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Discussion Starter · #1 ·
Just wondering if any other high FSHers have changed from a short to a long protocol after a failed cycle?

With my high fsh/low amh I was put on SP for my 1st ICSI with 400iu puregon daily from day 3 of AF and cetrotide/orgalutran injections after 4 days of stims.

I had 3 mature eggs collected, but one follicle had already ruptured due to early ovulation, and at my follow up the consultant advised that I try LP with 2 weeks of the contraceptive pill & 1 week on a low dose nasal spray, followed by 375iu menopur daily.  She thinks that this might produce a few more eggs and decrease the chance of early ovulation for me.

She thinks that because I normally have quite high levels of E2, a lead follicle is probably developing before AF has arrived (this does make sense as I have had a large dominant follicle seen on day 1 scans before), and that this increases the liklihood of early ovulation.  If I have the pill and D/R this should prevent early follicle development.

This all makes sense to me, but I am a bit worried as I have heard that many women in my position (i.e. with low ovarian reserve) don't respond as well on the LP.  My consultant hopes to get a few more eggs from me on the LP, but does anyone think this is possible?  I was fairly pleased with my response on the SP as I wasn't sure I was going to respond at all after my experience at the ARGC!

What are peoples experiences of this?  I guess that everyone responds differently to different things but I just wondered if anyone has found the LP better for them even with low egg reserve.

All advice gratefully received!
 
G

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Hiya - they are fans of this at the Lister with good reuslts...I def agree! After a good few SPs I tried LP and got my first positive - though sadly it was a chemical pregnancy in the end.....basically I guess you need to expect that it may take you longer to stim and that you may not get loads of eggs!....but controling your hormones (esp LH) early on can mean much better controlled LH throughout stims which is not only going to mean a reduced chance of early ovulation but is much better for egg quality - which IMHO is all that matters! I am a converted fan! Go for it but beware that until you try you just do not really know how you will respond :eek:

xxx
 

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Discussion Starter · #3 ·
Thanks Lukey  :)
 

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Hi,

I'm in a similar situation to you. I have low fsh but my amh is showing low fertility and I don't respond well to stims. I have just changed clinic and they want to put me on lp with gonalf, I am very nervous about this as I had such a poor response on my first round of ivf although the dose was much smaller. My 2nd cycle I did sp and produced 6 eggs out of 8 follies but only one fertilised. the new clinic feel that on lp I will produce better quality eggs, although they can't say it was my eggs that caused the low fertilisation as 4 were mature.

I am really unsure what to do, go with what the clinic recommend or try a compromise. I just don't want to go through weeks of down regging only to get 1 follicle again, which I would get without all the drugs anyway.

Anyway I don't really have any advise for you but just wanted to let you know you are not alone. I wish you loads of luck for your next cycle.

Take care,
Karen
 
G

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Hi both - don't forget there are a few different DReg protocols so maybe ask about these at the clinic? I know for such ladies The Lister like to do the pill for 2-3 weeks then a week of sniffs before stimms....so it is not that massive a DReg really ;)

xxx
 

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Discussion Starter · #6 ·
Hi Karen & Lukey

Thanks for your responses ladies

Karen - so sorry that you are facing this dilemma - it just seems so unfair that even when you got 6 eggs only 1 fertilised.  Mind you, as they say it only takes one good embryo to make a baby!  I can understand your nervousness about the response on a LP as well, though.  Does LP = better quality eggs & SP = more eggs then?

I am at the Lister & the DR they are putting me on is 2 weeks of the pill & 1 week of sniffing (but a low dose of synarel so that it is not too harsh).  As I have not done this before I am not too worried about this bit, I am just nervous about scans and blood tests once they start me on the stims (in case it hasn't worked & I don't respond well).  Like you say, Karen, it seems hardly worth all the drugs for 1 egg when you can produce that on your own at no cost to body, mind or bank balance.  However, I think that for myself I need to have one go on the LP just to know what happens.  I guess that our bodies probably respond differently at different times & even to small variations in protocol.  What will be different about your LP this time (apart from the doseage of stims)?  What clinic are you at?

Please let me know how you get on, Karen & I am thinking of you & wishing you a BFP for your next cycle  ^reiki^  ^reiki^
 
G

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I do really think you are right to try - and you are clearly aware that things may run differently so that is good :). I think if you do not try, you do not know. For me (and this may be relevant to you l/starter)- the Lister were amazing - on my first LP I did take ages to stim but slow and sure was best (even though a chemical pregnancy in the end) - they did not give up and I got some fab embies :). There is no rhyme nor reason as to why one protocol may work better for you over the other - other than to say that we are all fine-tuned machines that need tweeking in different ways and what may work for some may not work for others...it could be that the control of your LH (difficult in poorer responders) early on by the Pill and DReggers is just what you need for better eggs :)...and if not then at least you know.....loads of luck to you both!

xx
 

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Discussion Starter · #8 ·
Thanks for all your support & advice, Lukey

Just wondering how things are for you at the moment? x
 
G

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Good ta - should start the pill in early June and we are off again :eek: :eek: ;D ;D - smear test being ok that is :eek: :eek: :eek: ;)...thnx for asking :)...when I know "all is OK to go" I will do a new signature I think!

xxx
 
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