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Ganerelix (antagonist) protocol for DOR (very low AMH/high FSH)?

NootbarNootbar member
in Trouble TTC
So we had our meeting with the RE today. He said we have two choices: IUI w/ injectables (Follustim) or straight to IVF, where he recommends a max dose of Ganerelix - if I do not respond he says we re-evaluate and consider mini IVF (using a low dose of clomid). He is not steering us one way or the other, but he put our odds w/ IUI at 20% and our odds w/ IVF at 50% - IF (and this is a big if) we get enough decent looking embryos. He didn't say anything about estrogen priming or adding HGH - should I ask about these things? Any thoughts appreciated.

*Ticker/Siggy Warning*

Me: 37 DH: 38 TTC since 2011 DH normal Dx: DOR (AFC ranges from 6-11; AMH 0.16; FSH 11.9; E2 45) 11/13: 1st IVF converted to IUI due to poor response to high dose antagonist protocol (only 3 follies) = BFN 12/13: IUI #2 letrozole + Bravelle = BFP, beta #1 156, beta #2 196 (diff. lab), beta #3 1037; 1st ultrasound @ 5 wks 1 day = 6 mm gest sac; 2nd ultrasound 6 wks 1 day = tiny flickering heartbeat; 3rd ultrasound 7 wks 1 day 10.3 mm embie growing away! 

PAIF/SAIF Welcome!

BabyFetus Ticker
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Re: Ganerelix (antagonist) protocol for DOR (very low AMH/high FSH)?

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    STBMrsMillerSTBMrsMiller member
    We have a similar diagnosis and treatment plan. We've done two IUI's while we waited for my DHEA supplements to be taken for a period of time prior to IVF. Our odds were so low with IUI that we weren't very hopeful, but it was nice to see how I responded to meds/ injects and go through some monitoring.

    We had our consult yesterday and discussed the meds protocol, progesterone afterwards, lifestyle changes, and when to stop taking various supplements. Asking about estrogen and HGH sounds good to me, I always come with a list!
    Pregnancy Ticker

    TTC #1 since June 2012
    Me (28) - DOR (AFC <10, undetectable AMH, >10 FSH), homozygous E429A MTHFR
    DH (29) - MFI low count and morphology

    September 2013 IUI#1 - Clomid + Trigger + IUI = BFN
    October 2013 IUI#2 - Letrozole + Menopur + Trigger + IUI = BFN

    Nov 2013 IVF/ICSI #1 - Protocol: BCP prep, high doses Menopur and Bravelle (12 days), ganirelex
    Results: 5 retrieved / mature, 4 fertilized, 1 arrested and 3 complex abnormal after day 3 PGS = Cancelled after ER
    Jan/Feb 2014 IVF/ICSI #2 - Protocol: Estrogen priming, high doses Menopur and Bravelle (11 days), microdose lupron
    Results: Cancelled after 11 days of stims due to low response and E2 levels
    Feb 2014 IVF/ICSI #3 - Protocol: No prep, low dose Menopur (6 days), ganirelex, Bravelle booster with trigger
    Results: 1 retrieved / 0 mature = Cancelled after ER

    Officially moving on to embryo adoption! We used and love Embryo Adoption Services of Cedar Park
    October 2014 FET #1 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 4 from match #1, BFN
    December 2014 FET #2 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 4 from match #1, BFN
    March 2015 FET #3 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 6 from match #2, BFN
    May 2015 FET #4 - BCP/Lupron/Estrace/Prometrium, lost 2 to thaw, transferred 2 of 6 from match #2, BFN
    October 2015 FET #5 - Natural cycle, lost 1 from match #3 and 1 from clinic backup to thaw, transferred 1 backup, BFN
    February 2016 FET #6 - Natural cycle, transferred 1 from match #4, B FREAKING P!
    Beta 1 = 162, Beta 2 = 316, doubling just over 48 hours

     

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    STBMrsMillerSTBMrsMiller member
    Rumbera28 said:

    I'm confused... my RE had me on Ganerelix in my FW to prevent ovulating too early.

    That's true. I meant that I'm also using Ganerelux as opposed to Lupron, but there should be a FSH too.
    Pregnancy Ticker

    TTC #1 since June 2012
    Me (28) - DOR (AFC <10, undetectable AMH, >10 FSH), homozygous E429A MTHFR
    DH (29) - MFI low count and morphology

    September 2013 IUI#1 - Clomid + Trigger + IUI = BFN
    October 2013 IUI#2 - Letrozole + Menopur + Trigger + IUI = BFN

    Nov 2013 IVF/ICSI #1 - Protocol: BCP prep, high doses Menopur and Bravelle (12 days), ganirelex
    Results: 5 retrieved / mature, 4 fertilized, 1 arrested and 3 complex abnormal after day 3 PGS = Cancelled after ER
    Jan/Feb 2014 IVF/ICSI #2 - Protocol: Estrogen priming, high doses Menopur and Bravelle (11 days), microdose lupron
    Results: Cancelled after 11 days of stims due to low response and E2 levels
    Feb 2014 IVF/ICSI #3 - Protocol: No prep, low dose Menopur (6 days), ganirelex, Bravelle booster with trigger
    Results: 1 retrieved / 0 mature = Cancelled after ER

    Officially moving on to embryo adoption! We used and love Embryo Adoption Services of Cedar Park
    October 2014 FET #1 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 4 from match #1, BFN
    December 2014 FET #2 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 4 from match #1, BFN
    March 2015 FET #3 - BCP/Lupron/Estrace/Prometrium, transferred 2 of 6 from match #2, BFN
    May 2015 FET #4 - BCP/Lupron/Estrace/Prometrium, lost 2 to thaw, transferred 2 of 6 from match #2, BFN
    October 2015 FET #5 - Natural cycle, lost 1 from match #3 and 1 from clinic backup to thaw, transferred 1 backup, BFN
    February 2016 FET #6 - Natural cycle, transferred 1 from match #4, B FREAKING P!
    Beta 1 = 162, Beta 2 = 316, doubling just over 48 hours

     

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