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Ok, I am after advice and any information to support either short or long protocol.

First, the history. Trying since Oct 2007, unexplained infertility, with no luck from Clomid or the first IVF cycle (Nov/Dec 2010). Over-response to Clomid (two abandoned cycles with 3 and 8 follicles, dose reduced to 25mg to get 1 follicle in the last cycle).

The last cycle was our first IVF, we went to Liverpool Hewitt Centre, funded by NHS. It was long protocol, in the end, there was a number of follicles varying in size, but only 1 egg collected, it fertilised, was transferred as Day 2, 6 cell embryo. Didn't take. Later we were told that it was a medium quality.

I was on Buserelin for about 18-19 days, then 13 days on Menopur. Cyst drained at baseline scan. Started at 3 amps, increased to 4 for the last 5 days. There were only 3 follicles on the Day 7 scan, a few more on the Day 9, but too small, Day 12 - a bit bigger, EC date set.

We had our follow up appointment, when we 'pulled out' of doctor, that the next would be short protocol as I have responded poorly. I was on 3 amps of Menopur, increased to 4 for the last couple of days.

I have called the clinic yesterday to confirm if we have the NHS funding for the next cycle and to confirm things, etc., when the nurse informed me that 'they had new evidence' that short protocol doesn't work for poor responders! She got the doctor, and basically, the doctor now suggests to go for long protocol, and going for 5 amps of Menopur.

I am 'young' - 31, FSH was on the high side at 9.3 last summer. I did ask about repeating the FSH test, to see if it was just one off result, or my FSH is actually going up and my ovarian response is compromised. Doctor refused the test, saying it is not needed.

OH called the nurses station and spoke with the nurse. So, the news is that this is the internal change in policy, and there is no published evidence supporting this. It is just that they noticed that if you were on long protocol and didn't respond, there was no improvement when you were put on short protocol.

We are having an appointment set up with the head of the centre to discuss this. So, 'my plan' of having next cycle in May is out of the window.  I now need to gather any evidence I can find to support either choice and then we can discuss this with head of centre once we get the appointment.

Anyone can help in this and point me in the right direction? Are there any published studies that support short protocol? According to nurse, there is no proof that the short protocol works better...
 

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Hi

I can't really advise you to be honest because I'm not sure what I think.  I've done both first cycle I did LP and had a really slow and fairly poor response to stimms.  At one point I held the FF record for the longest stimming until Holly17 took it off me! ;D  BUT despite all the aggro when I got to EC they were all mature and all top quality and I had embryo's to freeze at the end of it (got  7 eggs in the end).  On subsequent cycles I did SP and got 10 eggs but a higher instance of immature eggs and still ended up with 7 and none to freeze.

So the end result for me was pretty much the same on both cycles but short protocol was less stressful and a shorter cycle and I think on balance I would still go for SP everytime.

Hope one of the "cleverer" ladies will be along soon and will have loads of evidence to cite at you to help your cause! :)

^goodluck^

Axxxx
 

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Hi,  ^hugme^

On my first ivf cycle i was on the long protocol and got 7 follicles 6 eggs, the clinic considered that a poor response as i was egg sharing.

On my 2nd cycle i was on short protocol and got 3 follicles and only 1 egg.  :eek: I was gutted at thought i'd end up with more, I really hope you are lucky in your next cycle which ever protocol you go for,  ^reiki^ ^reiki^ ^reiki^ ^reiki^

xxx
 
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