[Shannon_1025]

Hi. I'm hoping to hear some successfull stories for us labeled as "poor responders". I just had a cancelled cycle due to one dominant follicle on a cycle which consisted of Testosterone priming the month prior to a MDL flare protocol. From what I hear this is the most aggressive one out there and I sucked at it...Have my WTF appt next week with the Dr.

Just looking for some positive insight to a crappy last couple of months

[lbzg]

what protocol did you do??? in may i had mine cancelled due to only one bad egg... now im in the 2ww but only had 2 retrieved.. this time we did ganirelix... im so scraed it didnt work and im nervouse my dr is going to say theres nothing else we can do!

[houston]

Did you do BCP prior to MDL or any suppression with an estrogen patch? If not, this may have led to the dominant follicle.

I tried EPP and had a dominant follicle, but this is an aggressive protocol that is good for poor responders sometimes. It isn't great for me.

MDL has been the best for me, with BCP used before hand. However, sometimes the BCP lead to oversuppression.

Just b/c MDL did not work for you this time, does not mean it will not work for you again. It just sounds like they need to figure out what to give you, either the estrogen patch or birth control pills to prevent a dominant follicle but not oversupress you.

[Hopefully37]

I just completed an "Agonist/Antagonist" protocol. This was my third cycle. I did MDL back in November and had a chemical pregnancy, then did the Antagonist protocol in January and was cancelled due to premature ovulation (dominant follicle).

With the "A/A" protocol, I started with BCPs, then added Lupron. For stims, I used 300iu Follistim in the am and 225 units in the pm, along with 75units Menopur. I also used 1/2 dose of Ganirelix each morning beginning with the first day of stims (I had to empty half of it into a separate syringe to split it up). I did not have a dominant follicle on this protocol. I used estradiol patches after ET and have been on PIO shots. So far, it seems to have worked! My RE gave me the option of trying this protocol or MDL again (the meds for this were VERY expensive as you can see).

Good luck to you!

[Shannon_1025]

Thanks for the responses

IBZG - I did a testosterone priming in June and then the micro dose lupron in July along with follistim & menopur.

Houston - They did not have me on BCP prior to the MDL and stims. I did with the testosterone priming take estridol pills but I'm not sure if that would be the same as the estrogen patches or not.

Hopefully I'll hav more info and insight next week when I go in for my follow up appt.

[houston]

The pills work some to prevent a dominant follicle, but my understanding it isn't as good as the patches. But, the patch can oversuppress you, which did happen to me once.

I think maybe you should try low dose BCP to prevent a dominant along with the MDL. Sometimes BCP oversuppress, but it is worth a try to prevent the dominant follicle. I was not oversuppressed by the BCP the two cycles I did MDL. My FSH was 18 the first time and 32 the second, so it really just depends on the person and the month.

[ttc123]

I'm a poor responder and saw my best results on an estrogen priming protocol. I think the trick for me is no lupron and no bcp anywhere in my cycle. My first cycle had both and I only produce 4 eggs, none made it to blast. On the EPP I had 12 eggs and 8 made it to blast. I'm at a new clinic and from what I can tell I'm doing the EPP protocal again. For me as long as I don't see BCP or lupron on my list of meds I'm happy.

Good luck! I hope everyone gets lots of eggs with that one miracle egg among the bunch.

[Tooky51]

Originally Posted by Shannon_1025

Thanks for the responses

IBZG - I did a testosterone priming in June and then the micro dose lupron in July along with follistim & menopur.

Houston - They did not have me on BCP prior to the MDL and stims. I did with the testosterone priming take estridol pills but I'm not sure if that would be the same as the estrogen patches or not.

Hopefully I'll hav more info and insight next week when I go in for my follow up appt.

Did they ever try clomid with the meds? (look at my signature). I didnt respond before and they incorporated clomid and that was a successful cycle for me. Also my RE's try not to use BCP or Lupron with poor responders unless there is a cyst present because it can over suppress. You should ask for a natural cycle which means your not on any type of suppression.

[torontochick]

Hi ladies,

I am currently waiting to start my 4th IVF attempt. I have not discussed protocols with my RE, but I know he likes MDL. I did an EPP with a different RE and had only 1 egg fertilized out of 7 retrieved. Now I think this new RE is way more experienced and I also took lots of supps incl. DHEA and CoQ10 to improve my egg quality and I am wondering if I should give EPP another shot (more eggs, hopefully better fertilization rate this time).

For those of you who did EPP - would you mind sharing your protocol schedule?

Thanks so much!!

[houston]

Originally Posted by torontochick

Hi ladies,

I am currently waiting to start my 4th IVF attempt. I have not discussed protocols with my RE, but I know he likes MDL. I did an EPP with a different RE and had only 1 egg fertilized out of 7 retrieved. Now I think this new RE is way more experienced and I also took lots of supps incl. DHEA and CoQ10 to improve my egg quality and I am wondering if I should give EPP another shot (more eggs, hopefully better fertilization rate this time).

For those of you who did EPP - would you mind sharing your protocol schedule?

Thanks so much!!

If you had poor fertilization on EPP, I personally would switch to MDL if that is an option. Sometimes MDL can oversuppress, but if that happens, you can switch back and do EPP or something else if necessary.

I have done MDL 2 times and EPP 2 times. MDL I have excellent fertilization rates, but on EPP, I had poor to no fertilization. This may not happen to you, but I just feel like even though I have a couple less mature eggs on MDL, it is worth it b/c I end up with more embryos in the end b/c of the higher fertilization rates.

[sunrisec]

i feel like slipping clomid into my next cycle hummmm

Originally Posted by Tooky51

Did they ever try clomid with the meds? (look at my signature). I didnt respond before and they incorporated clomid and that was a successful cycle for me. Also my RE's try not to use BCP or Lupron with poor responders unless there is a cyst present because it can over suppress. You should ask for a natural cycle which means your not on any type of suppression.

[torontochick]

Thanks Houston... I've looked high and low all over the web and to me it seems there is only anecdotal evidence for the success of EPP.
I am second guessing my request for EPP and think I should go with the same protocol that got my BFP - long Lupron - but maybe sans the BCP this time.

I will prob call the clinic tomorrow and ask them to switch me...

[smprice]

I'm doing estrogen (and testosterone) priming protocol AND Micro Dose Lupron. Perhaps, like my doctor, yours could combine the two?? I'm still stimming on my first ivf, so I can't give thoughts on success. So far, it seems to be going well!

[boston78]

Sometimes more is not always more for poor responders. I did a cycle at C.CRM where they used the most aggressive, "everything but the kitchen sink" protocol and it was a total and utter disaster. I then did low-moderate stims with EPP and MDL at Corn.ell (but no HGH, testosterone, clomid and the million other meds I took at C.CRM) and was successful on the second try! To answer the last poster's question, you definitely can do EPP w/ MDL and it worked well for me (and as you can see from my signature I am indeed a VERY poor responder w/ a very high FSH and basically undetectable AMH). Wishing you luck!

[far2011]

Originally Posted by boston78

Sometimes more is not always more for poor responders. I did a cycle at C.CRM where they used the most aggressive, "everything but the kitchen sink" protocol and it was a total and utter disaster. I then did low-moderate stims with EPP and MDL at Corn.ell (but no HGH, testosterone, clomid and the million other meds I took at C.CRM) and was successful on the second try! To answer the last poster's question, you definitely can do EPP w/ MDL and it worked well for me (and as you can see from my signature I am indeed a VERY poor responder w/ a very high FSH and basically undetectable AMH). Wishing you luck!

Can you please share that for MDL with EPP, when and what dose of Lupron was started and did you take it till ER. I am also wandering what is considered moderate or relatively low stim.
Thank you,
Farah