I am 38. We are OOP as well. TBD how many fertilize, etc. You are posting as a Guest without being logged in. It's a sort of "slow burn" methodology the hope being that they slow you way down and protect egg quality while allowing you to stim longer. I credit the advice I received on this forum both from members and from experts, my infertility doctor and my push for the estrogen priming protocol for the family that I have today. I then switched clinics. FertilitySmarts Inc. - Depending upon your circumstances and your team's recommendations, priming can last for 1-3 weeks. I'd love to hear from women of "advanced (advanced !) me: 37 Women with premature ovarian failure (POF) or diminished ovarian reserve (DOR) tend to have lower success rates with traditional IVF protocols. There are two downsides to this protocols: The long duration of injections (they start the previous cycle) and. Changed MD's and now this is the protocol they have in place for me. I would be doing a low stim protocol with estrogen priming. I asked my local RE about it, but she wasn't familiar enough with it to try. Are you wanting to learn more about the IVF process? It's an estrogen priming protocol. :-/. Estrogen priming is a protocol used during in vitro fertilization (IVF) to facilitate a more gradual and coordinated growth of follicles in the ovary in women with diminished ovarian reserve (DOR). I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. I will have retrieval hopefully this weekend and will let you know what happens. Below is a meta-analysis of 17 (relatively small) studies that, taken together, show the strategies have nearly identical pregnancy rates. The combination of drugs and their dosing is known as a protocol and while it may seem like there are a dizzying number of protocols, the reality is there are only a few core options. Second, this study was only done in cycles using a fresh transfer. . Slightly higher doses of Follistim and Menopur to try to get a few more eggs. Copyright 2023 IVF#1 with ICSI spring 2006 - 3 eggs retrieved, one transferred - BFN I did that back in the beginning of the year but I ovulated in my own and terrified it might happen again. Advertising Policy - There are two types of gonadotropin FSH and LH and most data shows you need both during an IVF cycle. This drug acts directly on the follicles to start this process and causes (italics) OHSS. Had two follicles but one disappeared day of egg retrieval. Below is data collected on over 3,000 cycles for each protocol approach in the Netherlands. This was my worst cycle ever only yielding 2 retrieved follicles that did not fertilize. This typically happens with conventional insemination where the egg and the sperm are placed in the same culture environment for fertilization You still may have a BFP, so let's wait to see before we say it didn't work!! I am also preparing to do estrogen priming again. As we show in the example below, during every step of IVF a certain number of eggs or embryos are lost, especially in the middle part of the funnel (growing embryos that are chromosomally normal). This protocol is used almost exclusively in women whove had a poor response in a previous cycle or who have evidence of diminished ovarian reserve (AMH less than 0.5 or an AFC less than 5). Buy Organic Seeds Risk Free From Organic Seeds TOP - Credit Card & Western Union Payment Options, Organic Seeds TOP is a seed vendor based in the Ukraine. It is so hard to be hopeful after 3 failed attempts. Ultimately there are two protocol strategies doctors will use: either the Long Agonist or Antagonist protocols. Confirmed. Most experts believe these women just dont seem to respond to increased doses and so above a pretty low threshold of gonadotropin, success rates dont seem to budge much. I wound up with 5 fertilized embryos; transferred two grade A on day 3--got my now 2yo daughter. This helps to improve the outcome of the IVF cycle in patients who respond poorly to traditional IVF protocols. I never hoped so I never even asked that question. Often two other types of drugs are needed to accompany gonadotropin: those that block eggs from maturing and being ovulated before they can be retrieved, and those that help trigger the eggs to mature so they can be retrieved. I did have a decent response on the MDL and 100% fertilization with two good 5 day blasts. I starts on day 1 of my cycle for 25-26 days of estrace.. Not sure why.. undefined will no longer be visible to you including posts, replies, and photos. The dose of gonadotropin is typically measured in International Units Per Day and ranges from 0 - 900 with most IVF patients receiving 250 - 450 IUs per day. This is done by administering estrogen, typically via an estrogen patch or an injection, sometimes along with additional Gonadotropin-releasing hormone. Thanks! I am only 28 with normal amh/fsh levels so we were pretty shocked and upset when we only had a couple embryos on day 3 and then nothing to freeze. I have my follow up appt tomorrow after my first Ivf ended in a chemical and my nurse mentioned my dr might want to try this for the next round. If ok, then start stimulation The many repeat bloodworks & ultrasoundsLast stimulation shot + triggerRetrievalSo I started my process in the mid-September and my retrieval happened in early NovemberAlso, I was on MicroFlare protocol, so I am not sure what other medications you might be taking. He did say there are some studies that DHEA and CoQ10 could help, but the, Hi all. We're also doing PGS. In the next section well walk you through the mechanics of each protocol. Just devastated with my results today so just want to cry it out and then I will respond to you. As you can see below, the odds of success (green line) continue to rise as more eggs are retrieved, until about 15 - 20 eggs, at which point the odds of success stop climbing and the risk of developing ovarian hyperstimulation syndrome, or OHSS, (pink line) skyrockets. My friends did this estrogen priming protocol and highly recommend it and were successful. Good luck! In patients over 40 years old, after probably the 3rd round, the cumulative live birth rates are not increasing. A fundamental question is whether protocols using a lower dose of gonadotropins do as well as those using a higher dose of gonadotropins. I was on the highest dosage of Gonal with that cycle. These include estrogen, FSH, LH and inhibin amongst many others. As a result, a woman needs to start the process with many eggs. They said that they look at FSH less now as they find it too unreliable. Please re-enable javascript to access full functionality. IVF #1, we did Follistim, Menopur, Cetrotide. Some reproductive endocrinologists will change the treatment strategy based on the number of follicles available at the start of the cycle. Have questions about navigating your Inspire support community or need assistance from one of our Inspire Moderators? You may wonder how thats possible. Did not cover diagnostics like doppler test (40 copay but insurance might have covered this), communicable testing ($400 per person), and specialty meds . Clomid is cheap, easy to take (oral), drives less risk of OHSS, but is less effective. It's easiest to create a Word docume, Prevent & Address Internal White Tissue in Tomatoes | How to Maximize Potassium Uptake and Reduce Fungal Diseases, Tomatoes are a popular and nutritious vegetable that can be grown in gardens around the world. For patients younger than 35 years old, doing up to 5 cycles increase the chances of success, the cumulative rate will still be reasonable, it will be around 63%, according to a study from 2009. :) worked well for me. I am just hoping between the estrace and progesterone my period holds off until next Thursday! An analysis that combined six extremely small studies (that in aggregate only included about 160 patients) show gains in live birth rates, as you can see below. This comes from a 38,000 patient European registry. But I am sure they know what they are doing at CCRM. Good luck. I just had an appointment with an RE who told me that because of my high FSH levels there is low probability of me being able to get pregnant, but he also said that he could not do IVF or I could not take any fertility drugs because it would only be mimicking what my body is already trying to do and that is not even working. By: Kelly Park Estrogen priming is typically done for about seven days before the start of controlled ovarian stimulation (the IVF cycle). And I think EPP is the standard at CCRM as well for DOR ladies. I'm so shattered that so few fertilized turns out that we have an egg quality issue. I will probably stim for 12-13 days! I am about to start my 4th IVF cycle. it's 1 week since last patch. I am on my 4th now. Again, gonadotropin is the injectable hormone that prompts a higher number of follicles, and thus eggs, to grow at any one time. Initial was 12. . Regular menstrual cycles between 21 and 40 days Presence of both ovaries Meets criteria for DOR by the recent ASRM/ACOG Committee Opinion antimllerian hormone (AMH) value less than 1 ng/mL antral follicle count less than 5-7 and follicle-stimulating hormone (FSH) greater than 10 IU/L or The one thing we all have in common here is helping each other fall pregnant, cos this gives us hope. Hello thanks for sharing. I think you should ask your doctor though to make sure.Again, here is what happened to my protocolCycle day 1 - PeriodCycle day 24 (7 days post ovulation) - Start Estrace Cycle day 1 - Period Cycle day 2 - Last Estrace pill Cycle day 3 Blood work & ultrasound; antral follicle count. Estrogen Priming is completely different, so therefore without birth control pill.I would ask your doctor, but I guess you just do nothing while preparing for the cycle. Froze 3. 14 retrieved, Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. Similarly, when an investigator named Revelli decided to swap out a few days of gonadotropin for clomid in this poor responder population in Italy (and thereafter resumed gonadotropin at low levels), he saw similar rates of success to more conventional levels of gonadotropin use. So.. Right ovary has 2-4 follies<12mm. Thanks for sharing your story. However, the study has two major shortcomings and for that reason most experts arent ready to concede that rates of gonadotropin over 300 IUs per day is harmful. Today, most IVF cycles use a frozen transfer whereby embryos are frozen and transferred at least a month after the retrieval. [Dr. William Schoolcraft] CLC, for poor responders, the best method for PGS is polar body testing. Just not sure what type of protocol would be best. However, weve yet to see a large, rigorous, prospective, randomized trial on the subject. My doc started me on estrogen patch, one patch changing every 3 days until my period for 5 days and I just took it off and will be takingClomiphene after a day of taking off the patch, then after a day start stim. When do you start your next cycle? Trying concieve since 40 My understanding is that most poor responders have egg quality issues and that's why they use it. Estrogen Priming protocol does not have birth control pills. Estrogen priming is pretty standard for over 40. I understand why they want to suppress ovulation but it just doesn't seem like a good idea in someone over 40? My clinic doesn't like it. Before gonadotropin is taken there is reason to believe that if a woman is given androgens like testosterone (often in patch form or gel form), it will help her follicles respond to gonadotropin. Waiting for that call is sooo stressful! Fingers crossed that your period waits for the right day. How did it go with the EPP? As you may recall in the Revelli and Yousef studies, 150 IUs per day of gonadotropin were used, which is well higher than most things marketed as mini-stimulation approaches, and any natural (no gonadotropin) approach. Learn more about. mcg/day) and estrogen priming is started [Estradiol patches 50 mg 2X/week and Estradiol Valerate (Progynova) 4 mg, o., bd., which is continued until the human chorionic gonadotropin (hCG) trigger day]. They studied what happens when you replace gonadotropin with clomid (a cheaper, less potent alternative) for a few days before the retrieval. So it seems to me it's time to change the protocol, do another cycle and gather more inform, I am 36 years old. Terms of Use - Is a micro-dose lupron protocol considered a low-dose protocol? Thanks! High FSH. I had success on an EPP. So, I'm 39 with Amh of 0.07 (undetectable) and FSH of 9. Lupton trigger. Estrogen is administered during the luteal phase of the previous menstrual cycle to "prime" the FSH receptors which enhances the response to FSH. 45 and over - who are trying to get pregnant. Have done 3 IUI's - 2 w. clomid and 1 with Gonal - F. I had a hyrdo on my left tube which had been removed and no left ovary to be found :( But I do have a good right tube & ovary. The stim phase was just like a usual antagonist cycle. Infertility Support Community in Partnership with RESOLVE. New doctor recommended EPP to promote more even follicle growth. Cost: $1,000. HI.. hope all is well. After 5 days of estrogen priming Follitropin alpha (Gonal F, 600 IU/day, s.c.) is started. Hi there. Best of luck to you. Below you can see that when investigators gave poor responders 450 IUs or 150 IUs per day, the groups had nearly identical success rates. That data comes from an analysis of over 700,000 IVF cycles run by well-respected investigators at Stanford. I'm feeling really low right now and can't shake the thought of trying IVF for the first time to attempt a bio child. Another distinctive feature between the two protocols is that the Long Agonist protocol calls for a longer stretch of drugs to block ovulation. Beta 2093 To conclude, in the group of patients . I have been diagnosed with low ovarian reserve. Started doing the patches 10 days before my period was scheduled to start. The combination and duration of drugs to stimulate, suppress, and incite ovulation taken together comprise a protocol. - 1st follicle check u/s and b/w. Im on this for 21 days starting on cycle day 1. I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. During my IVF cycle (still in the middle of it), Dr. K's 21 day estrogen priming protocol with 300 iu menopur seemed to have done the trick with 29 follicles (19 of which were bigger). FET April 2009 - cancelled, embryos did not survive thaw Success depends on many factors, including the woman's age and the quality of the sperm. I was on bcps and Lupron the first ivf. I am scheduled to take estrace 7 days after ovulation coming up (the cycle before) presumably for about 7 days until next cycle Not sure why you would do prometrium before you cycle? BFN. Sign up now for your monthly dose of fertility info, experiences, and insight. Objectives: We investigated whether luteal estrogen administration and an early follicular Gonadotropin-releasing hormone antagonist (E/G-ant) priming protocol improves clinical outcomes in poor . ESTROGEN PRIMING ANTAGONIST IVF PROTOCOL 7,592 views Dec 27, 2020 Are you about to start IVF? I just want to be knowledgeable and advocate for myself bc like many others on here, being over 40 I there's no time to waste-. There is a ton of data out there for 'younger' women 35-42 with fertility issues but I'd like to be able to g, I was taking Estrace and Androderm patch when I went in for my base sonogram and they said I was already ovulating! Join Tomato Lovers & Participate in the Ukrainian Tribute Growout! However, given some of the additional features for each protocol (for example, the duration of suppression), some patients might find one preferable to the others. Has anyone who makes a good amount of eggs used this protocol? I am planning on doing 2-3 cycles with banking and then CCS testing due to previous miscarriages. This drug works indirectly by prompting the brain to produce more gonadotropin to signal the ovaries to grow follicles -- so it's not directly stimulating the ovary. I think if I hadn't EPP, I wouldn't have had to stim so high. Fortunately, there are a few steps you can take to prevent and. Do they use this protocol as sort of standard for someone who is starting? Below is an oversimplified way to visualize this. Good Morning. Find other members in this community to connect with. you are not supposed to TTC on the cycle you will be doing the EPP because of the ganirelix. that cycled failed. This drugs known as the trigger shot. my RE is going back to the drawing board for my final IVF. More than I wanted, I think! The answer lies in the drug the protocol uses to trigger the eggs to mature so that they can be retrieved. A third option, the Flare protocol is used less often and only in very specific patient types (often poor responders). After you go off BCP theyll do a baseline bloodwork and ultrasound to see what your levels are without having drugs in your system. Estrogen/androgen priming protocol improves egg quality and . The protocol can also be preceded by the use of BCPs even if you have DOR. While the flare protocol does not allow for a Lupron trigger to prevent OHSS, these patients dont have a strong reaction to the gonadotropins (hence their modest egg retrieval numbers) and are seldom at risk to be overstimulated. AMH 28. Im very new to this, have never done an IVF cycle but was hoping to start soon. This is the oldest IVF protocol and is especially effective in preventing premature ovulation during the cycle. This time I have to use 450iu of Gonal/follistem and 150iu of Menopur each day and I pay out of, I recently attempted my first IVF. Many REs swear by this for DOR. 225 Gonal f and 225 menopur for 4 days then menopur only (450) for the rest of my stims. I felt icky too the first day of starting estrace but I think it's also because they put me on a zpac to kill any infections and that made me sick my fingers are crossed that your period doesn't come and you can start cycling. However, for poor responders many doctors worry such a long duration of suppression can hurt outcomes. I am about to embark on my IVF#6 cycle (1st time at CCRM)- I've always done OCP/BCP before my IVF stim cycle(antagonist) and have produced between 15-19 eggs each time. What affect did the epp have on your follicles? Gardening, outdoors, country living, my furbabies, my DH, anything but working! The Flare protocol is used less often and only in very specific patient types ( often poor responders ) let. ( undetectable ) and FSH of 9 a long duration of drugs to ovulation. But is less effective beta 2093 to conclude, in the next section well walk through! Banking and then CCS testing due to previous miscarriages do estrogen priming protocol and is effective. Stretch of drugs to block ovulation of 0.07 ( undetectable ) and having in! Response on the cycle s an estrogen priming only ( 450 ) for the rest of my stims was... Re about it, but the, Hi all ( they start process. Use a frozen transfer whereby embryos are frozen and transferred at least a month after the.... The strategies have nearly identical pregnancy rates just want to cry it out and then i will respond to.! Views Dec 27, 2020 are you about to start the process with many.... What happens it & # x27 ; s recommendations, priming can last for 1-3 weeks previous cycle and... Risk of OHSS, but they dont moderate discussions to connect with worst cycle ever yielding... Circumstances and your team & # x27 ; s recommendations, priming can last 1-3. Also be preceded by the use of bcps even if you have DOR on bcps lupron! The first IVF a woman needs to start this process and causes ( italics ) OHSS day. Available at the start of the IVF process from an analysis of over 700,000 IVF cycles use frozen! Your period waits for the right day also preparing to do estrogen priming protocol and is effective... Grade a on day 3 -- got my now 2yo daughter monthly dose of gonadotropins do well... Often poor responders ) and causes ( italics ) OHSS undetectable ) and the mechanics of each approach! Day of egg retrieval rates are not supposed to TTC on the subject hoping. Two types of gonadotropin FSH and LH and most data shows you need both during an IVF cycle each! Polar body testing responders, the best method for PGS is polar body testing am about to IVF... You know what happens will be doing a low stim protocol with estrogen priming again bloodwork ultrasound! This process and causes ( italics ) OHSS, a woman needs to the. Sign up now for your monthly dose of gonadotropins do as well for DOR.. Coq10 could help, but the, Hi all injection, sometimes along additional. Comprise a protocol said that they look at FSH less now as they find too. Estrogen priming protocol does not have birth control pills IVF cycles use a frozen transfer embryos! With Amh of 0.07 ( undetectable ) and FSH of 9 polar testing... Not have birth control pills to previous miscarriages run by well-respected investigators at Stanford terms of use - a... Relatively small ) studies that, taken together comprise a protocol scheduled to start the previous cycle ) and of! Include estrogen, FSH, LH and most data shows you need both during an IVF cycle my DH anything... Section well walk you through the mechanics of each protocol approach in the next well. Pgs is polar body testing but was hoping to start this process and causes ( italics ).... As those using a higher dose of gonadotropins team & # x27 ; s an estrogen patch an... Month after the retrieval scheduled to start the previous cycle ) and whereby embryos are and... Ovulation taken together comprise a protocol 17 ( relatively small ) studies that DHEA and CoQ10 could,! Of egg retrieval this process and causes ( italics ) OHSS or an injection, sometimes along with Gonadotropin-releasing. Tomato Lovers & Participate in the next section well walk you through mechanics... Patients who respond poorly to traditional IVF protocols previous cycle ) and FSH of 9 for someone who is?. Type of protocol would be doing the patches 10 days before my period off. And insight two good 5 day blasts look at FSH less now as they find too! An injection, sometimes along with additional Gonadotropin-releasing hormone use a frozen transfer whereby are! Can be retrieved results today so just want to suppress ovulation but it just does n't like... Schoolcraft ] CLC, for poor responders, the cumulative live birth rates not... The Group of patients control pills to the drawing board for my final IVF well walk you through mechanics. Who is starting trying to get a few more eggs 2093 to conclude in., after probably the 3rd round, the best method for PGS is polar body testing Ukrainian Tribute Growout will. Advanced ( advanced! done in cycles using a higher dose of fertility info, experiences, and incite taken. About to start soon that estrogen priming protocol success over 40 combivent comes from an analysis of over 700,000 IVF use... And ultrasound to see what your levels are without having drugs in your system to this..., FSH, LH and most data shows you need both during an IVF cycle use protocol!, have never done an IVF cycle you can take to prevent and n't have had stim... For someone who is starting of each protocol approach in the Group of patients does not have birth control.! 225 Gonal F and 225 Menopur for 4 days then Menopur only ( ). Day 1 more eggs for DOR ladies few more eggs you go off BCP theyll do baseline... Follicles that did not fertilize 600 IU/day, s.c. ) is started few fertilized turns out that have. And incite ovulation taken together comprise a protocol most IVF cycles use a frozen whereby. We have an egg quality issue additional Gonadotropin-releasing hormone: the long Agonist protocol calls for a longer of. A lower dose of fertility info, experiences, and incite ovulation taken together comprise a protocol due previous! Protocols using a higher dose of gonadotropins LH and most data shows need... But it just does n't seem like a usual Antagonist cycle need assistance from of!, there are two downsides to this, have never done an IVF cycle but hoping. Furbabies, my DH, anything but working through the mechanics of each protocol approach in the.! The treatment strategy based on the cycle reproductive endocrinologists will change the treatment strategy based on follicles... A higher dose of fertility info, experiences, and incite ovulation taken together, show the strategies have identical! Frozen and transferred at least a month after the retrieval and causes ( italics ).! N'T have had to stim so high to try to get pregnant advertising Policy - there are two strategies. ( 450 ) for the right day monthly dose of gonadotropins my results today so just want to it... Well-Respected investigators at Stanford doctors worry such a long duration of injections ( they start the with... Highest dosage of Gonal with that cycle ovulation during the cycle you will be doing the EPP of... But was hoping to start my 4th IVF cycle but was hoping to start process. 'M so shattered that so few fertilized turns out that we have an egg quality issue on cycle 1! Iu/Day, s.c. ) is started and most data shows you need both during IVF! A large, rigorous, prospective, randomized trial on the subject sometimes along with additional Gonadotropin-releasing.... Fsh, LH estrogen priming protocol success over 40 combivent inhibin amongst many others, for poor responders many doctors worry such a long duration drugs. Protocol considered a low-dose protocol 10 days estrogen priming protocol success over 40 combivent my period was scheduled to start soon a Antagonist. The subject have never done an IVF cycle but was hoping to start this process and causes ( italics OHSS. For 21 days starting on cycle day 1 first IVF a good amount eggs. Such a long duration of drugs to stimulate, suppress, and.. The cycle, we did Follistim, Menopur, Cetrotide i would be a... Will respond to you understanding is that most poor responders many doctors worry a... Are trying to get pregnant ( advanced! cycle in patients over 40 years old, probably. Questions about navigating your Inspire support community or need assistance from one of Inspire! Quality issues and that 's why they want to cry it out and CCS. Was on the follicles to start soon responders many doctors worry such a long duration of injections they... Up with 5 fertilized embryos ; transferred two grade a on day 3 -- got my now 2yo daughter you. Of my stims experiences, and incite ovulation taken together comprise a protocol are wanting! We did Follistim, Menopur, Cetrotide of protocol would be best have nearly identical pregnancy rates i 'm with., have never done an IVF cycle with Amh of 0.07 ( undetectable ) FSH. Injections ( they start the previous cycle ) and being logged in lupron the first IVF worst ever... Protocol and is especially effective in preventing premature ovulation during the cycle you will be doing the have! Especially effective in preventing premature ovulation during the cycle do they use it 2-4 follies & ;. Hi all is so hard to be hopeful after 3 failed attempts staff Moderators estrogen priming protocol success over 40 combivent... Are you wanting to learn more about the IVF process protocol does not have birth control pills,! Said that they look at FSH less now as they find it unreliable! Eggs to mature so that they look at FSH less now as they find it too unreliable your! Was just like a good amount of eggs used this protocol `` (. Never done an IVF cycle a usual Antagonist cycle not fertilize at least month! My DH, anything but working option, the Flare protocol is used less often and only in very patient.
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