* Author Topic: Menopur or Gonal F for older women with low AMH?  (Read 5738 times)

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Offline katkat2014

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I was wondering if anyone has any thoughts if Menopur or Gonal f is better for women over 40? Any experiences (please could you add your fsh and lh if you have it)?

Here is my background and sorry for long story. I have had several failed cycles, my fsh is about 8.9 and lh around 8 (but last month was 4.5) and AMH of 0.78 (or 5 in the other measurement). I will be doing a mild cycle, I have done 2 of those previously with Gonal F and femara and had good quality embryos/blast (2 each time, out of 9 follicles/eggs). But i always have a lot of immature eggs. The doctor thinks that menopur will give me a better result in terms of more mature eggs. But my concerns are these. When I was 38 I took Gonal f only and had 7 mature eggs (so no Menopur needed). When I did a high dose cycle with 300 Gonal (reduced to 225 at day eight) and adding in 150 menopur around day 8 and 3 of my 4 embryos were terrible quality and arrested at 2-cell stage (was is the Menopur or the high dosage?). And also I read that older women produce more LH when they are older and adding even more LH will damage the eggs. And then finally Dr S in the USA said to me on his forum he totally disagrees with using an LH/FSH product because of the latter issue with LH (he says the lh we measure is not the bio active form he is talking about which is high in women over 40). So you can see my dilemma here. My doctor seems to think it will be good for me to do a femara & Menopur cycle for more mature eggs, but I have huge doubts and I don't have the luxury of doing many more cycles, financially and age wise.

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    Offline Dinapantz

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    Menopur or Gonal F for older women with low AMH?
    « Reply #1 on: 1/10/16, 18:17 »
    Apologies if ths response comes too late and I don't have any data BUT I'm undergoing fertility treatment for the 7th time and I was on 450 goal and 150 menopur.  This is the highest, legal dose + cetrotide.  I was only expecting 5 eggs and today I had egg collection and had 16.  I obviously responded very well to this regime and I'm delighted.  Hope this helps and good luck.

    Offline katkat2014

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    Menopur or Gonal F for older women with low AMH?
    « Reply #2 on: 8/10/16, 00:48 »
    Thanks so much for your input dina and sorry for my late reply as have been abroad. How did you get on? Fingers crossed you had good embryo development! How was the quality on such a high dosage?

    Offline Claudia H

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    Menopur or Gonal F for older women with low AMH?
    « Reply #3 on: 26/10/16, 15:39 »
    Hi KatKat,

    I am also interested in the whole menopur thing. I have had 4 cycles. For 3 of them I used Menopur only and for the other 1 I used Gonal F and Luveris. I have also heard that menopur wasn't good for older ladies due to having too much LH. But actually I seem to have had better quality embyros with the menopur than the Gonal F. IN fact, the Gonal F round turned out to be my worst round in terms of quality - no blast better than a 3BC. In Menopur rounds I have had fully hatched blastocyts and top quality ones to freeze too. But then again none of my fresh cycles have been successful...so I'm confused! I wish there was someone really knowledgeable that we could ask. I'm at a really good London clinic and I feel that if menopur was bad for older ladies surely they would know this and wouldn't be giving it to me? But how much should we just trust our doctor and how much should we advocate for ourselves?

    x

    Offline hambone1

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    Menopur or Gonal F for older women with low AMH?
    « Reply #4 on: 31/10/16, 21:43 »
    Hello!
    Thank you for posting this - I have the exact same question!  I recently had a gonal f (300) and cetrotide cycle that left me with mild OHSS and produced 15 eggs/9 mature/5 fertilised... with only 1 a good quality embryo (chemical pregnancy).   I can afford (both in terms of time and money) one more own egg cycle - and the clinic I am thinking of switching to has suggested using menopur instead of gonal f as they think it can help produce more mature eggs.  The doctor told me that as long as my LH level was low enough on day 3, we could try menopur.   My concerns are the same as yours.  I am heading to the fertility show in London on Saturday, and plan to ask every consultant there what they think/would suggest - and I will report back whatever I find out :)

    Offline Altai

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    Menopur or Gonal F for older women with low AMH?
    « Reply #5 on: 1/11/16, 11:48 »
    Hi,

    I used gonal f on my first cycle and it was one of the worst cycles with only 2 eggs retrieved.
    Menopur gave me 7 eggs but only 4 mature.
    My best response was from combined oral plus low doses of fostimon. Fostimon is fsh only drug I think is 'naturally derived' while gonal is synthetic version. Somehow, fostimon suited  me better.
    I also used merional & menopur, as far as I remember no significant difference.

    Offline Claudia H

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    Menopur or Gonal F for older women with low AMH?
    « Reply #6 on: 1/11/16, 16:48 »
    Hambone - great that you are going to the show. Yes please report back what they say! I'd go too but can 't be in London this weekend. Its a great opportunity to ask - would LOVE to hear what they say! x

    Offline hambone1

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    Menopur or Gonal F for older women with low AMH?
    « Reply #7 on: 4/11/16, 16:18 »
    Will do!!!! 

    Offline Agaamh

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    Menopur or Gonal F for older women with low AMH?
    « Reply #8 on: 12/11/16, 15:25 »
    hello ladies, what about the mix of gonal f and menopur in the same protocol? Do you have any experience?
    This approach is recommended by my clinic.

    Offline Claudia H

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    Menopur or Gonal F for older women with low AMH?
    « Reply #9 on: 13/11/16, 10:20 »
    agaamh - did they say why? i seen people use that but not sure why it's better than just straight menopur?