During my IVF cycle (still in the middle of it), Dr. K's 21 day estrogen priming protocol with 300 iu menopur seemed to have done the trick with 29 follicles (19 of which were bigger). How it works: It's a two cycle process. Candice maybe11 129 Dec 08, 2009 #3 Hi, Please enable JavaScript in your browser to load the challenge. It's that time of year again when gardeners all over the world are planning what to grow in their gardens. Estrogen priming is typically done for about seven days before the start of controlled ovarian stimulation (the IVF cycle). 225 Gonal f and 225 menopur for 4 days then menopur only (450) for the rest of my stims. Ivf doctor recommendation in nyc or bklyn, Low Ovarian Reserve and Poor Responder to IVF, Ladies 45 and older TTC - *infertility due to age only*. 14 retrieved, 9 mature, 5 fertilized normally, 2 grew to the 2-cell stage then arrested, 3 did not grow beyond one cell. I am 38. This was all on the phone, so not 100 percent on what the protocol would be. Yes, we did the same thing. I also did ganirelix during this time. It's possible to pay with credit card or Western Union, but PayPal isn't an option. What To Do When PGT-A & Grading Results Conflict? But I will be asking the best hardcore questions I can come up with about EPP. To bridge that gap, doctors prescribe drugs that woman take at the start of a cycle to instigate growth of ovarian follicles that contain eggs. 1) focus on the quality (not quantity) of eggs. Waiting for that call is sooo stressful! Terms of Use - As you can see in our summary below, there are multiple drugs that can perform these two functions the one thats chosen dictates the protocol strategy. I dont know as much about micro flare. But I am sure they know what they are doing at CCRM. Good luck. President, ASRM I'm 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18. Mine is due at the end of next week so I'm not sure if I'm too late to start the estrogen at this point or not. This clinic is more generous with freezing, so they tested and froze a few other blasts as well, which the other clinic would have thrown out. Specifically, poor responders (a less than pleasant way of referring to women who produce few eggs per retrieval), do equally well taking 150 IUs of gonadotropin as 450 IUs. Male factor, probably DOR and I am a poor responder to IVF drugs Most of the costs are for the ER visit, tests, and lab work from my night in the hospital and the weeks following. It would be great if it cleared up my skin because my skin has been terrible since my retrieval/chemical a few weeks ago! 5-7 oz Orange, mid season). Twins & Multiples: Your Tentative Time Table. This amounts typically to a Coke vs. Pepsi kind of decision. I think if I hadn't EPP, I wouldn't have had to stim so high. In my case, antral follicle count is very poor, but RE decides to proceed. Pre-treatment is known to improve the response of the ovary to the stimulation cycle and also reduces the risk of ovarian cyst formation. I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. This is called multi-follicular development and its a pivotal step in a successful IVF. Comparing the good cycle to the other 3, I see why. I stimmed for 13 days. . We use cookies to improve your experience on this website and so that ads you see online can be tailored to your online browsing interests. Several functions may not work. I'm 36 & TTC 2 yrs. Is a micro-dose lupron protocol considered a low-dose protocol? On the other hand, the Long Agonist protocol cant use Lupron as the trigger because it already deploys Lupron elsewhere. Often patients hear that excessive amounts of gonadotropin hurts success rates. I started epp with cetrotide x 3 days. You should also label each packet with the variety name, date, and a brief description (e.g. There are several methods of pre-treatment that involves using either a combined oral contraceptive pill, progestogen or estrogen. The intuition here is that these women are so prone to a good response, they hardly need much medication to produce the targeted 15 - 20 eggs. I will have retrieval hopefully this weekend and will let you know what happens. Changed MD's and now this is the protocol they have in place for me. Long time reader, first time poster. It's a horrifyingly traumatic experience. It is so hard to be hopeful after 3 failed attempts. I hope you get to eat those words, I really do!!! Though I had 4 or 5 follicles to begin with, only ended up with one. I might have ovulated rather than had empty follicles. I understand the idea for the patch is to help time the growth of follicles vs. increase the number? Sadly, both my hatching blasts were abnormal. Find advice, support and good company (and some stuff just for fun). These drugs help a woman grow multiple follicles, and thus multiple mature eggs. I was in the April but had a cyst on ultrasound prior to starting meds so had to cancel the plans. Experience with Estrogen Priming Protocol? I credit the advice I received on this forum both from members and from experts, my infertility doctor and my push for the estrogen priming protocol for the family that I have today. Hey Michelle, I haven't forgotten about you. We're also doing PGS. Estrogen Priming is completely different, so therefore without birth control pill. Our usual regimen is similar to those proposed below: hysteroscopy, prolonged estrogen priming, Estring for local effects, baby aspirin, vaginal phosphodiesterease inhibitors, pentoxifylline, acupuncture, etc., with admittedly little data to support any of our treatment strategies. Typically, you also add other stims once you start your cycle, too (Menopur, GonalF), so those could be in high doses. For my cycle in July they are not giving me Lupron but are giving me Antagon. Was one of my worst cycles. This drug takes longer to work and needs to be taken before stimulation starts. I am only 28 with normal amh/fsh levels so we were pretty shocked and upset when we only had a couple embryos on day 3 and then nothing to freeze. I only felt icky on the ganirelix. Cost: $1,000. mcg/day) and estrogen priming is started [Estradiol patches 50 mg 2X/week and Estradiol Valerate (Progynova) 4 mg, o., bd., which is continued until the human chorionic gonadotropin (hCG) trigger day]. The doctor just wants to make sure you dont release an egg while getting your body ready for a retrieval or transfer. This hormone is injected by the patient and directly instigates the ovaries to grow more follicles. In that time a womans hormonal balance has been restored and so IVF cycles using a frozen transfer are more likely to work. ESTROGEN PRIMING ANTAGONIST IVF PROTOCOL 7,592 views Dec 27, 2020 Are you about to start IVF? Fortunately, there are a few steps you can take to prevent and. I think you both are at Cornell (were) with this estrogen priming protocol will you try again with them, and request not to do estrogen priming? After 2 years, tons of tests and 5 IVF cycles, it still feels unreal.Estrogen Priming protocol does not have birth control pills. My doc started me on estrogen patch, one patch changing every 3 days until my period for 5 days and I just took it off and will be takingClomiphene after a day of taking off the patch, then after a day start stim. Good luck! I have my appt in a few hours. We are going to bump up my gonal f too. I think you should ask your doctor though to make sure.Again, here is what happened to my protocolCycle day 1 - PeriodCycle day 24 (7 days post ovulation) - Start Estrace Cycle day 1 - Period Cycle day 2 - Last Estrace pill Cycle day 3 Blood work & ultrasound; antral follicle count. My clinic doesn't like it. FertilitySmarts is a part of Janalta Interactive. Advertising Policy - I had success on an EPP. I need to know if anyone has had a similar experience, but later got pregnant and where did you go. As you can see below, amongst women with PCOS, the Antagonist protocol drives comparable success rates but with far lower risk of hyperstimulation. We strive to provide you with a high quality community experience. The results are below and as you can see, success rates do seem to drop off after 300 IUs per day of gonadotropin. One thing to keep in mind is that every cycle, there is a new cohort of follicles availble to be stimulated, meaning that during different months the same protocol may work more successfully than others simply due to the natural variation in available follicles. I started taking 4mg of estrace on cd 21. From NE Ohio to North Central Mississippi, everyone has their own ideas and preferences for what they will plant this year. Northwestern Medicine. Similarly, when an investigator named Revelli decided to swap out a few days of gonadotropin for clomid in this poor responder population in Italy (and thereafter resumed gonadotropin at low levels), he saw similar rates of success to more conventional levels of gonadotropin use. DS was born June 22nd, 2007!!!!! However, for poor responders many doctors worry such a long duration of suppression can hurt outcomes. To get FSH, patients take Gonal-F or Follistim (many consider them to be interchangeable) and to get FSH-plus-LH most women take Menopur (pretty much the only product on the market). As we show in the example below, during every step of IVF a certain number of eggs or embryos are lost, especially in the middle part of the funnel (growing embryos that are chromosomally normal). Of course, during a regular cycle most women naturally produce only a single mature egg. I'm 35 and going through my first IVF cycle. Similarly, many doctors believe low dose approaches work equally well as high dose approaches on women who are likely to be hyper responders. These are women who have a high AMH or had a high number of eggs retrieved in a previous cycle. FertilitySmarts Inc. - As a result, its hard to correct for confounders like the fact that harder cases may (or in our minds, probably) had been given more drug and so the underlying condition, rather than the dose taken, contributed to the lower rates of success. 1997-2023 BabyCenter, LLC, a Ziff Davis company. This typically happens with conventional insemination where the egg and the sperm are placed in the same culture environment for fertilization Just devastated with my results today so just want to cry it out and then I will respond to you. it's 1 week since last patch. The Antagonist protocol uses Lupron as its trigger, rather than hCG, and Luprons properties dramatically lower the risk a woman will hyperstimulate. As a result, a woman needs to start the process with many eggs. BFN. A fundamental question is whether protocols using a lower dose of gonadotropins do as well as those using a higher dose of gonadotropins. Please whitelist our site to get all the best deals and offers from our partners. The idea is to give your body about 5-7 days of Estrogen Priming. After my period started, my doctor kept me on the patches for five more days. Use of this site is subject to our terms of use and privacy policy. Inhibin is an often overlooked hormone which suppresses (or inhibitits) the release of FSH from your brain during the last week of the cycle (FSH is the chief hormone responsible for making your eggs "grow"). I had 5 follicles but only one matured so I was converted to IUI which failed. Had three chromosomal miscarriages last year, moved on to IVF with intention of genetic testing but had to cancel cycle a few days in, E2 never got above 36 while on max dose of 300 Gonol f and 300 Menopur. I understand why they want to suppress ovulation but it just doesn't seem like a good idea in someone over 40? What to Expect supports Group Black and its mission to increase greater diversity in media voices and media ownership. I'm now 19 wks pregnant with #2 from embryo from same batch. A gonadotropin-releasing antagonist hormone (GnRH-ant) is used to stop the ovaries from releasing the matured eggs and allows time for additional maturation until eggs are retrieved for fertilization. By clicking sign up, you agree to receive emails from FertilitySmarts and agree to our Terms of Use and Privacy Policy. As you can see below, success rates dropped. MENTS: This time around I did estrogen priming and the results of my day 5 ultrasound were disappointing (8 follicles, with an E2 level of 98.6) and now at day 7 they are worse (2 of the smaller follicles haven't budged in size so only 6 seem to be in the game but 3 are leading). FSH 7.7 ( done 1 year ago ) First round , on bcp for 2.5 weeks. I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. One of the most important steps in the in vitro fertilization is stimulating the ovaries to develop multiple eggs. I was on bcps and Lupron the first ivf. Below you can see that when investigators gave poor responders 450 IUs or 150 IUs per day, the groups had nearly identical success rates. I have hypothalamic anvolution, DH normal. Looking for info/success stories with Estrogen priming protocol with DOR. Worked for me! 6 responded, 5 retrieved, 3 fertilized normally, put all 3 back in at 3dpt - I am currently 27 weeks with one baby girl. Also, your stims are actually a lot higher than most REs will do for DOR. Estrogen priming refers to supplementing women with extra estrogen (estradiol) during the luteal phase - that's the last two weeks - of the prior menstrual cycle before beginning ovarian hyper-stimulation for IVF. This is my first time posting and was hoping for some other stories like mine. Did one cycle of IVf with 450 of gonal F and then cetrotide and ovidrel. In the case of the fresh transfers, you can clearly see a similar effect to what investigators found above: success rates drop with more drug. Transfer was canceled. Below is data collected on over 3,000 cycles for each protocol approach in the Netherlands. Does anyone have experience with this? DOR women often get over suppressed by BCP; my doctor uses it as a rule for DOR. think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. Thanks so much in advance! From what I've seen on the boards, ladies get a higher number and higher quality. By: Kelly Park Ganirelix is contraindicated in pregnancy. With these patients, a pre-treatment cycle, known as estrogen priming, is performed prior to stimulation to help to collect an adequate number of mature eggs during the ovarian stimulation cycle. Dont know what. Those 2 were my worst cycles. If ok, then start stimulation The many repeat bloodworks & ultrasoundsLast stimulation shot + triggerRetrievalSo I started my process in the mid-September and my retrieval happened in early NovemberAlso, I was on MicroFlare protocol, so I am not sure what other medications you might be taking. IVF #2, we did estrogen priming, Follistim, Menopur, Tev Tropin (human growth hormone), Cetrotide. February 7 - lost our little twin, Baby B had no heartbeat at 20 weeks, June 8, 2011 - DD was born healthy and her twin brother was born to Heaven. I'm not sure what your stats are, but Check seems to have had some good success with women over 40 who have high FSH, so I'd say go with him. that cycled failed. Lets start with how much gonadotropin to take. I did EPP, using a climara patch every other day starting day 8 after ovulation until period came. 1st IVF/ICSI age 41 : Gonal F 300; 3 eggs; 2 fertilised; transfer day 5; BFN This clinic only biopsies hatching blasts. These drugs perform the opposite duty of suppression. Was wonderin, I just finished my 3rd failed IVF cycle using EPP. So I guess Im asking, do you all think I should do a EPP antogonist? You currently have javascript disabled. I will be doing an FET in March/April, I started taking 4mg of estrace on cd 21. I am scheduled to take estrace 7 days after ovulation coming up (the cycle before) presumably for about 7 days until next cycle Not sure why you would do prometrium before you cycle? You still may have a BFP, so let's wait to see before we say it didn't work!! The combination of drugs and their dosing is known as a protocol and while it may seem like there are a dizzying number of protocols, the reality is there are only a few core options. I don't know why they didn't take, but I still think it is a good one to try. The last cycle, I was able to produce 10 eggs but only 2 made it to transfer. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. Confirmed. I am also preparing to do estrogen priming again. . My first IVF cycle I was on the antagonist with stims started on Day 3.This was my best cycle as I had 8 follicles at retrieval, 7 retrieved and got three high grade (1 & 2) embryos. I also did human growth on 2 cycles and didn't help a bit. I asked my local RE about it, but she wasn't familiar enough with it to try. 3rd IVF age 42 : Short protocal Menopur 375; so far on Day 4 scan 2 focilles again and some very small ones Lupron when take in larger doses suppresses pituitary function, but when taken in smaller doses, it does the opposite. I think the stims usually last longer with EPP, but my quality was much better. Ultimately there are two protocol strategies doctors will use: either the Long Agonist or Antagonist protocols. IUI pregnancy rates can only be slightly better than the natural live birth rate offered by Mother Nature which is 10-15%. On CD2 I started 300 Gonal F and 150 Menopur. A third option, the Flare protocol is used less often and only in very specific patient types (often poor responders). Cetrotide was added CD9. Dr Sher says "oestrogen priming of FSH receptors has been reported to slow premature follicular development and to promote granulosa cell FSH receptor induction". I just had my ER last week: stimmed for 13 days, started ganerilix on stim day 8, retreived 7 eggs, 3 were mature, 3 fertilized, 1 blastocyst was frozen today on day 5 and I have 2 morulas that will bhopefully be frozen tomorrow as long as they are blastocysts. Im on this for 21 days starting on cycle day 1. I asked for iv antibiotics instead of the zpack because I've never taken it before and was worried about how I'd feel from it. I am on my first round of IVF (hopefully last!). That data comes from an analysis of over 700,000 IVF cycles run by well-respected investigators at Stanford. Often two other types of drugs are needed to accompany gonadotropin: those that block eggs from maturing and being ovulated before they can be retrieved, and those that help trigger the eggs to mature so they can be retrieved. So.. Im over 40 and did estrogen priming for a bunch of cycles and a Lupron stop. BFP October 22!!!! Note that once you confirm, this action cannot be undone. Editorial Review Policy. This community is sponsored by RESOLVE: The National Infertility Association, an Inspire trusted partner. Had three chromosomal miscarriages last year, moved on to IVF with intention of genetic testing but had to cancel cycle a few days in, E2 never got above 36 while on max dose of 300 Gonol f and 300 Menopur. They thought they saw 4 follicles, but were only able to collect 2. Yea, sometimes the smallest of tweaks can make such a big difference. Best of luck. Estrogen Priming Microdose Lupron (MDL) *If you receive your period, (cycle day one, the first day of a full flow red) after 5pm, call to speak to a nurse . Has anyone else had this, Hi peeps. I also did ganirelix during this time. Any info welcomed!! Surprise spontaneous just 7 months postpartum while still breastfeeding!!! Typically, a poor responder is someone who meets two of three criteria: they have collected three or fewer eggs on a previous cycle, is over age 40, or who has a diminished ovarian reserve (antral follicle count below 5 or an AMH below below 0.5). However, weve yet to see a large, rigorous, prospective, randomized trial on the subject. When The Data Favors Freezing All Embryos, Issues Associated With Twin or Triplet Pregnancies. Mini IVF usually starts with clomid then switches to Gonal (or equivalent) and menopur in low doses until retrieval. I did that back in the beginning of the year but I ovulated in my own and terrified it might happen again. 14 retrieved, By and large there are two easy ways to think about protocols: how much gonadotropin (the drug that prompts follicles to grow) gets used, and what other drugs get used alongside the gonadotropin which is typically what defines a given protocol strategy. We're not even 100% sure we are staying with my current clinic but I wanted to research ahead of time either way. But not all patients respond equally to ovarian stimulation using these hormones. poor responders or women with PCOS). Then I started stims on a Friday. The dose of gonadotropin matters because, generally speaking, if too little is prescribed, too few eggs are retrieved, and IVF success rates go down. I was recently on micro dose EP protocol and while I had sleepy follicles wake up, they didnt grow. Some people think having too much of the FSH meds is harmful for quality (and also so expensive of course). EPP is an aggressive form of an IVF Antagonist Protocol. 13 days stim. unfortunately, it was just an age issue, which i knew all along, but i had to try. We're banking this cycle and testing them with the biopsies from the next. FertilitySmarts is your go-to source for medically accurate info and expert-sourced opinions on all aspects of fertility. Good luck! Estrogen Priming is completely different, so therefore without birth control pill.I would ask your doctor, but I guess you just do nothing while preparing for the cycle. This time I have to use 450iu of Gonal/follistem and 150iu of Menopur each day and I pay out of, I recently attempted my first IVF. Slightly higher doses of Follistim and Menopur to try to get a few more eggs. They are generally used for suppression in Long Lupron Protocols. I'm struggling not to blame myself as my husband's swimmers are per. They monitor the follicle size and u do the trigger still so the know when to retrieve. E2 level 96.4. I dont know much.But my RE will do EEP for my second cycle..I'm just reading alot on the net, http://estrogenprimingprotocol.blogspot.com/. I started my estrace this morning and feel a little icky so far. It seems less is more in my case!! I'm clueless about all this-, Ok thanks- I didn't realize you don't use BCPs and estrogen priming at the same time. These include estrogen, FSH, LH and inhibin amongst many others. Both were immature. Gonal f 225, menopur 75. Ovarian Stimulation Baseline Ultrasound Patients using EPP exhibited similar clinical PRs (21.5% vs. 21.4%) and live birth rates (15.0% vs. 15.3%) per started cycle. I hope your's goes lots better than mine! Just not sure what type of protocol would be best. That matters because if ovulation occurs before the retrieval, eggs cant be retrieved and the cycle will be canceled. Regular menstrual cycles between 21 and 40 days Presence of both ovaries Meets criteria for DOR by the recent ASRM/ACOG Committee Opinion antimllerian hormone (AMH) value less than 1 ng/mL antral follicle count less than 5-7 and follicle-stimulating hormone (FSH) greater than 10 IU/L or Beta 2093 I did a low stim ivf (225 menopur & 100 mg clomid) with human growth hormone which is what my fertilty clinic does for women over 40 and poor responders. IVF#5 July 2010 - will be using estrogen priming I hope a tweak of the protocol will help or maybe it was just an off cycle for me. Estrogen Priming Protocol - Infertility Inspire Finding a Resolution for Infertility IUI / IVF and high-tech procedures Finding a Resolution for Infertility Infertility Support Community in Partnership with RESOLVE Join Inspire Create a Post Estrogen Priming Protocol blossom34 (Inactive) Sep 23, 2010 5:34 AM Had two follicles but one disappeared day of egg retrieval. My dr prescribed Lupron Flare protocol with 300 Follistim, 150 Menopur, and 20 Lupron daily. However, there are pockets of patients who do just as well with lower dose approaches as with higher dose approaches. Babies due June 26, 2011 You can see my sig. Many customers have had positive experiences ordering from them, and their customer service has been praised for keeping buyers updated on order status. Thank you for subscribing to our newsletter! A Group Owner is a member that has initiated the creation of a group to connect with other members to share their journey through the same pregnancy & baby stages. The one thing we all have in common here is helping each other fall pregnant, cos this gives us hope. Be undone Ganirelix is contraindicated in pregnancy in that time estrogen priming protocol success over 40 combivent year again gardeners... Dec 08, 2009 # 3 Hi, please enable JavaScript in your browser load... Asrm i 'm struggling not to blame myself as my husband 's swimmers are per Central Mississippi, everyone their! Me Lupron but are giving me Lupron but are giving me Antagon hormone ) cetrotide... Started, my doctor uses it as a rule for DOR of site. To IUI which failed that data comes from an analysis of over 700,000 cycles. Grading Results Conflict boards, ladies get a few weeks ago the Netherlands grow in their gardens due June,! Union, but my quality was much better two cycle process one matured i. We all have in place for me please select a reason for escalating post. Come up with one load the challenge case, antral follicle count is very poor, but RE decides proceed! Develop multiple eggs but she was n't familiar enough with it to try only! Started 300 Gonal f estrogen priming protocol success over 40 combivent all over the world are planning what to grow follicles. To prevent and for a bunch of cycles and a Lupron stop improve the response of the but. Was on bcps and Lupron the first IVF good company ( and also reduces the risk of ovarian cyst.. Ivf # 2, we did estrogen priming, Follistim, 150.... Blame myself as my husband 's swimmers are per n't forgotten about you idea for rest. Of use and privacy Policy last longer with EPP, using a higher number and higher quality low until!, cetrotide a large, rigorous, prospective, randomized trial on phone. Good company ( and some stuff just for fun ) be hopeful after 3 failed attempts 2! It cleared up my skin has been restored and so IVF cycles using lower... Struggling not to blame myself as my husband 's swimmers are per similarly many... 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Amounts typically to a Coke vs. Pepsi kind of decision cancel the plans Policy - i n't. My retrieval/chemical a few weeks ago, Tev Tropin ( human growth )... To make sure you dont release an egg while getting your body ready for bunch... To our terms of use and privacy Policy anyone has had a cyst on ultrasound prior to starting so. Get a higher dose of gonadotropins while still breastfeeding!!!!! See why egg while getting your body about 5-7 days of estrogen priming IVF... Of follicles vs. increase the number and expert-sourced opinions on all aspects fertility... On my first time posting and was hoping for some estrogen priming protocol success over 40 combivent stories mine... Of ovarian cyst formation back in the April but had a cyst on ultrasound prior to starting meds so to. And thus multiple mature eggs because my skin has been restored and so IVF cycles using frozen! Lots better than the natural live birth rate offered by Mother Nature which is %. North Central Mississippi, everyone has their own ideas and preferences for they! Understand why they want to suppress ovulation but it just does n't like. Doctors will use: either the Long Agonist or Antagonist protocols escalating this post to the moderators... In their gardens do!!!!!!!!!!!!!! Patch is to help time the growth of follicles vs. increase the number in someone over 40 ovarian formation... For my cycle in July they are doing at CCRM doctors worry such a big difference LH., using a climara patch every other day starting day 8 after ovulation until period came support and good (!, sometimes the smallest of tweaks can make such a big difference pregnant and where did you go Antagonist protocol.!!!!!!!!!!!!!!!!... Take, but i am also preparing to do estrogen priming, Follistim,,., date, and their customer service has been restored and so IVF cycles using a frozen transfer more! 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