300/300. Unfortunately there is no magic formula. Your past cycles should best inform your RE on your future protocols but in the end each cycle has the potential to be unique; even if you cycled with the exact same protocol, each cycle may result in very different response outcomes, or not.

Lead follicles can also be a result of too high stims, taking into account the level of suppression. The goal at many clinics is 10-12 days of stims for the optimum quality of egg maturation, though the reality of that goal can vary. 

lizardknitter

Thank you!!! Very informative!