Ghost Protocol Question

[tali]

I am gearing up for cycle #5. My first 3 cycles were kind of wasted as the RE did not change protocols. First 2 were converted to iui, and I only ended up with one follicle that did not make it to transfer on the 3rd.

I changed RE's and had a much better cycle for #4. He tried EPP with high doses of Gonal F and Menopur. I stimmed for 14 days and ended up with 4 follicles, 2 fertilized and were transferred.

This cycle, he is recommending EPP again, but wants to up the menopur and decrease the Gonal F. He said that my E2 was slow to rise in cycle #4 and he thinks that if we can get the E2 to rise earlier in the cycle, we would get more follicles. I was hoping you could give me your opinion on this protocol.

Also, you mentioned on a previous post that the lining gets damaged each cycle because of the meds. My lining was 10mm on my last cycle. Is there anything I can do to reduce the damage that the meds cause?

We are not moving on to DE because our insurance does not cover it and we still have coverage for IVF.

Thanks

[Ghost]

I am gearing up for cycle #5. My first 3 cycles were kind of wasted as the RE did not change protocols. First 2 were converted to iui, and I only ended up with one follicle that did not make it to transfer on the 3rd.

I changed RE's and had a much better cycle for #4. He tried EPP with high doses of Gonal F and Menopur. I stimmed for 14 days and ended up with 4 follicles, 2 fertilized and were transferred.

This cycle, he is recommending EPP again, but wants to up the menopur and decrease the Gonal F. He said that my E2 was slow to rise in cycle #4 and he thinks that if we can get the E2 to rise earlier in the cycle, we would get more follicles. I was hoping you could give me your opinion on this protocol.

Also, you mentioned on a previous post that the lining gets damaged each cycle because of the meds. My lining was 10mm on my last cycle. Is there anything I can do to reduce the damage that the meds cause?

We are not moving on to DE because our insurance does not cover it and we still have coverage for IVF.

Thanks

Gonal F and Menopur are similar, in that they are both FSH products. Menopur has some hCG added, which helps to mature large follicles.

The thickness of the endometrium is not an indicator of "damage" from ovarian stimulation. It would take a microscope to see the impact, and also a biopsy, and they almost certainly will not biopsy your endometrium in a transfer cycle.

Reducing the "damage" would require shortening the stim or reducing the meds, both of which are a bad idea in a poor responder, or else freezing all the embryos for use in an undisturbed cycle. How good is your clinic with frozens?

[tali]

THanks for the reply - My RE did mention that he would like the cycle to be shorter than the last one which was 14 days.

Not sure how they are at freezing. Are those stats on SART? I have never produced enough to consider freezing so I have never paid attention to that.

[Ghost]

THanks for the reply - My RE did mention that he would like the cycle to be shorter than the last one which was 14 days.

Not sure how they are at freezing. Are those stats on SART? I have never produced enough to consider freezing so I have never paid attention to that.

Success rates with frozen embryos are on SART.

Most clinics will be reluctant to freeze all the embryos.