s/o of DOR ang aggressive IVF post- edwina come in please

kbrodie06 · August 2011

I posted a reply while butting in to the DOR and aggressive IVF protocols? post and I have questions and mass confusion apparently. I really dont have a clue half of what Edwina's response was but it made me want more info.

I am happy to go to responses here or have emails sent to me. (pm on thebump does not work for me)

So here is my background:

IVF #1 that was cancelled. I was on Follistim 325iu and menopur 225iu for 10 days. On first monitoring day, day 2 of stims I had 7 follies (most ever). On next monitoring , day 3 of stims, i had dropped to 6 follies. Of course there was always one ahead of the rest. On the 3rd monitor day/day 5 stims I was down to 5 follies and one ahead and then 2 others next and the rest smaller. Next is the fun part. My 4th monitoring day was on a Wednesday and was day 7 of stims. It also was on my calendar to start Ganirelix. (I have a crazy body and have ovulated on day 9 and day 18 and others in between when doing IUI). Well we still had the 5 follies and 1 larger, 2 a little smaller and rest smaller. Anyway I mentioned to Dr to remember that I have ovulated on my own while on cetrotied and synarel and should i be starting Ganirelix today. He blew me off. So prior to leaving I ask his nurse and told her he blew me off and what has happened before. Sure enough they call later to tell me to start it. Fridays monitoring went the same 1 follie ahead and 2 coming in closer and the rest behind. However later I noticed i had massive discharge and it continued Saturday. I figured i was ovulating or going to. Next appt was sunday. I told the dr about the discharge very first thing. He straight out looked me in the eye and told me "you are reading the wrong blog" "its the progesterone causing the discharge" and I was speechless. Granted he has the medical degree and should know what he is talking about right, so I took his word for it. (saying in my head uh, progesterone and ovulation, go hand in hand) anyway I waited for the call to see whats next. Sure enough, a few hours later, i got a call saying i am ovulating and cancel IVF and do IUI. Well you are f'ing kidding me. Duh. Yes livid me.

So my history is that I am all over the place- now I have to go talk to this numbskull and find out what he would do next or tell him what to do next (as it usually is) However I am at a loss now.

any suggestions other than see another RE?? other RE cant get me in for along time and one is thousands more. So I have to at least hear what he has to say. (hoping i dont go off on him) I dont know what to suggest trying now. Help!!!!

Kristin

Mrs.McIrish · August 2011

Now I'm butting in!

Kristin-- you had no suppression at all? Just went straight into stimming??

MamaLo1216 · August 2011

So, no lupron to keep you from ovulating early?

On another note - can you change doctors? Your doctor sounds like he has the bedside manner of a rock! In my opinion, the infertility journey is emotional enough.....you should have doctor and nurses who are willing to take time with you and be somewhat nurturing!!

kbrodie06 · August 2011

I was on BCP and then Norethindrone for 19 days. (that stuff is brutal) Then had a 2 day break of no BCP and the 3rd day I started stims.

Who knows if there is anything else but ask away

Kristin

STL34 · August 2011

My RE doesn't like the normal antagonist protocol (which is what it sounds like you were on) for DOR patients. He either starts you off on lupron so that you overlap the lupron with BCPs or estrogen or he will start half doses of antagonist a couple of days before you start stims. He says that DOR patients are more likely to O early. But, I know every RE is different in that respect. I would ask your RE about one of these other options.

For DOR patients, Dr. Sher has a protocol that is called agonist/antagonist conversion with EPP. You start out on lupron overlapping it with BCPs. Then you stop the lupron around the time you start stims, you do delestrogen injections while on stims and then you switch to the antagonist (ganirelix/cetrotide) at some point. It is supposed to work well for DOR patients.

If I were you, I might try getting in to get a second opinion with the other RE even if you intend to cycle with your current RE. Another set of eyes and more information never hurts.

Good luck!

Edwina.McDunnough · August 2011

Some protocols use BCPs (like MDLF) but I have not been on BCP for any antagonist or EP/antagonist cycle I have done. Perhaps it is suppressing you too much. But if you have a good number of follicles and you're getting a lead, I would ask about EP and actually getting you on max meds (600 total, so 300/300 or something like that). EP will suppress you and so it can be a long burn type of stim. I would also ask about stepping down your stims (if appropriate) to further keep your cohort together.

You have a lot of information here (and below) to ask pointed questions about your current and future cycles. I don't know what else to say except that your current RE is clearly not listening to you and does not seem experienced with hard cases.

kbrodie06 · August 2011

Oh here is a big thing- never diagnosed me with anything- just unexplained

STL34 · August 2011

kbrodie06:

Oh here is a big thing- never diagnosed me with anything- just unexplained

How low is your AMH? Do you know what your antral follicle counts are like?

Low AMH is consistent with DOR which seems to be reflected with your response to stims during your IVF cycle. It sounds like you maybe should consider seeing a different RE, preferably one that is experienced with DOR.

Want a personalized experience?

s/o of DOR ang aggressive IVF post- edwina come in please

Re: s/o of DOR ang aggressive IVF post- edwina come in please

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