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Microdose lupron/micro flare lupron vs agonist-antagonist ivf protocol.
Has anyone done or started with micro-dose/micro-flare lupron then switched to agonist-antagonist ivf protocol? Any success on the latter protocol and what is your over-all experience and/or response?
Best Answer
Thanks for your good wishes Jo!
I meant to ask you, how long are you waiting between your cycles? At what day was your embryo frozen? Have any of your embryos gotten to blastocyst in the past?
Your RE sounds a bit like mine. He's really wanting to give up on me, and I find that so negative and stressful. I'm in New Zealand, and I think there's only this one clinic in my town. It's the best fertility clinic in NZ, and they get good results, but I think the RE I have has lost the passion. There is another younger RE there who I would prefer to see. My RE I've seen since I conceived my son and daughter easily, using IUI. He seems to have the idea now that I already have two children, so shouldn't be bothering. He says if I didn't have any children, he would say to keep trying. I don't think this is any of his business. He is only there to treat me, not give his opinion on how many children I should have! My second IVF was better and he asked me if I had been taking DHEA. My thoughts are that if he thought DHEA can be a good thing, then why hadn't he suggested me taking it before my second IVF? I also suggested trying the estrogen priming protocol to him a few months back, but his response was "we don't have to resort to that yet"?!?!?
ICIS is used when IVF doesn't work ie. when the sperm doesn't fertilise with IVF. The sperm is actually injected directly into the egg. It is more expensive than IVF. I'm actually using a sperm donor - the same one used for my other two children. His sperm has been fine in the past for IUI, but for IVF, the count isn't quite high enough, and that's why I had to use ICSI.
I really pray the antagonist works for you. I've heard good things about it. It didn't work for me, but we are all different, and respond differently. Are you using any supplements? Does insurance cover your treatment? In New Zealand, insurance companies don't cover anything related to infertility. It is very wrong!! Also, I don't qualify for any funding here as I'm doing this as a single woman (I left my husband back in 2004 to pursue my dreams of motherhood).
How have you felt in your past cycles during the TTW? I will let you know how my test goes - it's in two days. It's sounds so downbeat, but I know it's a BFN. I am so in touch with my body, especially in that region!!!!! I'm a bit over it now, and trying to look forward to Spring weather and all. I need to let go a bit, at least for now.
I pray this cycle works for you!!!!! We must stay in touch on here!!!!
:0)
I meant to ask you, how long are you waiting between your cycles? At what day was your embryo frozen? Have any of your embryos gotten to blastocyst in the past?
Your RE sounds a bit like mine. He's really wanting to give up on me, and I find that so negative and stressful. I'm in New Zealand, and I think there's only this one clinic in my town. It's the best fertility clinic in NZ, and they get good results, but I think the RE I have has lost the passion. There is another younger RE there who I would prefer to see. My RE I've seen since I conceived my son and daughter easily, using IUI. He seems to have the idea now that I already have two children, so shouldn't be bothering. He says if I didn't have any children, he would say to keep trying. I don't think this is any of his business. He is only there to treat me, not give his opinion on how many children I should have! My second IVF was better and he asked me if I had been taking DHEA. My thoughts are that if he thought DHEA can be a good thing, then why hadn't he suggested me taking it before my second IVF? I also suggested trying the estrogen priming protocol to him a few months back, but his response was "we don't have to resort to that yet"?!?!?
ICIS is used when IVF doesn't work ie. when the sperm doesn't fertilise with IVF. The sperm is actually injected directly into the egg. It is more expensive than IVF. I'm actually using a sperm donor - the same one used for my other two children. His sperm has been fine in the past for IUI, but for IVF, the count isn't quite high enough, and that's why I had to use ICSI.
I really pray the antagonist works for you. I've heard good things about it. It didn't work for me, but we are all different, and respond differently. Are you using any supplements? Does insurance cover your treatment? In New Zealand, insurance companies don't cover anything related to infertility. It is very wrong!! Also, I don't qualify for any funding here as I'm doing this as a single woman (I left my husband back in 2004 to pursue my dreams of motherhood).
How have you felt in your past cycles during the TTW? I will let you know how my test goes - it's in two days. It's sounds so downbeat, but I know it's a BFN. I am so in touch with my body, especially in that region!!!!! I'm a bit over it now, and trying to look forward to Spring weather and all. I need to let go a bit, at least for now.
I pray this cycle works for you!!!!! We must stay in touch on here!!!!
:0)
hi marietta:
all my 4 cycles have been IVF. i thought IVF is better than ICSI... right?
yes, my dh and i have read about estrogen priming and we want to try it in our next cycle but my re is insisting i don't need it or that it wouldn't work. ugghhhh! i can't wait to have a free consultation with another ivf clinic (i mentioned this to you, right) on sept 16. i'll let you know how it goes.
as for you feeling cramps 2-days after your transfer... let's hope it is trying to implant. TRY to relax... i know it is hard not to think about it... but TRY. it is all out of your hands now and the embryo will do whatever it'll want to do inside you and let us HOPE it is trying to implant :)))
i'm waiting for my AF to come then they'll put me on bcp. i'm going to try my luck with the agonist-antagonist protocol (i've only been doing microdose lupron)... so we'll see how my body responds.
please keep me posted on how you are doing. and if you need anyone to talk to during your 2ww... just drop me a note.
take care and wishing you an EXTRA SUPER STICKY BABY DUST :))))
jo
all my 4 cycles have been IVF. i thought IVF is better than ICSI... right?
yes, my dh and i have read about estrogen priming and we want to try it in our next cycle but my re is insisting i don't need it or that it wouldn't work. ugghhhh! i can't wait to have a free consultation with another ivf clinic (i mentioned this to you, right) on sept 16. i'll let you know how it goes.
as for you feeling cramps 2-days after your transfer... let's hope it is trying to implant. TRY to relax... i know it is hard not to think about it... but TRY. it is all out of your hands now and the embryo will do whatever it'll want to do inside you and let us HOPE it is trying to implant :)))
i'm waiting for my AF to come then they'll put me on bcp. i'm going to try my luck with the agonist-antagonist protocol (i've only been doing microdose lupron)... so we'll see how my body responds.
please keep me posted on how you are doing. and if you need anyone to talk to during your 2ww... just drop me a note.
take care and wishing you an EXTRA SUPER STICKY BABY DUST :))))
jo
Hi Jo!
Thanks for that info! There are so many different drugs used, and so many differing protocols. I used to have a problem with premature LH surges before I had my daughter, and that's why I used drugs with IUI to conceive her. I think because I still have a tendency for these premature surges, that is why my RE felt I wouldn't need menopur. Also, I think on the micro-dose, a greater amount of LH us possible. I will ask my RE though. My main problem now seems to be embryo quality. Seven of my 8 eggs were mature, and 6 fertilized, but they don't seem to be strong enough to get to blastocyst, or achieve pregnancy. I am 100% certain AF is coming, so I know this 2nd attempt is over. Do you think it is normal to cramp only two days after a 3 day transfer? Even if not pregnant, why would I have this cramping? I've never had any problem with lining, but I wonder why my cramping starts so early. Goodness, I don't even get a chance to dream!!!! I'm a very crampy person, so maybe I'm just so much more sensitive. The timing of the HCG is critical to the process, as you say. One of the doctors wanted me to take it on the Saturday night, but my RE looked at my E2 levels, and told me to take it on the Friday. I've been reading up on DHEA, and I'm thinking this could be my only chance to try and improve quality. Jo, have you heard of the estrogen priming protocol? I wanted to try this one a while back, but my RE wasn't keen. Since I got 8 eggs on micro-dose, and my E2 levels rose so well, I may stick with the micro-dose, but I will ask about this protocol also. It seems to be the one many clinics are opting for now, especially for women with DOR. When are you due to start your next cycle. It's strange your RE isn't open to using a different protocol. Most REs do change protocols as IVF is often just a matter of changes meds and protocols, until one finally works!! Did you use IVF or ICSI? Please keep me posted on what you do. I will be taking time off. I know I don't have time to waste, but my RE likes a rest period of two months. I will start new cycle when I get AF in December. GOOD LUCK!!!
To: USUK
Well, I will ask if menopur can be added to the mix! Who knows, all of this is such a mystery. And I think a lot of it is still guess work. I so wish medical science would leap ahead so all of us women coping with older ovaries can get pregnant!!!! Of those 13 eggs you got, how many fertilized etc? Did you get to freeze any? For me now, I'd rather have quality over quantity, but the question is whether it's possible for me to get much in the way of quality, now that I'm 38. GOOD LUCK!!!
Thanks for that info! There are so many different drugs used, and so many differing protocols. I used to have a problem with premature LH surges before I had my daughter, and that's why I used drugs with IUI to conceive her. I think because I still have a tendency for these premature surges, that is why my RE felt I wouldn't need menopur. Also, I think on the micro-dose, a greater amount of LH us possible. I will ask my RE though. My main problem now seems to be embryo quality. Seven of my 8 eggs were mature, and 6 fertilized, but they don't seem to be strong enough to get to blastocyst, or achieve pregnancy. I am 100% certain AF is coming, so I know this 2nd attempt is over. Do you think it is normal to cramp only two days after a 3 day transfer? Even if not pregnant, why would I have this cramping? I've never had any problem with lining, but I wonder why my cramping starts so early. Goodness, I don't even get a chance to dream!!!! I'm a very crampy person, so maybe I'm just so much more sensitive. The timing of the HCG is critical to the process, as you say. One of the doctors wanted me to take it on the Saturday night, but my RE looked at my E2 levels, and told me to take it on the Friday. I've been reading up on DHEA, and I'm thinking this could be my only chance to try and improve quality. Jo, have you heard of the estrogen priming protocol? I wanted to try this one a while back, but my RE wasn't keen. Since I got 8 eggs on micro-dose, and my E2 levels rose so well, I may stick with the micro-dose, but I will ask about this protocol also. It seems to be the one many clinics are opting for now, especially for women with DOR. When are you due to start your next cycle. It's strange your RE isn't open to using a different protocol. Most REs do change protocols as IVF is often just a matter of changes meds and protocols, until one finally works!! Did you use IVF or ICSI? Please keep me posted on what you do. I will be taking time off. I know I don't have time to waste, but my RE likes a rest period of two months. I will start new cycle when I get AF in December. GOOD LUCK!!!
To: USUK
Well, I will ask if menopur can be added to the mix! Who knows, all of this is such a mystery. And I think a lot of it is still guess work. I so wish medical science would leap ahead so all of us women coping with older ovaries can get pregnant!!!! Of those 13 eggs you got, how many fertilized etc? Did you get to freeze any? For me now, I'd rather have quality over quantity, but the question is whether it's possible for me to get much in the way of quality, now that I'm 38. GOOD LUCK!!!
thanks for your comment. how did your 13 eggs do? i was on the lupron-menopur-follistim protocol for all of my 4 ivf cycles and the most # of eggs i produced was 5 eggs. on my next and 5th cycle, my er agreed to drop the lupron and see how i do on menopur and follistim alone. i'm scared but i won't know how my body will respond unless i try... what's another month... i guess.
good luck with your eggs and ivf. let me know how you do... will yah?
thanks again and wishing you a BFP,
jo
good luck with your eggs and ivf. let me know how you do... will yah?
thanks again and wishing you a BFP,
jo
hello marietta:
i'm sorry to hear that the embryos did not develop as well. but, hey all you need is one to grow normally and stick, right? so let's hand on to that and hope that on sept. 5 you get a BFP. NO AFs... please :)))
as for the protocols... lupron is used to prevent your brain (for simplicity) from producing large, pulses of LH. this large amount of LH can affect the # of eggs/follicles developing before they can mature for retrieval. but b/c you will still some level of LH, menopur is given. menopur has both LH and FSH but in known, small amount. this amount is enough to support the developing follicles but not too much that it can have a bad effect. follistim is just pure FSH which helps you (stimulates) your ovaries in producing multiple follicles. and then there is hcg which causes final maturation of the eggs. my last ivf... they were only able to get 3 eggs, of which only 1 survived as an embryo. later i found out i received hcg a bit too early and that i could have probably waited a little longer until more eggs have gotten bigger and then take hcg.
i don't know which of these 3 medications have, if any, effect on the development of the embryo, such as the # of fragmentation. i know that the timing and the dose of each medications is important, especially for older women who needs that special (fine) tuning per se. this is where come clinics that have high rate of pregnancy in women 40 and above are good at. if you can afford it... you should get all your medical records and get a consultation from one of these clinics. let me know if you want a name of the clinic. you can also get a FREE consultation from the sher institute. i'm doing it on the 16th just to see if they will say something different. of course, understanding what each meds do will help you figure out if what the 2nd and 3rd opinions are valid.
i hope i'm not confusing you further.
hang in there... and let me know how you are doing... i would love to know and provide you any support i can :)))
i'll be thinking of you and saying a prayer for you.
Extra Super Sticky Baby Dust to you :))))
hugs,
JO
i'm sorry to hear that the embryos did not develop as well. but, hey all you need is one to grow normally and stick, right? so let's hand on to that and hope that on sept. 5 you get a BFP. NO AFs... please :)))
as for the protocols... lupron is used to prevent your brain (for simplicity) from producing large, pulses of LH. this large amount of LH can affect the # of eggs/follicles developing before they can mature for retrieval. but b/c you will still some level of LH, menopur is given. menopur has both LH and FSH but in known, small amount. this amount is enough to support the developing follicles but not too much that it can have a bad effect. follistim is just pure FSH which helps you (stimulates) your ovaries in producing multiple follicles. and then there is hcg which causes final maturation of the eggs. my last ivf... they were only able to get 3 eggs, of which only 1 survived as an embryo. later i found out i received hcg a bit too early and that i could have probably waited a little longer until more eggs have gotten bigger and then take hcg.
i don't know which of these 3 medications have, if any, effect on the development of the embryo, such as the # of fragmentation. i know that the timing and the dose of each medications is important, especially for older women who needs that special (fine) tuning per se. this is where come clinics that have high rate of pregnancy in women 40 and above are good at. if you can afford it... you should get all your medical records and get a consultation from one of these clinics. let me know if you want a name of the clinic. you can also get a FREE consultation from the sher institute. i'm doing it on the 16th just to see if they will say something different. of course, understanding what each meds do will help you figure out if what the 2nd and 3rd opinions are valid.
i hope i'm not confusing you further.
hang in there... and let me know how you are doing... i would love to know and provide you any support i can :)))
i'll be thinking of you and saying a prayer for you.
Extra Super Sticky Baby Dust to you :))))
hugs,
JO
not sure what menopur does. but one month i did follistim/lupron/low dose hcg and bombed. next month just follistim and menopur and got 13 eggs. i never asked even though i am pretty much a pain in the butt :)
Hi Jo!
Well, things haven't gone well. I ended up with a 3 Day transfer of one 8-cell, minimal fragmentation, and a perfect 12-cell (8-cells preferred on Day 3 though). I had four remaining embies, three with fragmentation, and one 8-cell with some fragmentation. None of them made it to Day 5, the 8-cell almost did, then arrested. So, I either have only really bad eggs left or the drugs are 'frying' them. I test on 5 Sept, but two days past my transfer, I've been having cramps, which have only increased. So, I know the outcome already - I've had these same exact cramps for my past failures. I know my body so well, and know I'm not pregnant. So, I'm not sure what to do next. I see my GP today, and want to get my DHEA and testosterone levels taken. I want to try DHEA if I go another round. This microdose prot. was better in that I got more eggs, but the outcome was exactly the same as my first IVF with regards to the embryos and their cell division and all.
I think we have to try new protocols. I only got 6 eggs on the long prot. The antagonist didn't work for me, as I said, there were only three large follies, so I converted it to IUI. But, who knows what would have happened if I had continued with IVF/ICSI. One of those eggs may have been better quality. What counts with IVF/ICSI is the quality of the embryos, not the number of eggs. I know of so many women who have only gotten 2 or 3 eggs, ended up with one embryo, and that embryo has become a child! I don't know if there's a lot we can do to improve egg quality, but I still think a lot has to do with the type of protocol used. What else can explain women who have bad cycles, change REs, and then get much better responses? GOOD LUCK with what you decide!! I would definitely try a new protocol!
USUK. I wonder, what is menopur used for? I asked my RE about it, but he said I wouldn't need it, as I had 'no problems' with LH.
GOOD LUCK EVERYONE!!!
Well, things haven't gone well. I ended up with a 3 Day transfer of one 8-cell, minimal fragmentation, and a perfect 12-cell (8-cells preferred on Day 3 though). I had four remaining embies, three with fragmentation, and one 8-cell with some fragmentation. None of them made it to Day 5, the 8-cell almost did, then arrested. So, I either have only really bad eggs left or the drugs are 'frying' them. I test on 5 Sept, but two days past my transfer, I've been having cramps, which have only increased. So, I know the outcome already - I've had these same exact cramps for my past failures. I know my body so well, and know I'm not pregnant. So, I'm not sure what to do next. I see my GP today, and want to get my DHEA and testosterone levels taken. I want to try DHEA if I go another round. This microdose prot. was better in that I got more eggs, but the outcome was exactly the same as my first IVF with regards to the embryos and their cell division and all.
I think we have to try new protocols. I only got 6 eggs on the long prot. The antagonist didn't work for me, as I said, there were only three large follies, so I converted it to IUI. But, who knows what would have happened if I had continued with IVF/ICSI. One of those eggs may have been better quality. What counts with IVF/ICSI is the quality of the embryos, not the number of eggs. I know of so many women who have only gotten 2 or 3 eggs, ended up with one embryo, and that embryo has become a child! I don't know if there's a lot we can do to improve egg quality, but I still think a lot has to do with the type of protocol used. What else can explain women who have bad cycles, change REs, and then get much better responses? GOOD LUCK with what you decide!! I would definitely try a new protocol!
USUK. I wonder, what is menopur used for? I asked my RE about it, but he said I wouldn't need it, as I had 'no problems' with LH.
GOOD LUCK EVERYONE!!!
long story short - did horrible on lupron. cycle cancelled. next month: got 13 eggs with menopur. did not get preg but the difference was obvious for me. good luck :)
hi marietta2000,
thanks for sharing your experience with different ivf protocols. i met with my re this morning and having been on mircoflare for 4 ivfs now (one one resulted in pg but m/c), and all gave no more than 4 eggs/follicles retrieved and no more than 3 fertilized in all 4 ivfs, i wanted to try another protocol. like you said, we are all different and i wanted to see if my body will respond better or worse with the antagonist/agonist protocol.
my re was not supportive of my decision and was reluctant. no reason was offered... other than he doesn't believe that the others are better. but i don't want to keep on spinning my wheels on the same protocol and i'm getting the same outcome. maybe this is the best my ovaries and my body can do but i want to try and see. i can always go back to microflare again... like you did.
you wrote your note on 8/22. how did your transfer go? are you in your 2ww now?
good luck and let me know how you are doing. i'm surprised that now a lot of people weighed-in on my question. so, thanks for giving some feedback.
take care and wishing you a BFP.
jo
thanks for sharing your experience with different ivf protocols. i met with my re this morning and having been on mircoflare for 4 ivfs now (one one resulted in pg but m/c), and all gave no more than 4 eggs/follicles retrieved and no more than 3 fertilized in all 4 ivfs, i wanted to try another protocol. like you said, we are all different and i wanted to see if my body will respond better or worse with the antagonist/agonist protocol.
my re was not supportive of my decision and was reluctant. no reason was offered... other than he doesn't believe that the others are better. but i don't want to keep on spinning my wheels on the same protocol and i'm getting the same outcome. maybe this is the best my ovaries and my body can do but i want to try and see. i can always go back to microflare again... like you did.
you wrote your note on 8/22. how did your transfer go? are you in your 2ww now?
good luck and let me know how you are doing. i'm surprised that now a lot of people weighed-in on my question. so, thanks for giving some feedback.
take care and wishing you a BFP.
jo
Sorry, I meant to say, what may work for one person, CAN work badly for another!!! Hope you get my drift!
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I've just done my second IVF cycle, trying for baby #3! I used micro-dose flare. My first IVF was the long lupron protocol, I got 6 eggs from 7 follies, 4 fertilised, & one 'perfect' 8-cell was replaced on Day 3. None to freeze.
I tried a second IVF in May - I was split between whether to use antagonist or micro-dose. I ended up going for antagonist, but it didn't go well for me. I had two dominant follies, and three smaller ones, so I converted to IUI, which didn't work.
My current IVF, I went for micro-dose. My E2 really sky-rocketed - was at 12,446 on day of trigger. I stimmed three or four days less than on the long protocol. Unfortunately, I only got 8 eggs from 9 follies. 7 were injected yesterday for ICSI, and today I was told that 6 have fertilised. So, I'm praying hard that at least one will last the distance!!!!
I think the micro-dose flare and antagonist can both give good results, but we are all different, and what may work for one person, can't work badly for another. I think the micro-dose worked better for me, but I will need to see how the embryos develop before I have the final verdict!!!!
All the best for you!!!! This is a tough journey!!! :0)