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Failed IVF and a change in protocol


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#1 ice9082

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Posted 25 November 2016 - 11:06 AM

I wanted to ask we just finished our first IVF with no fertilisation so onto the next round, 

The protocol we were on was a long protocol starting on day 21 with suprefact nasal spray and primolut together for 10 days, the discontinue the primolut and finally on day 6 we dropped the suprefact down by half and added 125 Gonal-f for 12 days. This gave us 4 follicles (originally 22 but my clinic didn't want to take a chance on OHSS so only 4 matured) 2 of them didn't fertilise and 2 of them had three sets of nuclei instead of two so my doctor thinks we need ICSI since the eggs and the sperm looked great. 

We are starting our next cycle in January and this time my doctor wants to start Centrotide and menpur on day one and do a short protocol. 

My question is with my diagnosis that is basically just PCO looking ovaries (my doctor really hasn't made the diagnosis just says they are very powerful), amh of 22.8 and a normal FHS LH ratio (las measured on day 3 it was FSH 7.1 U/L and LH 8.5 U/L and on 7-8dpo FSH was 1.4 U/L and LH = 5.4 U/L), is a short protocol with menopur the correct way to go here? I'm a little affright of the menopur having to much LH in it but my doctor feels comfortable with using a short protocol to prevent OHSS since the plan is to be bold with the stimms. 

Thanks in advance 

 

 

 



#2 DrMichaelHartman

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Posted 25 November 2016 - 11:53 AM

I would not be concerned about additional LH from the menopur. In face, when taking a GnRH analogue like suprefact or cetrotide it may significantly reduce your LH levels so supplementing is something many RE's would do.

Changing the protocol seems like a very reasonable option to try to optimize the number of follicles that grow and adding ICSI makes sense given the failure to fertilize.

 

 

Good luck!


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#3 amp77

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Posted 25 November 2016 - 02:11 PM

I don't have PCOS but have PCOS-like ovaries with AFC > 30.  I did antagonist twice.  Started right with Gonal-F 150 and Cetrotide once leading follicles were 16mm, I think, and HCG trigger (Ovidrel I think).  First cycle retrieved 8, 6 mature, 5 fertilized, 1 transferred (BFN), nothing to freeze (I stim quickly - 7 days then triggered).  Second time, started the same.  After 6 days, increased Gonal-F to 225 as I wasn't responding that well, increased to 300 the next day, then triggered.  11 retrieved, 10 mature, 8 fertilized, 1 transferred (BFP), 4 frozen (11.5 weeks pregnant from my first FET).  I don't know about the other protocols or anythings since this is all I have done.  I am sorry that your cycle didn't go as planned and hope that you will find success next time.  And nice to have an RE here to give advice :)


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Age 39, DH 43 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son.

 

FET #1 -  Sept 2016

Day 1 - Sept. 9

Monitoring - Sept. 18-22

Lining Check - Sept. 22 (11.3 mm)

Transferred 5B-BB Sept. 25 - BFP!!!  HCG 890 @ 12dp5dt and Progesterone 95.
Midwife appointment Sept. 19 and first ultrasound Nov. 4
3 Frosties left

 

<a href="https://lilypie.com/"><img src="https://lbdf.lilypie.com/9GKrm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

 

-------------------------------------------------------------------------------------------------------------------------------------

 

Seems like forever ago...

 

Age 37, DH 40.

TTC on and off since 2007

Unexplained Infertility

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

 


#4 Ola1981

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Posted 25 November 2016 - 02:59 PM

I have pcos like ovaries too without having full on pcos and both my cycles with menopur gave me my 2 beautiful babies:) From what I've read, menopur can decrease the number of eggs but possibly make them better quality...one way or another, it worked great for us :)
Good luck with your next cycle!!!
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See about me for details of our journey to become parents to 2 beautiful children