* Author Topic: agonist/ antagonist conversion protocol with estrogen priming  (Read 3504 times)

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Offline Jessie72

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hi everyone.

i know there has been a previous post on flare v conversion protocol, but i thought i might revisit the issue following an article i came across by geoffrey sher and how they treat ( and have success with) older women and/ or women with low ovarian reserve. they use an agonist/ antagonist conversion protocol with estrogen priming.


basically its a kind of long protocol but key us when you start taking the agonist eg buserelin you bleed after a few days, then they switch the agonist for a low dose antagonist eg cetrotide and continue this throughout stimming. the antagonist stops luteinising hormone from getting too high ( which sher claims is detrimental for eggs of women with low ovarian reserve)- the advantage of this protocol he says is that unlike the agonist ( buserelin) an antagonist will not 'outcompete' the stimm drugs for fsh receptors. another key issue with this protocol is they add in an estrogen primer to get best response.

i have amh 4, had two icsi cycles using two different protocols, with poor response:

cycle 1
 down reg with buserelin, 300iu menopur stimms- 17 days stimming, 3 follies, 3 eggs. did end up eith two embies to transfer, day 3, one top grade quality.bfn

cycle 2 ( note took dhea for few months before cycle)
short/ flare protocol- stimm with 600iu gonalf, 75 iu luveris. cetrotide started day 6, luveris stopped day 10. i was stimming for 12 days- 8 follies, 4 eggs, only 1 embryo survived( 1 egg was immature and two other embies expired next morn post fertilisation). again top grade day 3 embryo but bfn

this guy, geoffrey sher, does not rate flare protocol at all for women with low ovarian reserve because the rise in lh stops the follicles from developing properly and effects egg quality ( this is what happened to me when i was on flare see cycle 2 above). he also says that the 'standard' long protocol is problematic where agonist is used as eg buserelin suppresses the stim response too much ( this also happened me on 1st cycle, see above).

has anybody tried this protocol/ know of a clinic in ireland/ uk/ europe that does the agonist/ antagonist priming with estrogen priming?

i know i may be clutching at straws and may never get a good response but thought this protocol may be worth a look!

i am hoping to increase my embryo number by improving the protocol as i would like embies genetically screened ( as i feel this may well be our problem).

would be grateful for any input on this!

j x



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