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Estrogen Priming Antagonist Protocol IVF

January 22 2017 at 1:55 AM
Penny  (Login pingpong77)

Hello everyone. So glad I found this forum.

A quick background. I'm 39. Started IVF at 38.
My day 3 FSH is between 7.1 and 10.5.
My day 3 LH is between 5.0 and 4.6.

I've done 4 IVF cycles.

First cycle was long down reg with synarel and 300 IU gonal f and 75 luveris. Gonal F was increased to 450 IU on day 8. Day 10 showed 8 follicles, but only 2 eggs retrieved, both icsi'd and both transferred on day 3, BFN.

Second cycle was long down reg. We used 450 IU Gonal F and we added growth hormone and 75 IU luveris. 10 eggs retrieved, 9 fertilised with icsi, 6 were still around on day 3. 2 transferred and 4 frozen. BFN. 1 FET of 2 embryos was BFN and the other two were transported to another FS and thawed and tried to grow to day 5, but they arrested on day 4.

Third cycle was an antagonist, but on this cycle my day 3 FSH was 10.5 and LH was 4.6. I was given 600 IU puregon along with high dose of growth hormone and luveris. Unfortunately, we had severely scattered egg growth that I lost a few at the time. 8 follicles resulted in only 2 eggs and after icsi'd, they both arrested on day 4.

Fourth cycle was long down reg. 7 follicles, but very high dose of FSH (600 IU Gonal F), growth hormone, 150 IU Luveris daily which resulted in 2 eggs. Both fertilised with icsi and only one made it to day 5, but grade was 4CC. It's frozen. My LH every day on this cycle never went beyond 0.7. My FS fried my eggs and then tried to tell me that I had very bad quality eggs and I should go down the donor path.

Moved onto a much better FS who agreed to trial me on the estrogen primed antagonist protocol.

4mg progynova started 7 days after LH rise.
Day 1 FSH was 5 and LH was 1.2
Day 2 FSH was 6 and LH was 2.0.

I started 300 IU Gonal F on day 2. It's only day 4 today.

My friend did the estrogen primed antagonist protocol and her day 1 FSH was 1.0 and LH was 0.1.

Anyone know why my FSH only got down to 5 on day 1? Do you think an increase in estrogen would drop that FSH even lower?

My FSH to LH ratio is usually 1:2 (sign of diminished ovarian reserve), so I am surprised my FSH and LH didn't drop much further.

My AMH is 7.0 pmol/l OR 0.98 ng/mL. I didn't think my AMH was that bad, but my old FS (who completedly

My friend succeeded with the estrogen primed antagonist protocol and her starting day 3 FSH was 13. Anyone know why my FSH on day 1 after 7 days on estrogen was only 5? Is that a good number or should it be much lower on this type of protocol?

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(no login)

Re: Estrogen Priming Antagonist Protocol IVF

January 23 2017, 7:23 AM 

Are you cycling in the US? Unfortunately, I can't really answer your question. I never had that much emphasis on my FSH when I started my protocols. I would not over analyze the numbers, and from what I know your numbers seem fine.

Now, I don't think you are that poor of a responder and I don't think you need donor eggs unless you want to go that route (I think donor eggs are a wonderful option). I am not a fan of your prior protocols or of growing out to day 5, thereby causing the embryos to arrest, when you did not have many to work with. I am a huge fan of 3 day transfers when you have few embryos. Also, embryos often arrest in the lab b/c of the lab, not b/c of the embryos. If you are in the US (even if you aren't if you want to travel here), given your history, it looks like you are a good candidate for CCRM. They have the best lab here. It seems like they would be really good for someone with your history.

I would post your questions on the over 40 board because there is more activity and you don't really have to be over 40 to comment over there. I have been on that board for years and I just turned 40.

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(Login pingpong77)

Re: Estrogen Priming Antagonist Protocol IVF

January 24 2017, 12:47 AM 

Many thanks for your message hun. I will post in the thread you suggested!

I am cycling in Australia.

Actually, my first two cycles were day 3 transfers. Two embryos each time and nothing.

It was the following two protocols with a different FS where the embryos were grown to day 5. But i never had a transfer cos he couldn't get more than 2 eggs out of me, even though my estrogen suggested a lot more eggs.. He really used an aggressive protocol which did not work on my tiny body (I'm quite petite).

Is CCRM aka Dr Sher? I had a telephone consult with him and I wasn't entirely impressed.. He also quoted me $50,000... there is an FS who does his protocol here, so worst case scenario I can do that protocol here in Australia and save myself about $43,000....

Again, thank you for responding! I'll go over to the other thread now (see you there). happy.gif

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(no login)

Re: Estrogen Priming Antagonist Protocol IVF

January 24 2017, 7:26 AM 

CCRM is not Dr. Sher (I consulted with him too, but I just felt reservations about using him). There are numerous good doctors associated with CCRM (I used Dr. Surrey, but the most well known is Dr. Schoolcraft). It is called the Colorado Center for Reproductive Medicine. They cycle lots and lots of international patients b/c they are supposed to be the best. While I think protocol is important, very important, I also think the lab is equally if not more important. It sounds to me like you can benefit from a really good lab. That is where CCRM excels. They are known to have the best lab anywhere. I never had any embryos make even reasonable quality anywhere except there. In fact, they all arrested my first cycle before I went there. They are expensive though, really expensive. The likelihood of success usually takes a few cycles with high FSHers, so if you went that route, it would be something to consider. There is a wait for an appointment (seemingly less with Surrey, who I believe is great), but they do offer telephone consults.

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