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Protocol tweaking: WWIFV do?

AnasaraAnasara
in Infertility Veterans

For IVF #2 we did a "kitchen sink anatagonist" approach which yielded much better results than IVF #1 (see siggy).  Here was what we did in exact terms; sorry it's long but it might be useful to some of you:

IVF #2 protocol

 

2 weeks of BCPs (Apri); got AF 8 days (!) after taking last pill.

 

7/24-CD3

Clomid 100

 

7/25-CD4

Clomid 100

 

7/27-CD5

Clomid 100

 

7/27-CD6

Clomid 100

Follistim 450

 

7/28-CD7

Clomid 100

Follistim 450

 

7/29-CD8

Follistim 450

 

7/30-CD9

Follistim 450

Cetrotide 0.25

 

7/31-CD10

Follistim 450

Cetrotide 0.25

 

8/1-CD11

Follistim 450

Cetrotide 0.25

Menopur 75 IUs

 

8/2-CD12

Follistim 450

Cetrotide 0.25

Menopur 75IUs

 

8/3-CD13

Follistim 450

Cetrotide 0.25

Menopur 150IUs

 

8/4-CD14

Follistim 450

Cetrotide 0.25

Menopur 150IUs

 

8/5-CD15

Follistim 450

Cetrotide 0.25

Menopur 150IUs

 

8/6-CD16

Follistim 450

Cetrotide 0.25

Menopur 150IUs

 

8/7-CD17

Trigger with HCG (Novarel)

 

8/8-CD18

Nada

 

8/9-CD19

Retrieval (10R, 8M, 4F with ICSI; transferred 2 & 1 frozen)

This time, the doc is going to nix the Clomid & instead start me with Follistim 225 (or the equivalent in Gonal F depending on what's cheaper), then add the Menopur starting @ 150 & go up if need be.  I'll also be taking Cetrotide again.

Anyone done this protocol, or something similar?  I think these changes sound reasonable but like anything, I am curious what you ladies think.

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Re: Protocol tweaking: WWIFV do?

  • SweetDahliaSweetDahlia

    I thought this was so interesting and I hope by tweaking it a bit your get your BFP. I do think Menopur is good to help with quality.

    PAIF and SAIF Always Welcome!
    TTC since 2007
    6 IUIs, 3 IVFs, and 2 m/c :< PCOS, Blood Clotting Disorder & MFI
    IVF #2 Aug 2011 is a BFN:<
    IVF #3 March 2012 is a BFN
    Not sure what to do now. Sad and lost.
    Lilypie Angel and Memorial tickers Lilypie Angel and Memorial tickers
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  • BzeetyDBzeetyD member

    I did a very similar protocol on my 2nd IVF (where we got PG and saw a heartbeat but had chromosomal issues.) And very similar to my 3rd (but we added DHEA).

    This is what I would probably cycle with again if we choose to use our current clinic for our 4th try.

    BzeetyD = 38, Mr. BzeetyD = 44 together 12/02 married 9/08
    TTC #1 since 1/10
    DX: Unexplained/??? MFI issues

    Our lil' lost sparks:
    5w3d loss 7/30/10 - EDD March 2011
    8w loss 4/15/11 - EDD November 2011
    8w3d loss 8/2/12 - EDD March 2013
    4w c/p loss 10/29/12 - EDD July 2013

    Long story: trying on our own + testing testing testing with 6 rounds of Clomid, more testing, injectables + TI, laparoscopy - one tube blocked, 2 IUIs with Follistim...BFNs.
    RPL testing all normal, Karyotyping normal

    Moving on to IVF.

    IVF #1 April 2012 = BFN, IVF #2 June 2012 = BFP. U/S 7/23 = saw heartbeat but measuring behind. Follow up U/S on 7/30 - no heartbeat. D&C 8/2. Trisomy 12. IVF #3 Oct 2012 = Chemical Pregnancy

    Phone consult with CCRM on 12/12/12 - ODWU 1/4/13 - both tubes clear(!) - AFC 24, AMH 3.2, FSH 9.6, LH 5.4, E2 25. DH has high frag rate but improved!
    IVF #4 March 2013 CCRM. EP protocol w/ Menopur, Gonal-F & Dexamethasone. ER 3/29 & IMSI, PICSI. 43R 13M 10F 6blasts bio'd. CCS testing reveals 3 normals!!!
    FET 5/31/13 of 1 4AA blast - thawed and expanded. 4dp5dt BFP.
    Beta 9dp5dt = 181, 11dp5dt = 427. 1st u/s showed a healthy heartbeat! EDD 2/16/14

    After 4 years of hoping and heartbreak, our sweet little bean was born on 2/19/14
    We are so in love with her.

    "I'm not telling you it's going to be easy, I'm telling you it's going to be worth it."

    Everybody is welcome!!!
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  • BAKERMOMHDSBAKERMOMHDS member

    We increased the menopur this round as well

    Morning : - 150 units menopur / 20 IU diluted Lupron

    Evening : - 375 units Gonal F / 20 IU diluted Lupron / Dexamethasone

    Previous cycles, I was on 75 IU of menopur.  Interestingly, today is trigger shot day and I will trigger with 10K HCG, but I'm to continue the menopur this morning and tomorrow morning..but only 75 IU....

    Dr. Bank.owski believes Menopur and Dexamethasone help with egg quality.  They had me discontinue the DHEA for this cycle (previous cycles I did DHEA for 3  months prior to stims). 

    Me = 39 DH = 50 TTC (since 01/2009 after a short break, I stopped counting *cycles* in 2010)
    DX 2010 : Unknown Infertility , AMA
    HSG 2005 = Normal / HSG 2010 = Normal
    SA 2005 = Normal / SA 2010 /2012 = Slightly low count : motility, morphology GREAT!
    Chromosomal analysis, MTHFR, ANA's, Lupus, Protein C, Protein S, APCR = Normal 2011

    M/C : 2005 (7wk), 2010 (6wk), 2011 (7wk)

    8 IUI's 2010-2011 all BFN

    IVF/ICSI antagonist 01/2012 #1 = BFN

    IVF/ICSI antagonist long 06/2012 #2 = BFN

    IVF/ICSI/CGH MDLF New Clinic/New RE 11/2012 #3 = One beautiful boy blasty frozen PGS normal

    IVF/ICSI/CGH MDLF 02/2013 #4 = One more beautiful boy blasty frozen PGS normal

    FET 6/20 : One 5AA PGS normal transferred Beta 1 6/28 = 53.9 / Beta 2 7/1 = 220 / Beta 3 7/3 = 550!

    1 U/S  6w3d - Heartbeat 119 /  2 U/S - 7w5d- Heartbeat 169 / 3 U/S (OB) 8w5d - Heartbeat still great!

    Baby G welcomed into the world 3/7/2014

    SAIF / PAIF always welcome ****

     

    image

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  • katt3233katt3233 member
    I don't have advice, but wanted to wish you lots of luck!
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  • annaliselannalisel member

    Your new protocol is like my 2 cycles (300 follistim/150 menopur, antagonist when the lead follicle got over 13 or so). In the cycle where I had a good response despite my DOR, it produced mature eggs down to 13 mm follicle size - 4 of 6 fully mature eggs fertilized to produce high quality day 3 embryos.

    Wishing you luck with your cycle! 

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  • mm29mm29 member
    imagekatt3233:
    I don't have advice, but wanted to wish you lots of luck!
    This!  GL and lots of PPVs.  I have everything crossed for you!
    ::: Married June 2003:::
    TTC #1 since: Aug. 2008
    Me: 34, DOR, MTHFR-A1298C (heterozygous), decreased blood flow to uterus, Mild Endo
    DH: 38, Balanced translocation 5&10, unexplained MFI, normal SA and SCSA
    Tx History: IUI 1&2= BFN
    IVF# 1 W/ICSI= BFN
    IVF# 2: cancelled d/t no response
    IVF# 3= 1 egg retrieved=immature/not viable
    IVF# 4= c/p
    ***CCRM ODWU***
    Found DHs BT and Me-decreased blood flow to uterus
    Recommended DE IVF w/PGD, incorporate electro-acupuncture. Decided to cycle locally
    ***New RE***
    DE IVF# 1(cycle #6) w/pgd, (freeze all): 30R, 23M, 15F, slow/poor embryo development, 4 biopsied, 1 Normal "Norm"; DE IVF w/PGD, incorporate electro-acupuncture. 
    IVF# 6: (OE/DS) cancelled
    IVF# 7: (OE/DS) 1R, 1M, 1F, arrested day 5
    Plan-DE IVF# 2 (cycle #8): DE/DS in May 2015

    http://icanhazbabyz.blogspot.com/
    imageimage image 
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  • glueckglueck member

    I did something *similar* but with letrozole instead of clomid. However, my clinic failed in that they didnt stim me high enough, nor did they monitor closely enough. I think the theory behind it is to wake up and recruit follicles early before adding heavier stims. 

    I understand this has worked for some DOR gals very well.  

    imageimage

    TTC#1 since October 2010

    "The jump is so frightening between where I am and where I want to be...because of all I may become I will close my eyes and leap." Mary Anne Radmacher

    Me:35, 5 major abdominal surgeries for Ulcerative colitis, failed j pouch, perm. Ileostomy DX-DOR & Tubal abnormalities/Extensive Adhesions from earlier surgeries.latest fsh -26 :(

    IVF 1- March 2012 Antagonist Protocol; BCP until March 3; AFC this cycle is 10 (Hooray); Start stims on March 9; ER on March 19- 2R; 2T (1 perfect 8 cell, 1 scrappy 3 cell); tubal infection from ER-hospitalized. Doomed! BFN

    Essure Procedure to treat bilateral hydrosalpinx; June 2012, wait 3 months for confirmation test.

    IVF2 (Egg Banking)-letrozole/antagonist cycle; June/July 2012 225iu merional + cetrotide; slow responder, Ovulated before ER. Unbelievable. Canceled remaining cycles with my eggs

    DE IVF in Brno, Czech. Approx. ET on Oct 6 CANCELLED-Essure didn't close both tubes-test again in 3 months

    IVF3-DE IVF ET on Dec 9, 2012 (decided to roll the dice no matter what!)

    2 perfect HB transferred; 8dp5dt beta:36; 10dp5dt beta 15; chemical pregnancy.

    Turning our hearts toward adoption

    DH:36, SA-perfect

    Married since July 11, 2009

    Fur baby Cairn Terrier

    SAIF/PAIF Welcome

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  • joules12joules12 member

    imagemm29:
    imagekatt3233:
    I don't have advice, but wanted to wish you lots of luck!
    This!  GL and lots of PPVs.  I have everything crossed for you!

    More good luck headed your way -- so hoping that your cycle is successful!

    TTC since honeymoon in 9/2010
    Me: 39, Dx DOR (FSH = 10.5, AMH = 0.43, best AFC = 10), AMA
    MH: 37, Dx Obstructive Azoospermia, multiple successful sperm retrieval procedures

    1/2012: IVF/ICSI #1 Antagonist = cancelled d/t poor response to max stims
    2/2012: IVF/ICSI #2 MDLF (4R, 4M, 1F) = BFP, saw heartbeat, missed m/c 9w0d, D&E
    8/2012: IVF/ICSI #3 EPP/MDLF (7R, 2M, 1F) = BFN

    12/2012: (New RE) Operative hysteroscopy to remove scar tissue

    1/2013: IVF/ICSI #4 Low-dose stim/Antagonist (AFC=6); ER=1/26 (5R-couldn't access rt ovary, 5M, 4F), ET=1/29 (trans 3) = BFP!; 2/11 beta#1(13dp3dt)=2127, 2/13=3367; twin girls due 10/19/13

    PAIF/SAIF very welcome!

    <a href="http://www.thebump.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Pregnancy"><img src="http://global.thebump.com/tickers/tt16bf7d.aspx" alt=" BabyFruit Ticker" border="0"  /></a>
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