* Author Topic: Best Protocol For Over 40  (Read 2627 times)

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Offline Syd72

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Best Protocol For Over 40
« Reply #10 on: 31/01/17, 11:23 »
Hi ladies, sorry for the slow response.  Some of you are on other threads that I'm on so apologies for repeating stuff :)

In the end I had 10 days of stimms, triggered on day 11, got 10 eggs, 8 fertilised with icsi.  On day 3 I had 3 doing exactly what they should be and two that weren't looking so good but were still a possibility  they decided to do a day 5 transfer.  I ended up getting one early blast and one compacting (or compacted?) morula transferred.

So overall I think I responded well to short protocol given my age, I was on 375 of gonal f per day.

Claudia, so very sorry for the bfn.

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    Offline Claudia H

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    « Reply #11 on: 31/01/17, 13:45 »
    Hi Ladies,

    eekeech - thanks for the articles. I'd see the first one but not the second. Interestingly the second is very damning about using Dexamethasone during pregnancy because it is a steroid and crosses the placenta and in some cases has been show to cause bith defects. And guess who they quote in the article as saying they recommend it for women in the first trimester? Dr Sher. To be honest I don't really rate him - I know his clinic is famous but I think he talks quite a lot of poo. So I wouldn't worry about his advice on long v short.

    Veracruz - was that a BFP? I think I saw on another thread that it was. if so - congrats!

    Syd that is a great number of eggs! well done!!

    AFM - just saw my doctor for a follow up after our failed FET. I asked him about Dexamethasone and HGH - he said neither work and studies have proved that. He has though finally agreed that I can take DHEA - he says he doesn't think I'm in the target group that it works for but this is our hail mary round so might as well through the kitchen sink at it. He says it won't do any harm and I don't need my testosterone levels checked as they are v unlikely to be high anyway.

    on Long V Short he says he generally prefers Long - but studies don't show much difference between the two. Long has a marginally better outcome - but it is only marginal (and maybe its because younger patients all generally do Long and have a better prognosis anyway!) He doesn't think cetrotide harms egg quality (another consultant said it did) - but there is some theory that it harms the uterine environment so that is something to think about if you are doing a fresh transfer I suppose. Again - its probably marginal though.

    So we have decided to give it one last bash. We are already on the waiting list for donor but not quite there yet so while we wait we are doing 3 more back to back retrievals (if we can - he might insist on a break in between the last two). We are doing short protocol due to time - its just quicker and I really want to get on with it! We will biopsy everything before freezing and then PGS test the lot. If we are lucky enough to have another normal one, we will do an FET the following cycle. I can't quite believe I am doing this but best not to really think about it.

    xx

    xx

    Offline Altai

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    « Reply #12 on: 31/01/17, 14:03 »
    Syd - that's was a very good outcome. Fx for 2ww.

    With regards whether short or long  protocol - I was looking at it too when did my IVF. Got impression that over 40 ladies who do long protocol are those with good ovarian reserve (both high amh and AFC).
    Those of us with DOR are usually advised to do short protocol.


    Offline veracruz

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    « Reply #13 on: 31/01/17, 19:39 »
    Claudia H - thank you, yes it's BFP for me but very early days so trying to stay optimistic.  Really sorry to hear about your struggles, I can't even imagine how you must feel.  :(

    Just to say that I did use Dexamethasone my first BFN round but not my second successful (so far) round.  Instead, I was on all the same other meds like aspirin, Clexane, Gestone, and Prednisolone instead of Dex.  Also first round was 11 days of stims and 2nd round was 10 days.   Wish I knew what worked this round vs. last but I'd just be guessing.

    Offline scattykatty

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    « Reply #14 on: 31/01/17, 20:49 »
    Congrats Veracruz.. fingers crossed x

    Syd congrats on being PUPO - I'm one of the I think many 40-43ish ladies who have been silently cheering you and the others in the over45 thread on. Am thinking of you lots x

    Claudia H - sounds like you're really going for it - I admire you bouncing back harder than ever... Great! Interesting protocol. The result of my cycle was a non-viable preg which we basically  knew from the start but took 8 weeks to 'call' so I feel like I want to avoid going through this potentially as it hit me that my ovaries will be >6 months older than the last cycle. Eek. Back to back retrieval and short protocol seems a lot easier to recover from and PGS testing is something I've considered but we only had one borderline freezable blast last time so I'm not sure how realistic it is. Plus the $$ it all costs...

    AFM Well, I'm debating visiting a couple of clinics slightly further away that do mini IVF as I could imagine banking with them 3-6 times with less stressful stimulation and then doing FET. Then again, it'd mean every month driving further away for repeated procedures. Just keen to avoid the intensity of this last cycle. Might be wishful thinking! My review appointment is in 10 days time so hopefully that'll be a good time to come with my 101 questions about protocols for egg quality etc etc.Then I also debate looking at CRGH as they seem to have the most successful PGS programme from my stats hunting and also an IVF only preg/live birth rate almost double most others for age 40-42... Then again, London trips for a cycle from the Midlands is not something I fancy... Decisions!

    Offline Blondie71

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    « Reply #15 on: 1/02/17, 23:31 »
    Serum put me on a short flare protocol based on an amh of 55 or in USA think that would be 5.5, I was 40 at the time and no pcos or anything found although I did have tubal issues which could have blocked ovulation 😕 my protocol was menopur, puregon, decapeptyl, clexane and prednisolone and 5mg folic acid, I managed to get 17 eggs, 10 of which fertilised and were frozen, 4 out of 5 survived thaw and were put back (twins from that) and 5 are still frozen for future x

    Offline Syd72

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    « Reply #16 on: 2/02/17, 02:50 »
    Scattykatty thanks so much x

    Claudia H I'm really glad you're giving it another go. I may have said this elsewhere so apologies if I'm repeating myself but I had one clinic wanting to do long protocol for me and one wanting to do short.  I decided to give long ago but for various reasons ended up doing short (timing reasons, nothing to do with reserve etc).  I do have good reserves for age so maybe that's why they were considering long for me although the strong impression I got was that they prefer to do long for everyone if possible.  I'm happy that I did short in the end.

    Thanks Altai.

    Veracruz, huge congrats on the bfp

    Offline eskeech

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    « Reply #17 on: 2/02/17, 04:08 »
    Hi Ladies,

    @Claudia H,
    You made me laugh! I agree, I believe his opinions are a lot of "poo!" I'm not worried at all anymore. I'm very excited for your plans while you want for the donor. Who knows what could happen?

    @veracruz,
    I can't imagine how excited/nervous you must feel. A BFP!! What a dream. Good for you!

    @scattykatty,
    I know exactly how you feel about far away clinics. It's one added stress to an already pretty stressful experience. Still, if you feel that one of those clinics could give you a better outcome, I say go for it.

    @Blondie71,
    Good to hear what your protocol at Serum was! And great successful! Twins! I'm secretly hiring that might happen to me, as I would really like my child to have a sibling and I can't imagine doing this when I am older. But, you never know. For me, my only issues thus far seem to be age (I'll have just turned 44 when tx begins) and endo. The endo has me more concerned than my age, actually. It seems, given al my testing, that I am likely to respond well to stimms. The endo can prevent implantation or cause early miscarriage. It's such a frightening thought.

    @Syd72,
    My guess is that you;re absolutely right. You have great reserves for age and thus they wanted to use high stimms. It seems some clinics, like Serum, still prefer short protocol because of our fragile ovaries.