Low and Slow Stim Protocol for PCOS

CLaNa · January 2012

I'm interested in hearing about your experiences with injectables. I'm on my first injection cycle and my RE started me out at 75 units of gonal-f because she is very concerned about me getting too many follicles. It started out okay but the 3 lead follicles essentially stopped growing by day 8 when they reached 10mm. On day 10 when they were still sitting at 10 and my estrogen dropped, my RE increased my dose slightly to 112 units a day.

I am now at day 12 and the thee follicles have only grown to about 11mm and my lining has gotten progressively thinner each day. I've read a bit online about stimming protocols for ladies with PCOS and it looks like some studies encourage starting very slow and stimming for a somewhat long period of time. I'm afraid that stimming for 15 or more days could be a problem. I'd really like to hear about your experiences!

Thanks!

genmalone · January 2012

I also started with 75 IU and then went to 100 IU. I am a slow responder which is frustrating but after about 14 days I was ready to trigger with 2 follies at 18mm+. I know another gal on here stimmed for over 3 weeks before she triggered so maybe she'll chime in as well.

My 2nd injects cycle we started at 100 IU, I overstimmed, and my IUI was cancelled. It was a big fat fail and much more frustrating than the endless stimming.

Good luck!

JennPierog · January 2012

I stim for 26 days with Gonal-f I started at 75cc and every 3-4days increased my does based on E2 levels to a final dose of 225iu. I ended up with what I believe now was only one lead follie at 21mm on trigger day.

Mid cycle I had a few 12mm then I exposed which my RE said is normal for PCOS. I trigger with a 21mm, 18mm, 18mm and several 16mm. And a few 12mm. My e2 levels were only in the 600 range So how many follies were really mature was unknown. We did have to have the talk about HOM.

It ended up being my BFP cycle with just one baby. My RE believes that we may have only had one good mature egg.

Low and Slow works it was a long hard cycle but that protocol worked well

For me. Best of luck to you.

CLaNa · January 2012

genmalone:

I also started with 75 IU and then went to 100 IU. I am a slow responder which is frustrating but after about 14 days I was ready to trigger with 2 follies at 18mm+. I know another gal on here stimmed for over 3 weeks before she triggered so maybe she'll chime in as well.

My 2nd injects cycle we started at 100 IU, I overstimmed, and my IUI was cancelled. It was a big fat fail and much more frustrating than the endless stimming.

Good luck!

I'd definitely rather go slowly and avoid overstimming. I'm sure that was very frustrating! I should be more patient I suppose. :-)

CLaNa · January 2012

JennPierog:

I stim for 26 days with Gonal-f I started at 75cc and every 3-4days increased my does based on E2 levels to a final dose of 225iu. I ended up with what I believe now was only one lead follie at 21mm on trigger day.

Mid cycle I had a few 12mm then I exposed which my RE said is normal for PCOS. I trigger with a 21mm, 18mm, 18mm and several 16mm. And a few 12mm. My e2 levels were only in the 600 range So how many follies were really mature was unknown. We did have to have the talk about HOM.

It ended up being my BFP cycle with just one baby. My RE believes that we may have only had one good mature egg.

Low and Slow works it was a long hard cycle but that protocol worked well

For me. Best of luck to you.

Thank you so much for responding! This is very reassuring!!! I'll feel so much better going through all these injections and appointments now that I know it can work. It definitely started to seem like it was just a waste of time and money, but it worked for you. Yay!

nycitygirl1 · January 2012

CLaNa:

I'm interested in hearing about your experiences with injectables. I'm on my first injection cycle and my RE started me out at 75 units of gonal-f because she is very concerned about me getting too many follicles. It started out okay but the 3 lead follicles essentially stopped growing by day 8 when they reached 10mm. On day 10 when they were still sitting at 10 and my estrogen dropped, my RE increased my dose slightly to 112 units a day.

I am now at day 12 and the thee follicles have only grown to about 11mm and my lining has gotten progressively thinner each day. I've read a bit online about stimming protocols for ladies with PCOS and it looks like some studies encourage starting very slow and stimming for a somewhat long period of time. I'm afraid that stimming for 15 or more days could be a problem. I'd really like to hear about your experiences!

Thanks!

Hey there. I've only stimmed one cycle, but I also have PCOS and my RE had similar concerns. I did letrozole CD2-6, then 75 of Gonal-F CD 8-11, then 1/2 dose of 75 Gonal-F CD 12-13. I went in for a bunch of ultrasounds and toward the end my RE cut the dose in half to prevent me from overstimming. Problem is, I only had one follicle that was borderline mature. It is definitely a tricky line to walk.

I went in for my baseline the other day and lo and behold...a cyst. Which is totally the Gonal-F since I never had cysts before. GL to you and here's hoping those follies mature without overstimming!

racheyt0227 · January 2012

Slow & steady it is. I have stimmed anywhere from 11 days to 25 days. The average was around 17.

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