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Am I considered a poor responsder?

microdose EPP poor responder

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#1 KennyandFooty

KennyandFooty
  • Cyclebase
  • 1204 posts
  • Gender:Female
  • Location:Montreal, QC
  • Dx:Tubal
  • My Clinic:McGill Reproductive

Posted 11 July 2012 - 11:58 AM

HI Dr. Liu.

I wasn't going to pursue this much before my appointment with my own RE in August, but my husband felt it important that we try to find as many opinions before then, to better prepare.

I am trying to find out if...despite producing a lot of mature eggs (16 retrieved, 16 mature, 13 fertilized, 5 made it to blast) during my last fresh IVF cycle, using the Microdose Flare protocol, could I have still been what is referred to as a "poor responder"?

I posted a few questions to Dr. Sher and Dr. Fisch (SIRM) on their forum about "Why" my 3 frozen embryos did not survive the thaw recently (after having a BFN from the fresh cycle that produced them) and they are of the belief that the embryos all may have been genetically abnormal. They believe if this was the case, it may have been the MDF protocol that damaged them at retrieval (too much testosterone).
They have suggested to me that maybe their Agonist/Antagonist conversion EPP (estrogen priming protocol) would be better for me...but I always thought, since I had first heard about EPP, that it was intended for those with DOR or poor responses. I guess I'd always assumed high egg volume retrieved = good response.

Is this not the case and what are your thoughts on the EPP approach to my situation??

I have my WTF appointment in August...and would just like to prepare myself as best I can to put this on the table with my RE if it makes sense. As far as I know, he wants me to proceed with a fresh cycle in September using the Microdose protocol we did last time.

My history is in the "About Me" section of my profile if you'd like to see how I've responded in the past.

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3


#2 KennyandFooty

KennyandFooty
  • Cyclebase
  • 1204 posts
  • Gender:Female
  • Location:Montreal, QC
  • Dx:Tubal
  • My Clinic:McGill Reproductive

Posted 11 July 2012 - 04:52 PM

This is the response I got from Dr. Fisch this afternoon - for those of you interested.

"By the number of follicles and eggs you produce, I would call you a normal/good responde, (bordering on a high responder). The general issue here is usually Unexplained infertility, which is still related to abnromal egg quality. Interestingly, we think the underlying problem is the same in both group: too much male hormone effect. Women who make a lot of eggs (PCOS is one extreme) make too much male hormone, while women who make less than 5 follicles often are overly sensitive to male hormone, even at low blood levels. In either case we think it is important to limit the amount of male hormone in the stimulation protocol. We think the MDL protocol would be a poor choice for you for this reason. Regarding our approach, we would probably use still agonist-antagonist conversion, but without estrogen priming. After reviewing your case with you in more detail, I could make more specific recommendations."

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3






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