Just went through my first ICSI procedure and got a BFN on 6-20. I was on the Luteal Lupron protocol (Lupron,Menopur,Gonal-F). I had 12 follies; 11 were retrieved; 7 matured; and 3 fertilized. I had 2 eggs transfered and 1 frostie. One was a 9 celled and the other 7 celled for a 3 day transfer. Beta was 3! ICSI is our only choice due to male factor. Now my RE wants to change protocols- he wants to try the Microdose Flare. The clinic I go to is closed for the month of July so I have to wait until August. But does anyone know anything about this protocol? My RE states in the letter that he wants my ovaries to rest. He hopes this protocol will produce more eggs. I thought 11 eggs was a pretty good number. Now I am afraid I will end up with Over stim or Hyperovulation. Has anyone had any success with changing protocols?
Your doc thinks the Lupron flare protocol might be better. It's not all that much different, you'll just start the Lupron about a week later. They may switch you over to a different family of drugs (GnRH antagonists) for pituitary suppression after that or maybe keep you on the Lupron.
We've tried flares in some poor responder patients and gotten what seemed to be somewhat better responses. We have not scientifically studied it, however.
It does not sound like you are a poor responder. More in the medium range. Not sure why your doc thinks 12 follicles and 11 eggs is inadequate response. You'll have to ask him/her.
Your physician seems to believe your OHSS risk should not be excessive with the new protocol. I'd tend to agree. Severe OHSS rarely strikes in patients with anything like 12 follicles. Mild OHSS is possible down there, but the severe cases usually have over 20 follies. More like 30, 40, numbers like that.
Your physician will have to explain his/her rationale. Maybe your clinic has had a lot of success with it?
You said you have one frostie. Why go through ovarian stimulation (costs, risks) again if you can try the frozen embryo?
Thanks for the response Ghost! Yes have one frostie, but the nurse stated to me over the phone that the RE would prefer me to do the stimulation again. I assume because of the risk of the frostie not surviving the thaw. Plus wouldn't I have to prep my body for pregnancy again with the progest. and the estrogen? Why go through that and waste another month when the risk is so high that the egg may not make it? Really I'm just guessing since my clinic is closed for july and I haven't spoken to the RE directly. I do think of the risk, especially since I had an infection after my last egg retrieval. Antibiotics cleared it up in a jiffy but I'll always wonder if it was why I didn't get PG The money isn't an issue since my insurance covers all but co-pays (so sorry for the girls who have to pay each time- especially for those in the UK! )
So about this Microdose Flare- I was told I would have to start BCP at my next period (July 23) When do you think my Retrieval would be approx.?
This time I would like to transfer 3 eggs - 2 fresh along with my frostie. Just hoping for that miracle!!!!
tracyrae wrote:Thanks for the response Ghost! Yes have one frostie, but the nurse stated to me over the phone that the RE would prefer me to do the stimulation again. I assume because of the risk of the frostie not surviving the thaw. Plus wouldn't I have to prep my body for pregnancy again with the progest. and the estrogen? Why go through that and waste another month when the risk is so high that the egg may not make it? Really I'm just guessing since my clinic is closed for july and I haven't spoken to the RE directly. I do think of the risk, especially since I had an infection after my last egg retrieval. Antibiotics cleared it up in a jiffy but I'll always wonder if it was why I didn't get PG The money isn't an issue since my insurance covers all but co-pays (so sorry for the girls who have to pay each time- especially for those in the UK! )
So about this Microdose Flare- I was told I would have to start BCP at my next period (July 23) When do you think my Retrieval would be approx.?
This time I would like to transfer 3 eggs - 2 fresh along with my frostie. Just hoping for that miracle!!!!
Yes, you'd need preparation for an FET, including estradiol and progesterone. These are relatively inexpensive and safe, compared to another cycle of stimulation. It helps a lot that your costs are covered, in your case.
Also consider that stimulation disturbs the endometrium. This may be why some clinics do better with frozens than with fresh. But if your clinic was doing better with frozens than fresh, they'd probably be advising you to try the frozen first.
With the schedule you stated, your retrieval would be in the first week of August. Sorry can't be more precise. Clinics and patients vary a lot. Some clinics schedule retrievals rigidly (fixed number of days), while others base it on observed follicular growth. Some patients respond quickly and only need maybe 8 days of stim, others may take several days longer to develop a good cohort of follicles.
ICSI is our only choice due to male factor. Now my RE wants to change protocols- he wants to try the Microdose Flare. The clinic I go to is closed for the month of July so I have to wait until August. But does anyone know anything about this protocol? My RE states in the letter that he wants my ovaries to rest. He hopes this protocol will produce more eggs. I thought 11 eggs was a pretty good number. Now I am afraid I will end up with Over stim or Hyperovulation. Has anyone had any success with changing protocols?