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Low follicle producers please come in

mamabearsmamabears
in Infertility

The protocol we are using this cycle is Estrace from cd 21-cd 4,  450 follistim with 2 menopur starting day 2,  we are doing an IUI. (I know it seems wierd but I do not have IVF coverage until July)  The intention was to "grow" more follicles... 3 previous stim cycles with 6, 2, 5 follies,  and I actually have more with clomid but not much.  My RE basically said the cycle with 2 if were IVF would be cancelled, they like 5 or more.  The current cycle I only have 4,  better than 2,  but not good enough for IVF in my office. 

My question is if you are a low follie producer,  what protocol did your Dr use to increase your follicle number?

 Thanks 

 

SAIFW TTC 3 years natural m/c 9-14-09 6w 6d, cp 02-10 Low ovarian reserve, poor responder to meds Starting IVF 10-17-11
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Re: Low follicle producers please come in

  • CityPixieCityPixie
    I think lupron flare or antagonist are the two main ones.  Estrogen priming (I think) can be used with either one.  ivfauthority dot com is a blog that you can search for protocol info.  Good luck to you.  -Pix
    About me: A pixie in the city, 41, TTC #1 since May 2010, married 18 years. Diagnosed with, surgically removed, endometrioma Aug.2010 Sept 2010 IUI #1=BFN, Oct=cyst/bfn, Nov 2010 IUI #2 = bfn. Had to postpone IUI #3 b/c of a cyst natural=BFN. Skipped IUI #3, decided to go for IVF. Found/removed uterine polyps Jan 2011. IVF cancelled, no follicles. IVF #2: 3 great embies put in on Easter Sunday = BFN. Hoping for another chance at IVF in July. TTC is NOT for wimps. http://www.fertilityfriend.com/ticker/2fab90/ttc.png
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  • 07may0707may07

    For IVF I have used 3 different protocols:  Long lupron (5 eggs), Antagonist (3 eggs), EPP (7 eggs, and 15 eggs).

    I think the EPP helped increase my follicle production.  For stims for my first cycle on EPP, I was on the max dosage of gonal-f (450) and menopur (150).  Ganirelix was added in.  For the second cycle, my RE changed up my meds and I was on gonal-f (300) and menopur (300).  I think the EPP helped me produce more follicles and the change in meds for my last cycle made a huge difference.

    Good luck!

    *P/SAIFW* TTC since 1/08 Clomid, 2 IUIs, 4 IVFs, FET 7 losses Baby Birthday Ticker Ticker
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  • STL34STL34 member

    I have done two IVF cycles.  We did Long Lupron the first time and only four eggs were retrieved.  We did antagonist with EPP the second time and six eggs were retrieved but only four were mature and they weren't as good quality wise as the four from my long lupron cycle.  That being said, even poor responders react differently to different protocols.  So, it is kind of a trial and error process. 

    We will be doing IVF #3 in April.  I'm not sure what protocol we will do.  I am hoping to convince my RE to try the agonist/antagonist conversion protocol with EPP that Dr. Sher promotes in his blog (www.ivfauthority.com).  If my RE still doesn't want to do it, I will likely try long lupron again. 

    I am getting a second opinion from a new RE and I think he would recommend micro dose lupron flare protocol.  So, if IVF #3 doesn't work, I will likely do it for #4.  You can see in Dr. Sher's blog that he doesn't like flare protocols.  But, there are other REs/clinics that believe in them for poor responders.  It is one of the protocols CCRM uses.

    Good luck, hon!

    imageimage


    ~SAIF/PAIF/Everyone Welcome~ 

    Me= 37 and DH = 41 

    Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)

    IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN

    IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.

    IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132.  Lil is here!

    TTC#2:  Trigger + TI = BFN; Clomid + Trigger + IUI = BFN.

    IVF #4:  BCP + MDLF + Lovenox = 7R, 1F = Transferred 1 6-cell embryo on day 3 = BFN

    IVF #5:  MDLF + Lovenox = 4R, 1F = Transferred 1 10-cell compacting embryo on day 3 = BFN

    IVF #6:  (New RE):  Long Antagonist November 2014 (transferred two 8 cell grade 1 embryos and froze one blast) = BFN

    FET#1:  BFN

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  • njohnson1972njohnson1972 member

    ***ticker warning****

    I hope you don't mind me responding.  I didn't see PAIF/SAIF welcome in your siggy.

     

    IVF #1 - Antagonist - 4 eggs retrieved - 4 fertilized - 3 transferred - BFN

    IVF #2 - EPP Agonist/Antagonist Conversion - 5 eggs retrieved - 4 fertilized - 2 transferred - c/p

    IVF #3 - converted to IUI due to incorrect protocol instructions - BFN

    IVF #4 - EPP Agonist/Antagonist Conversion - 6 eggs retrieved - 6 fertilized - 2 transferred - BFP

    My RE thinks it was a combination of EPP and taking DHEA that finally got me my BFP.

    The EPP Agonist/Antatgonist Conversion protocol is based on Dr. Sher's research for poor responders with previous failed IVF cycles.

    Good luck!

     

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  • mamabearsmamabears
    Thank you ladies,  all of you gave very helpful info!!!!!
    SAIFW TTC 3 years natural m/c 9-14-09 6w 6d, cp 02-10 Low ovarian reserve, poor responder to meds Starting IVF 10-17-11
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  • mjm579mjm579

    I tried EVERY protocol, can't remember all of the details right now, but I remember doing everything they could think of....and still never produced 5 (except my last IVF cycle - which was femara and follistim/menopur).

    I know not much data exists (randomized), but after all of my IVF BFN, I moved on to IUI (with donor sperm).  Still only 1 follie per cycle with high levels of follistim (400-600 Units).  I took a 4 month break and took 75-125 DHEA and this cycle I have 4 follicles.

    Granted, it isn't a lot considering, but it was grando performance from my ovaries.

    I'm 32, so the RE is hopeful!!  Also, my FSH went from 15+ to 5.2!

    Unfortunately, my AHM is still ~0.1 (BOOOO).

    What is your FSH (day3)?  AMH?  Antral follicle count? 

    Are you on any supplements?

    Trying to conceive #2 since May 2006. Started IVF in 2008; IVF #1 cancelled (poor responder); IVF #2 cancelled (poor responder); IVF #3 BFP (MC day 26); IVF #4 BFN; IVF #5 BFN; Vas Rev Jan 2010 - azoospermia to date; DS IUI October 2010 - BFN; IUI November - Cancelled --- BREAK from November to March (on DHEA)(FSH from 15 to 5)(AMH 0.1, no chamge) --- FINALLY --- DS IUI March (19th) - Beta 4-5 (16dpo) = BFP (205)!!!! --- Beta #2 4-7 (18dpo) = 477 BFP!!! --- 7-11-11 IT'S A BOY!!!!
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