* Author Topic: Menopur or Gonal F for older women with low AMH?  (Read 5650 times)

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Offline hambone1

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Menopur or Gonal F for older women with low AMH?
« Reply #10 on: 13/11/16, 19:09 »
Hi All (and thank you Claudia for reminding me to post!) -

As for the Fertility Show - it was really informative and would highly suggest going next year if you can - I ended up meeting with 6 clinics and there was NO consensus over Menopur (or other LH/FSH combos)  vs Gonal F (straight FSH).   I asked this question at a Q&A (the panellists were Dr. Nargund from Create & Dr. Christopolous from Hammersmith - it was a great panel) - both of them were adamantly against using Menopur, as they thought this would raise the LH too high and could also raise estrodial too high, especially in women prone to overstimulation.  I then met with IVf Spain - Alicante - and the doctor I met with (I was quite impressed with her, actually) suggested using an LH/FSH combination drug like Menopur since it more closely mimics the natural cycle and she thought led to better quality eggs.  Embryolab (Greece) said the same thing.  Barcelona IVF said it depended on the individual case, and that she liked to use a new drug on the market that only requires one shot, as it keeps the FSH levels more stable over the cycle and she thought led to more mature eggs (downside is that it is more expensive and not commonly used - I can't find the name of the drug). 

And so - no more clarity, I'm afraid, other than it seems to fall back on what people are comfortable using and what one's individual estrodial/LH levels are going into the cycle - and that the protocol needs to be tailored throughout the cycle based on response.    Also, everyone seemed to agree that the only supplements that seem to be of benefit are Ubiquinol, Vitamin D and Folic acid and a good diet.

One thing I did pick up was to check what the success rate with donor eggs was, as that is a good indication of the quality of the lab.  Since donor eggs should all be healthy, young eggs (with high fertilisation rates), clinics with good labs should be getting very high success rates with these.  Success rates with own eggs for older women is low no matter what the protocol, unfortunately - so getting more eggs seems to be the preferred aim - the quality is really not something we can do a whole lot to control - but to maximise success you want a good lab and an experienced doctor.

Good luck everyone!!!

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    Offline Agaamh

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    Menopur or Gonal F for older women with low AMH?
    « Reply #11 on: 15/11/16, 17:24 »
    @hambone thanks for you report on the Show.
    I just confirmed with my new clinic that I will do the estrogen priming protocol with a high dose of menopur and gonal F as well as femara.
    I already had a long protocol with puregon  and slightly modified own cycle on low dosage of menopur and clomid.
    In both cases the same results, two 8AA transferred back. Unfortunately unsuccsesful.
    Now I also take DHEA, and high dosage of vit B complex and Mg,. I stopped with vit D3 and Coenzyme 10 as I am on detox now.
    I will also have acupuncture (only three sessions).
    X


    Offline hambone1

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    Menopur or Gonal F for older women with low AMH?
    « Reply #12 on: 16/11/16, 18:50 »
    Hi All-
    I've just confirmed my protocol as well - I will be using Menopur.  I am a bit worried to switch as I responded well to the gonal f, but am willing to try something different if it does anything to improve the #s of mature eggs.
    I am curious about the gonal f/menopur combination, though - it sounds like the best of both!

    Good luck!!!!!!!

    Offline katkat2014

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    Menopur or Gonal F for older women with low AMH?
    « Reply #13 on: 16/11/16, 20:21 »
    Sorry haven't posted so long (I don't like people starting posts and then not following up). I guess the jury is still out on gonal f vs menopur. Well it could be my terrible eggs (I think that's the case) or the Menopur, but my last cycle was a bust. Again. I had decided to go with a mix of gonal and then adding in Menopur on cycle day 7 and although I had 10 eggs with this on my mild cycle, only 2 were mature! I meant to pgs test but nothing grew past day 3 so nothing to test and nothing was transferred 😐 when I say 8 were immature - it was actually because most of them were degenerate. My doctor things it's because we triggered too late, but I've triggered late a few times and I sill had more mature and better eggs then (when not using Menopur). I just wished there was clear rule on what protocol to use if you're a bit older. I am considering the agonist/antagonist conversion protocol  (no LH!) Or a clomid baking cycle as I think older women have success with this at Serum. But that's exactly the same thing. .. clomid makes your body use your own LH which is supposedly bad for older women ...but why do Serum use this for most of the women cycling with them? One thing I noticed, I had lot and Lots and Lots of ewcm this time,  I think my estradiol was super super high. Every day I thought I had ovulate already. Is that bad for eggs? Sorry for my monologue ;)

    Hambone wishing you the very best of luck ☺☺ your post has been most useful. Please keep us updated!

    Seems like we're all using entirely different protocols too. Menopur only. Estrogen priming with gonal and Menopur. Fostimon.  Etc etc ...


    Offline Agaamh

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    Menopur or Gonal F for older women with low AMH?
    « Reply #14 on: 17/11/16, 19:15 »
    Unfortunately, the doctors cannot offer us a "miracle" protocol. The protocol that worked well for somebody, will not work for another one...
    I will Report on my mix protocol soon.
    Good luck for everybody X