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05-29-2009, 11:16 AM
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Antagonist vs Microdose Lupron Flare
Does anybody have any words of wisdom on these two protocols? I am doing the Microdose flare now and not responding well. Should I push for the Antagonist next go around? I am now on 3 vials of Repronex in the AM and 225 Gonal-F PM. Then of course the 20 units of Lupron AM and PM.
Also, my RE does not like to go over 225 on Gonal-F or Follisitm. He said studies show that a higher dose makes no difference. Any comments on that?
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Alli Me 34 Endo and poor responder DH 38 Low everything on SA Beautiful adopted daughter 2yrs TTC since 1998 Several IUI's all  IVF #1~ May 2005 Converted to IUI due to poor response Endo and fibroid surgery ~3/31/09 IVF #2~ May/June 2009 Stim Day 10 U/S~still 4 follies under 10~not growing. Cycle cancelled. IVF #3~June 30, 2009 Estrogen Priming Day 15 E2 1600 2 follies larger than rest, convert to IUI IUI~8/11/09 Beta~8/25/09 IVF#4~August 27, 2009 Base line U/S~8/27/09 2 cysts  On hold till next monthIVF#4 again~Oct 27,2009 Base line U/S~10/27/09 Start stims~10/30/09 Day 4 E2~317 Day 6 U/S~1 large follicle Cycle cancelled~Timed intercourse 
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05-29-2009, 12:27 PM
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I was on the Antagonist protocol and I responded really well. I don't think they thought I would respond well because my AFC were not that great. They were 11 and 12 on day 3. On day 5 of stims my E2 level was already 1200 and they had me cut down on my doses of Follistim and Menopur and then I didn't take any more medication. So in all I only took stims for 5 days and coasted till retrieval. I don't think they'll start me out on such a high dose next time. The Antagonist protocol worked for me or at least they were able to get a lot of eggs.
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Me: 33 Everythings normal except ovarian cysts DH: 34 Everythings great DX: unexplained infertility DD: 4 yrs old. 1yr 2mo to get BFP (3rd try on Clomid and used CB fertility monitor) TTC baby #2 since Oct 2006 10/2006-5/2007 Clomid and timed bd x5 BFN 7/2007 Clomid and IUI #1 BFN 8/2007-10/2007 Letrozole and IUI x2 BFN 3/2008 100mg Clomid IUI cancelled due to large ovarian cyst 4/2008 Laparoscopic surgery to remove cyst 6/25/2008 FSH 7.4 Estradiol 50 6/25/2008 started Letrozole again(last try with OB/GYN) *cycle cancelled due to another cyst* 7/18/2008 1st RE appt. Started on Aygestin to shrink cyst. 2/23/2009 Appt with new RE. 4/7/2009 AFC 11 FSH 9 , SIS and HSG normal. 5/3/2009 Start Stims 5/12 ER (27 eggs) 3 blasts frozen 5/17 ET 2 4BB blasts 5/26 Beta BFN FET July 2009 BFN 8/28 Endometrial biopsy for Beta 3 integrin: Negative
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05-29-2009, 12:51 PM
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What about the estrogen priming protocol (EPP)? That is another consideration. That might work for you. and boost any of your protocols.
good luck!
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 Me: (>35) Endo IV/Hashimoto DH: slight MF, great supportI intend to give birth to at least 1 healthy child in early 2010..........,It is time for you to come home, sweet child. HISTORY (TTC since 2006): 2007-09: 4 IVF cycles, 3 transfers, 3 BFNs Sep. '09: Miracle BFP on our own ended in miscarriage Moving to donor to avoid increased risk for ovarian cancer ...and to finally become the parents we are destined to be.
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05-29-2009, 01:21 PM
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There is a line of thinking out there that's it's best to hit the follicles hard upfront with FSH in order to recruit the largest number of cohorts. Rather than, say, start out at 200 Follistim, and then after BW shows slow response to try to increase Follistim to 300 to get more folliciles. The idea is that you can back off the dosages once you have recruited as many follicles as possible but it's not really possible to recruit additional follicles into the cohorts by increasing the dose mid way through the cycle. I think from what you've written that Antagonist might work for you and that you might need higher doses (at least in the beginning). I agree with Mamasoon that adding estrogen before stimming may be helpful as it also acts to suppress the follicles by acting on the hypothalmus (rather than the ovaries themselves) leading to better cohort numbers.
I would definitely talk it over in more detail with your RE as there are definitely other options besides the MDL protocol. Good luck to you!
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ME: 29 H: 49 TTC: approx 2 years DX: MF: SIF, azoo FF: SIF, elevated FSH, low AFC, spontaneous ovulation TX: First IVF with ICSI April 2009
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05-29-2009, 01:43 PM
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Thanks for your responses! I agree that I think I need the estorgen priming as well. I will be talking to my RE on Monday. It will be interesting to see what he thinks.
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Alli Me 34 Endo and poor responder DH 38 Low everything on SA Beautiful adopted daughter 2yrs TTC since 1998 Several IUI's all IVF #1~ May 2005 Converted to IUI due to poor response Endo and fibroid surgery ~3/31/09 IVF #2~ May/June 2009 Stim Day 10 U/S~still 4 follies under 10~not growing. Cycle cancelled. IVF #3~June 30, 2009 Estrogen Priming Day 15 E2 1600 2 follies larger than rest, convert to IUI IUI~8/11/09 Beta~8/25/09 IVF#4~August 27, 2009 Base line U/S~8/27/09 2 cysts On hold till next monthIVF#4 again~Oct 27,2009 Base line U/S~10/27/09 Start stims~10/30/09 Day 4 E2~317 Day 6 U/S~1 large follicle Cycle cancelled~Timed intercourse
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