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Follistim Dose Question

marissa1082marissa1082 member
in Trouble TTC

I am starting my first medicated cycle on Wednesday (follistim + ganirelix + trigger + IUI). My Dr. has prescribed 225 IU doses for the Follistim. Does this dose seem high? How is the initial does amount determined?

Based on FSH results my ovarian reserve is normal but my AMH is 0.46, which is very low and indicates DOR (I am 31). My initial thought is that maybe the high dosage is due to DOR and potential for poor response to the medication? I see that some people have 50 IU doses and 100 IU doses, so my 225 IU dose caught me off guard. Any insight would be greatly appreciated! 

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Re: Follistim Dose Question

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    StacyLH24StacyLH24 member
    Dosages of medication are based on your own body and numbers. I start at 150 iu of Gonal-F and get decreased as appropriate based on my blood work and u/s. I'm guessing that if you had blood work done prior to starting your meds, CD 3 blood work for me, it showed something that made your RE think that 225 was a good place to start. Also, I know that the nurse asked for my weight when we started Gonal-F. I think there is a lot that goes into where they decide to start you and some guesswork as well. It seems like some REs like to start low and increase and others, like mine, start higher and decrease. You could always ask for an explanation from your office.

    Me: 30  DW (aka C): 29

    Together since 2/15/11 ~ Legally married in NY on 9/29/12

    ***CP mentioned***

    We've been working on baby #1 since July 2013 using Open ID donor sperm.  8 IUI attempts with 5 actual IUIs and one chemical pregnancy.  We have one fresh IVF cycle under our belts as well as a FET.  I have endometriosis and a uterine septum that was corrected via surgery in November 2013. 

    11/14/14 -  Second HSG shows that tubes are still clear and ute is looking good. 

    12/6/14 - Started BCPs in prep for IVF #2

    12/22/14 - Saline u/s and endometrial scratch (All was clear and OUCH!)

    1/2/15 - Began stimming for IVF #2

     ****All Welcome!****

    We are Mommas to four fur babies - 3 dogs and 1 cat.

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    gsanchogsancho member
    It is probably due to your low AMH.  It's a bit high for a medicated IUI (225 is a norm starting point for IVF), but I've seen other ladies on this board take those levels for an IUI before.  Good luck!


    Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
    IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
    IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
    Beta #s = 445;1,098; 9,545  -- EDD 5/2 -- Team Pink!
    Camila Josephine arrived 4/30 :)
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    nutaskeetnutaskeet member
    Has something to do with age as well. I am 39 and started at 300.
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    marissa1082marissa1082 member
    Great! Thank you for the info!
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    Pintobean39Pintobean39 member
    I'm 39 with an AMH of about 1.6. I did 3 medicated cycles with diff starting dosages, 50, 125, and 225. My best response was on my starting dose of 225. I don't know how they base the starting dosage. Every time I went for monitoring my RE changed my dosage. Good Luck!
    Fucking bump!!!!
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    Lillovebug79Lillovebug79 member
    I started my IUIs on follistim 75u, my AMH and FSH showed great ovarian reserve so they started me on a low dose and it worked well for me. For IVF, I will be starting on 225u. I think they base it off of your labs and what they think your response might be.



    ********Siggy/Ticker Warning***********



    Me (35) no known issues DH (37) MFI. TTC 21 months (24 cycles)
    Dx MFI with low to normal count, low motility, morphology 3%
    HSG normal, ultrasound and labs on me all normal. 

    1 cycle of Clomid 50mg and TI, unmonitored by OBGYN= BFN
    1 cycle of Clomid 50mg and IUI, unmonitored by OBGYN= BFN
    Started seeing an RE!!
    2 more cycles of clomid 50mg (great response), with IUI and Pregnyl trigger (4.8-8 mil good ones after wash) = all BFN
    1 cycle of clomid 50mg (3-7) followed by Follistim 75iu (7-11) + IUI = BFN
    December 2013 DH saw urologist and is taking Anastrozole, CoQ10, and L-Carnitine
    IUI #5 natural cycle (needed a med break) = BFN
    IUI #6 Follistim 75iu (CD3-10) + Pregnyl (CD11) + IUI (final count after wash 300K) = BFN
    IUI #7 Follistim 75iu (CD3-9) + Pregnyl (CD11) + IUI on 2/20 (post wash count 12.5 million)= BFN
    IUI cancelled (DH OOT) Clomid 50mg (CD3-7) 1 follicle +(not well timed) TI = BFN
    IUI #8 and last one!! Clomid 100mg (CD3-7) +OPK before US + IUI 4/17 (post wash 8.5 mil)= BFN

    Pre-IVF testing complete! SHG great and measurements taken! Labs for infectious diseases completed, FSH (5.4), TSH (1.6), Prolactin (11), AMH (2.6), Estradiol (40).

    Started BCP 5/29 and Lupron 6/11 prep for IVF #1! Started follistim 225u/day on 6/28. Monitoring on 7/2 >15 follicles measuring 11-14, E2 758. Monitoring on 7/5 all ready to go!! Great follicle sizes and lining is at 9. Tigger 7/5, ER 7/7 16R 9M 3F. Stimmed too fast in just 7 days. 7/10 3dt of 2 8-cell grade 2 & 4. 7/14 P4 >60.
    Holy crap BFP!!!
    Beta #1 (14dpo) 7/21 112 Beta #2 (16dpo) 7/23 286 a Beta #3 (18dpo) 7/25 761 Beta #4 (21dpo) 2631!!! Hold on tight little embies!!      First Ultrasound 8/7- 1 perfect little bean with a beating heart 117bpm!! EDD 3/30.
    Second ultrasound 9/2 Little bean measuring a few days ahead with a heart rate of 161!


    PAIF/SAIF/All Welcome!

    image




    Pregnancy Ticker} 




    March 15 Siggy Challenge: You had one job

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    marissa1082marissa1082 member

    Thank you for all of the input!

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