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Discussion Starter #1
Hi, am in the middle of trawling through clinics so wondered if anyone would be happy to share the medication protocols they have used when having successful pregnancies with low AMH/high FSH.  Am finding that a lot of clinics still tend to go for maximum stims even when there is a lot of evidence out there to suggest that this may not always be the best thing to do with older women with low egg reserves/quality so just wondered if anyone would be willing to share what meds they took on successful cycles to give some food for thought for the rest of us?  Thanks.  Val xx
 

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Hello

I know you said successful and mine wasn't but when my AMH was 2 I cycled with Max dose of Menopur 450 and Cetrotide on a Sp and got 4 eggs from 4 follicles, all mature with 100% Fert, whilst it wasn't a bfp I still did better than I expected

Good luck!

L x
 

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Discussion Starter #3
Thanks Lily, sorry it didn't work out but know what you mean about responding better than you thought, unfortunately for me it's usually worked the other way around!  :eek: Good luck for your scan next week!xx
 

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Val best bet is prob natural/mild IVF, I think serum, CREATE (they also have a clinic in UK I believe) and also couple other clinics do this (maybe Russia??) sounds like you want to preserve quality over quantity, high doses of drugs do tend to compromise quality in older women unfortunately.
 

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Hi Val,

I am yet to have a successful pregnancy - last one was a chemical but I have very low AMH and high FSH. First cycle in the UK was cancelled, I had 3 follicles and after 10 days of stims only had 1 follicle measuring 19mm. Second cycle, natural cycle at Serum I had 3 follicles and was on 150 merional from day day 6 and got two eggs - resulted in a chemical. Just had my third cycle (2nd at Serum) I had 5 follicles and managed to get 5 eggs, started stims from day 3, 150 merional. I have just had 3 embryos transferred. I have found I respond better with no suppression i.e. the pill. My clinic in the UK mainly did this as they don't open on the weekend and wanted to schedule the egg collections. I think Merional which is naturally derived FSH and LH also suits me better, although some people think too much LH for women over 38 effects egg quality.

x
 

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Hi janieliz, thanks  for that I've not heard of Merional, will have a read around it. Your last response was excellent wasn't it! Good luck with your embies, let's hope your positivity continues  ^pray^ Blondie thanks for info, have heard lots of great things about Serum but get ridiculously anxious in cities, stupid I know. We went to see Create but opted not to cycle with them as had quite poor communication from them. If we do decide to cycle again in the uk though may have to use them as not many others specialise in mild.xx
 

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Hi Val,
I was really pleased with it, but who knows, its all a bit random I think IVF. I had a 3 day transfer this time as I just wanted to put them all in. Probably should have waited till blast like I did last time, but that didn't work so just felt I needed to try something different!
Just to say, where I stay in Athens is not busy busy, I'm a Londoner and apart from the traffic in Athens - which is busy, I have found it really good to be here. I honestly don't think I would cycle again in the UK. I find it so negative as a poor responder. I had some tests done ages ago at Create and it took me months to get the results. I have heard the admin is shocking and there are loads of hidden costs to the natural cycles. It might be worth just booking a phone consultation with Penny ands seeing whether you get a feel for the clinic. It might help overcome the fear of cities?
xx
 

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Discussion Starter #8
Over the weekend I sent all previous cycle info off to two clinics. Got their response this morning and it was everything I've beenjlooking for: direct and detailed. Only problem is they're both talking of max stims, 450iu, andthat worries me. Everything I've read goes against this, that high stims nukes egg quality. So confused! :(
 

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I think that there are lots of different opinions on it. Dr Sher in America uses this whole agonist/antagonist oestrogen priming protocol for poor responders, the stims start off at 600! I think it is very subjective, while high stimms might not effect quality in one person, it might in another. Very hard to judge until you try it. 450iu is high but not mega high. Have you ever tried stimming in your natural cycle i.e. not being on the pill beforehand? it really helped me to respond better. When I only had 3 follicles one month I had to weigh it up - is it worth taking loads of drugs to try and get all 3? The maximum I have had on my last two cycles has been 150iu. I stimmed earlier on this cycle too. If there is a next time, I am going to think about maybe trying some sort of oestrogen priming to try and lower my FSH a bit but I need to ask more about that!! What clinics are you thinking of going with?
 

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Discussion Starter #10
I don't think my oestrogen has ever been tested can ypur GP do that? Been looking at two clinics in Cyprus so can do tandem but have treatment under guise of holiday. My best response was on 300iu where we only had few follicles and four eggs. When they increased to 375iu got more follicles but only one damaged  egg. I get more  clueless as I go along!
 

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I did short protocol.
Day three to fourteen gonal f 300
Day three to seven Menopur 75 rising to 150 for days eight to fourteen
Oraglutron days ten to fourteen
Pregnyl trigger shot on evening of day fourteen

Egg collection day sixteen. From seven follicles seen on scan at day 13 we got four eggs, three fertilised, two put back on day three and right now nervously waiting for twelve week scan.

Fromm egg collection I did a week of antibiotics.
Also from egg collection did Cyclogest 400, times per day until twelve weeks.

My AMH was 5.6 two years ago and I've never had FSH tested.
 

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Thanks mrsww. So happy it worked for you. Your AMH is great compared to mine (0.5). I'm so torn, my current clinic  aren't suggesting anything other than to try anything I ask about, the other clinics I've spoken to abroad all suggest 475iu. So hard to know what to do.xx
 

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Val maybe it's time to try a change for the higher dose and see what happens?? I didn't have low amh but was stimmed to the max with short flare protocol (I was 40 so prob standard to do max stimms with oe abroad)
 

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Discussion Starter #14
Yes maybe it is time Blondie as I am driving myself crazy reading so many different things  ^idiot^. Just need to make a decision and stick to it I think. Thank you.xx
 

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Go on girl be brave take the plunge  ;D

ps are you going abroad or home for tx this time?
 

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Hi Val,

After a successful attempt with ARGC following two failed treatments through nhs I am of the opinion that it is a combination of dose and type of stimms you are given, alongside your diet that will affect egg quality.

My first two cycles I was given Merional (fsh and lh combined) 450ui first 7 days and dropped to 225ui towards the end. Cetrotide last 4 days and my eggs were very poor quality.

With ARGC because they were looking at my blood work too they knew how to respond and also knew that I didn't need much LH in my stimms drugs so I had mainly Fostimon which is just pure FSH.  I had just 150ui of merional over the entire cycle and they doubled up on my cetrotide on some days.  I yielded 7 eggs...ended up with 5 eggs and transferred 3 good quality eggs back.  They used pregnyl as the trigger whereas nhs used gonasi.

My nhs cycles I feel they gave me too much merional and overcooked me.

Hope this helps.

My fsh and Amh when I was cycling with nhs was 13.9 fsh and 4.2 Amh. 
My Amh was same with argc but fsh improved to 6.7 through diet and being less stressed.
 
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