Gonal f 450... is it too high?

Re: Gonal f 450... is it too high?

• isareeya member

  April 2021

  Depends... there is some new research suggesting too much is less beneficial although they're probably a few more years away from giving a definitive answer.
  
  High doses of FSH in small ovarian reserve heifers reduced estradiol levels and ovulation rate | Fertility SCIENCE
  
  You could always bring the topic up with the specialist and send them the above link/paper to read. At the end of the day if financially you are ok to accept the risk of 'no ovulation,' they might agree and readjust the dosage.
  
  In the UK, 375IU is the max dose given for AMH < 15.... so 450 does sound a bit excessive.
   

  Report0 Reply
• Loading the player...
• isareeya member

  April 2021 edited April 2021

  Your in luck, stumbled upon another recent study ( https://doi.org/10.1016/j.xfre.2021.01.004 ), covering 2773 cycle results for those with POR (AMH <1ng/ml).
  
  In women under 35 'mild-stimulation' (Clomid or Letrozole) was significantly better than all the other Gondal stimualtion protocols (PPOS, GnRH-antagonist, modified long protocol, GnRH-agonist long protocol).
  
  They stated that 'The effectiveness of mild stimulation in women ≤35 years may be due to avoiding disturbances on oocyte quality by high gonadotropin dose' citing a previous study comparing quality 'markers' between natural and stimulated oocytes ( https://doi.org/10.1186/s12958-019-0489-4 ).

  
  

  Report1 Reply
• greateggspectations member

  May 2021

  TW: pregnancy
  
  
  
  I am 44 and pregnant with twins, I was always on Gonal-F 450IU for each cycle. My AMH was 2-something. 

  Report0 Reply
• andreamm31 member

  May 2021

  I was on the same doses I believe when I did ivf, with severely low AMH of 0.26.  I think it fried my eggs,  they literally fell apart when they came out of my body and we only got 2 eggs once and 1egg another time in 2 rounds.  But I had 2 natural pregnancies with my eggs (that I had MM die to chromosomal issues,  so I really think it was high doses of meds that my body didn't like. 

  
  
  39 years old   DH 41.  Sperm looks great.  We live in San Diego  
  Me:  ****TW loss mentioned***
  MTHFR Homozygous 677TT (dx 2016)
  hypothyroid
  8/2018           Off birth control
  11/29/2018    CP
  2/10/2019.    CP
  3/8/2019        Saw fertility doctor, AFC 5, labs drawn
  3/14/2019      Pregnant
  4/18/2019      9 week ultrasound  MM , stopped growing at 6 weeks, no HB.  D&C 
  5/2/2019       Return to fertility doctor, labs show AMH 0.27. Diminished Ovarian Reserve
                       1st of 3 Egg retrievals planned tentatively for July
  6/29/2019     started Antagonist Protocol 
  7/12/2019     First egg retrieval, only retrieved one egg and fell apart immediately, poor quality.
  8/7/2019.      Second cycle (follicular antagonist) canceled on day 5 of stims when a very large lead follicle grew out of nowhere.
  11/8/2019.    Second Egg retrieval with Lupron Flare Protocol.  2 eggs retrieved, fertilized with ICSI but no reaction occurred at all.                       Told I will never have my own babies with my eggs.
  12/20/2019    ERA - pre-receptive.  Needed 24 hours more of progesterone
  2/2020          CP
   3/2/2020     Egg donor cycle in Prague at Unica Clinic, 2 AA embryos, 1 transfer, 1 on ice. BFN.  Due to pandemic, we could not return to Prague and will abandon our remaining embryo.
  4/20/2020.  BFP trying on our own! 
  06/04/2020   After HBs at 7 and 9 weeks, MM at 10 weeks 3 days.  D&C, Hemorrhaged out 1 liter of blood from uterine artery rupture during procedure.     Spent 1 night in the hospital with a balloon tamponade in my uterus. Baby was mosaic Trisomy 21.
  8/2020.  Moving forward with Donor Egg cycle at Utah Fertility Center and sharing a cycle with ladypOtter (Gina) I met on the Bump who was also supposed to go to Prague but couldn't.  
  9/26/2020 Donor retrieval of 26 eggs, 24 mature.  Split cycle so I have 12 eggs with all 12 fertilizing. 6 PGS normal 3 boys, 3 girls
  10/29/2020 Transfer day of  girl donor egg embryo.     BFP! First HCG 92.9. Then inappropriate rise, plateau and falling.  Possibly ectopic pregnancy.  ER visit with diagnosis of "pregnancy location unknown". CP
  1/19/2021 Embryos shipped from Utah to my local clinic, starting prednisone for anti-histamine protocol. 
  2/26/2021 FET girl embryo BFP. Betas 62, 139, 386! HB at 6 weeks, then baby stopped growing at 8 week check up with weak HB measuring 6 weeks 4 days.  MM at 9 weeks. D&C 4/15/21
  7/13/2021 FET boy and girl embryos. First beta 10dp5dt 177, 14dp5dt 1631, 16dp5dt 6809. Pregnant with Identical triplets.  At 9 weeks, Baby C no longer had a heart beat. Identical Twin Girls.   Pregnancy complicated by TRAP Sequence with baby C an Acardiac fetus still receiving blood flow being pumped to it by other girls.  Referred to UCSF at 18 weeks for consultation.  No intervention needed at this time
  2/18/22 After a failed NST, at 34 weeks 1 day, Charlotte born 4lb 4oz and Lily born 4lbs 10 oz.  Our hearts are complete.  Baby girls in NICU to grow and learn to eat.

  History in Spoiler

  Report1 Reply