Protocol for DOR - Waiting Lounge - IVF.ca Forums

Jump to content



Photo
- - - - -

Protocol for DOR

dor low amh protocol estrogen priming

  • Please log in to reply
7 replies to this topic

#1 lovesgreentea

lovesgreentea
  • Member
  • 10 posts
  • Dx:DOR
  • My Clinic:Hannam

Posted 05 April 2015 - 03:59 PM

I just had a failed IVF cycle (nothing to transfer) and am waiting for plans for next steps. I was on the estrogen priming protocol (EPP) with HGH and high stims and ended up with 1 mature follicle at retrieval. I also responded very poorly to this cycle - I was trigged on day 7 after the dominant follicle became a good size.

 

What's the experience of other women who have tried the EPP without success, but had other cycles with a better outcome?

 

We've been told natural cycles may be the way to go to wait for the golden egg; however I'm afraid we'll be waiting forever as we've tried for years without any luck.



#2 Anika

Anika
  • Cyclebase
  • 320 posts
  • Gender:Female
  • Location:Hamilton, ON
  • Dx:DOR
  • My Clinic:ONE Fertility

Posted 05 April 2015 - 10:14 PM

Hi lovesgreentea,

 

I'm so very sorry about how your last IVF cycle went.

 

I don't have any personal experience with EPP, but I do have DOR. We did a high dose protocol with no BCP or estrogen primiing. My RE feared that any suppression might prevent me from producing any follicles. They basically just started our IVF cycle at one of my regular cycles and gave me max doses of drugs (Puregon and Menopur) followed by Orgalutran starting at around day 5/6. You're welcome to check out the details under my profile. I produced 7-8 eggs for each of my cycles, which from what I understand is very good for a DOR patient.

 

I hope this info is helpful to you!


History:
Me & hubby - 33
Got married to my wonderful husband on June 14, 2008
TTC since June 2011
Diagnosed with DOR (low AMH) and slight MF in 2012
4 Unsuccessful IUI's
IVF# 1 - BFN

IVF# 2 - Baby Girl born March 26th, 2014 babygirl.gif

 

FET #1 - November 2015

Betas December 12th/14th: Positive and doubling! :D

 

More details about our fertility journey in "About Me"


#3 mouse

mouse

    Honorary PhD

  • Super Moderator
  • 7473 posts
  • Gender:Female
  • Dx:Tubal
  • My Clinic:BKK/KWI/JHFC

Posted 06 April 2015 - 09:30 AM

Truly loads of good spam!

Superb forum spam.  With extra spam!

 

Seriously, if you want to promote your site, why not contact the admin for advertising info and rates?

 

EDITED to note that my response was to a fly by poster spamming the site.


  • abm likes this
The plural of anecdote is not data.

Charity gives a meal; justice provides a place at the table.

#4 Traveladdict

Traveladdict
  • Member
  • 17 posts
  • Gender:Female
  • Dx:DOR
  • My Clinic:Astra

Posted 06 April 2015 - 10:15 AM

Hi lovesgreentea,

 

first time posting here, I've been reading various threads but I'm quite passive...

 

It's hard to comment on your situation without knowing basic details about you such as your age, AFC, FSH and so on. I too have DOR and we are also dealing with MFI. As you'll see from my signature, we had 4 failed IUIs last year and a really poor response to our first attempt at IVF... For that failed attempt, we did antagonist protocol without BCP suppression; I had an AFC of 7, started with 300IU gonal-f, got bumped to 375IU, but had only one follicle growing :( Our latest attempt with microflare protocol, again without BCP, was successful (so far); I had an AFC of 9 (me RE wanted a minimum of 8 to start a new cycle), I did low-dose lupron and stimmed for 8 days with 375IU gonal-f, my RE decided to let the biggest follicle go to waste and wait for the other ones to catch up. I had only 5 follicles at retrieval, but they all fertilized with ICSI. Went in for a 5 day transfer and got my first ever BFP 5dp5dt.

 

I had originally asked my RE whether he would do EPP, but he said that my ovarian reserve wasn't that severely diminished yet. There is huge variation in how we respond from cycle to cycle, my RE kept telling me we have to wait for the right wave of follicles. I was on DHEA and co-q10 for a full year by the time we did IVF. I also did acupuncture for 3-4 months as well as some acupressure on my own at home. For the 3-4 months leading up to IVF, I also drank wheatgrass juice, took royal jelly, fish oil and L-Arginine to help with egg quality. My RE was aware of these supplements. I also worked on improving my diet, even made my own bone broth (supposedly highly nutritious). I did yoga daily, well, leading up to the cancellation... then switched to walks as the weather improved and I needed some sunshine. I also did femoral massages before ovulation/ER to help with blood flow.

 

Quite frankly though, I don't think natural IVF is the way to go based on what I have read... I would recommend you get a second opinion about your situation. Send me a private message if you'd like to share more info about your situation or if you have any questions I may be able to answer.

 

Whatever you do, please do not lose hope. DOR isn't easy to deal with, but there are lots of women who've had successes with ART.


Me (32) - DOR

Him (33) - MFI (10-20% motility, 0-5% morphology)

Jan 2013: started TTC

Jan 2014: first consult with RE; Mar 2014: dx with DOR (AFC:7, FSH:12.5), started 75mg DHEA and 600mg co-q10 daily

Jul-Oct 2014: FSH varrying between 3.5 and 6.5! ... IUIs #1-4 (3 x femara + 1 x overlap(femara+gonal-f) all BFN

Feb 2015: DH had follow-up with urologist, no varicoceles detected, DNA fragmentation is 9.77! Prescribed Clomid

Feb 2015: IVF 1.0 (AFC:7; FSH:?) - Antagonist protocol (no BCP): 300-375IU gonal-f ... cancelled due to poor response converted to IUI#5, BFN

Mar 2015: IVF 1.1 (AFC: 9; FSH:6.5) - microflare protocol (no BCP): 10 units diluted lupron twice daily + 375IU gonal-f daily:  5R/5M/5F-ICSI (2015-03-17), transferred 1 day 5 embryo grade 5AB (2015-03-22); froze 2 early blasts (grade 1BB) on day 6 Faint BFP at 5dp5dt... Beta#1 (10dp5dt): 391, beta#2 (12dp5dt): 1097! First US (2015-04-17): measuring 6w1d, 117bpm, EDD: Dec 10

May 2015: DH had follow-up with urologist, Clomid did nothing


#5 mouse

mouse

    Honorary PhD

  • Super Moderator
  • 7473 posts
  • Gender:Female
  • Dx:Tubal
  • My Clinic:BKK/KWI/JHFC

Posted 06 April 2015 - 10:38 AM

Thanks for bringing the spam Spamuel!

 

EDITED to note that my response was to a fly by poster spamming the site.


The plural of anecdote is not data.

Charity gives a meal; justice provides a place at the table.

#6 EverHopefull!

EverHopefull!
  • 1000+
  • 1600 posts
  • Gender:Female
  • Dx:Unexplained
  • My Clinic:Genesis/VFC

Posted 30 April 2015 - 11:25 AM

Traveladict, what/where have you read about natural IVF starts that makes you believe it's not a good protocol? 

 

My clinic just recommended it for me yesterday.  I had a good response on the EPP (11 follies), but they think I can do better on the natural start.  From what I read a natural start just means that you don't supress (which I don't need to do anyway), so that it's easier to stim after.  My clinic feels I will have more follies, and therefore more eggs, this way.   

 

If there's a negative to this protocol I'd like to read up on it before we get started.  I like to know the pros and cons before I'm neck deep in it! 

 

Thanks!


TTC since December 2004

One successful IVF

Many, many unsuccessful IF treatments

Finally a successful DE cycle!  babyEver is due July 1st.

 


#7 Traveladdict

Traveladdict
  • Member
  • 17 posts
  • Gender:Female
  • Dx:DOR
  • My Clinic:Astra

Posted 29 May 2015 - 03:59 PM

Traveladict, what/where have you read about natural IVF starts that makes you believe it's not a good protocol? 

 

My clinic just recommended it for me yesterday.  I had a good response on the EPP (11 follies), but they think I can do better on the natural start.  From what I read a natural start just means that you don't supress (which I don't need to do anyway), so that it's easier to stim after.  My clinic feels I will have more follies, and therefore more eggs, this way.   

 

If there's a negative to this protocol I'd like to read up on it before we get started.  I like to know the pros and cons before I'm neck deep in it! 

 

Thanks!

Hi Everhopefull, my apologies for not checking this thread until now...

 

From what I have read on "natural IVF" it sounds like they just go for the one dominant follicle and don't use drugs for stims. As a result, they just harvest the one dominant follicle and hope for the best, this way it relies on the body's natural cycle. I've seen a few people on this board use this protocol and it didn't have much success for them.

 

I agree with you in that not using birth control/suppression is better for people with low reserve, previous poor responses and advance maternal age.

 

I'm sorry to see that your last cycles haven't been successful :(


Me (32) - DOR

Him (33) - MFI (10-20% motility, 0-5% morphology)

Jan 2013: started TTC

Jan 2014: first consult with RE; Mar 2014: dx with DOR (AFC:7, FSH:12.5), started 75mg DHEA and 600mg co-q10 daily

Jul-Oct 2014: FSH varrying between 3.5 and 6.5! ... IUIs #1-4 (3 x femara + 1 x overlap(femara+gonal-f) all BFN

Feb 2015: DH had follow-up with urologist, no varicoceles detected, DNA fragmentation is 9.77! Prescribed Clomid

Feb 2015: IVF 1.0 (AFC:7; FSH:?) - Antagonist protocol (no BCP): 300-375IU gonal-f ... cancelled due to poor response converted to IUI#5, BFN

Mar 2015: IVF 1.1 (AFC: 9; FSH:6.5) - microflare protocol (no BCP): 10 units diluted lupron twice daily + 375IU gonal-f daily:  5R/5M/5F-ICSI (2015-03-17), transferred 1 day 5 embryo grade 5AB (2015-03-22); froze 2 early blasts (grade 1BB) on day 6 Faint BFP at 5dp5dt... Beta#1 (10dp5dt): 391, beta#2 (12dp5dt): 1097! First US (2015-04-17): measuring 6w1d, 117bpm, EDD: Dec 10

May 2015: DH had follow-up with urologist, Clomid did nothing


#8 SunshineTTC

SunshineTTC
  • 1000+
  • 1037 posts
  • Gender:Female
  • Location:Regina, SK
  • Dx:DOR
  • My Clinic:VFC

Posted 29 May 2015 - 11:10 PM

Big difference between natural IVF, and natural start IVF, above posts are talking about 2 different things. The former uses no meds and goes after the one egg you'd normally ovulate that month, the later only means no BCP or suppression meds just start stim meds with your natural Day 1 (and usually need less meds bcs no supression).
  • CdnHockeyGal and Traveladdict like this

Me: 40 41 42 43 44 45, single, FSH 6, LH 2 (FSH not high, but exceeded 2:1 ratio), DOR (AFC 5-7, v.low AMH), all else normal/healthy.

After a difficult 6 year journey of everything going wrong, amazing baby boy born Dec 2018.  Donor sperm + DEB-USA donor eggs.  Detailed journey in 'about me'.

 






Also tagged with one or more of these keywords: dor, low amh, protocol, estrogen priming