Thanks! Please enable JavaScript in your browser to load the challenge. (This was to work with their schedule, because they are closed on the weekends.) Weill Cornell Medical Center, Division Chief I did EPP my second round of IVF. This time she is switching me to EPP w/ 100 Follistim/150 Menopur. Very helpful! Also, your stims are actually a lot higher than most REs will do for DOR. I used two patches a dayandchanged the patches every third day. 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. I cannot say if it will be a success yet, as I am currently doing the EPP protocol. 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. But I am sure they know what they are doing at CCRM. Good luck. I had success on an EPP. How does a micro-flare protocol differ from mini IVF vs natural cycle? The protocol can also be preceded by the use of BCPs even if you have DOR. Within both, doctors can prescribe as much gonadotropin as theyd like. Now this is a guesstimated number. xx, Oww Hun, please dont worry about me, look after yourself, here if you need a listening ear xxx. DH: 36 that cycled failed. Polyspermy refers to the fertilization of one egg with multiple sperm cells that result in the formation of an embryo with abnormal sets of chromosomes. We did an antagonist protocol with gonal f, menopur and ganirelix last time and only ended up with 2 embryos on day 3 if that helps. As a result, most fertility doctors shoot to retrieve 15 to 20 mature eggs per cycle. The misoprostol was not expensive; on average, it's about $30. There are several methods of pre-treatment that involves using either a combined oral contraceptive pill, progestogen or estrogen. I did a phone consult with Sher and he suggested the conversion protocol to me as well. Really hope the next cycle goes well for you! This is caused by insufficient potassium reaching the fruit due to environmental factors such as high air/soil temperatures and overcast skies or heavy fruit load on plants with lower organic matter content in their soils. Slightly higher doses of Follistim and Menopur to try to get a few more eggs. Just not sure what type of protocol would be best. You still may have a BFP, so let's wait to see before we say it didn't work!! I also did human growth on 2 cycles and didn't help a bit. Implantation Calendar: What is Happening During the Two Week Wait. This comes from a 38,000 patient European registry. You can be assured it is a good protocol. I am interested in hearing from women who have never tried to get pregnant and therefore do not have any specific infertility issue per se, other than age. FET April 2009 - cancelled, embryos did not survive thaw Only 2 drugs during stim and finally got one good pgs tested embryo!!! Hey Michelle, I haven't forgotten about you. Twins & Multiples: Your Tentative Time Table. Time is of the essence and whatever information we have, we are happy to share to help you! :-/. Best of luck choosing. I just had a consultation with an RE he recommended a "estrogen priming micro-flare lupron" protocol. HiI'm new. - Apply first estrogen patch. I have AMH of 0.1 or something like that. 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. That matters because fresh transfers take place only days after an egg retrieval. Today, most IVF cycles use a frozen transfer whereby embryos are frozen and transferred at least a month after the retrieval. They monitor the follicle size and u do the trigger still so the know when to retrieve. Estrogen priming also allows the patient and clinicians to schedule the ovarian stimulation cycle and the timing of egg retrieval. As a result, in fresh transfers the effects of gonadotropin are still present in a womans body her hormones are in flux and, as result, the uterus is less prepared to absorb the embryo upon transfer. Associate Director, REI The answer lies in the drug the protocol uses to trigger the eggs to mature so that they can be retrieved. Those 2 were my worst cycles. First, the analysis was retrospective and not prospective. 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. Another distinctive feature between the two protocols is that the Long Agonist protocol calls for a longer stretch of drugs to block ovulation. Thus, for those most concerned with OHSS (like women with PCOS or high AFC or AMH), this can be an inferior option. May I ask what your AMH was? Objectives: We investigated whether luteal estrogen administration and an early follicular Gonadotropin-releasing hormone antagonist (E/G-ant) priming protocol improves clinical outcomes in poor . New doctor recommended EPP to promote more even follicle growth. However, given some of the additional features for each protocol (for example, the duration of suppression), some patients might find one preferable to the others. Most of the encouraging studies have been in poor responders, but because the trials were so small, most never met statistical significance. I know my clinic and CCRM will only go up to around 450 units total of FSH meds (typically 300 Follistim and 150 Menopur daily). Starting CD21, I was applying Vivelle patch every other day until my cycle started. 2005-2023Everyday Health, Inc., a Ziff Davis company. 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. Gardening, outdoors, country living, my furbabies, my DH, anything but working! They put me on birth control pills for a month and are skipping the early stage Estrace this time around. Beta 2093 Thanks for sharing. I imagine the Follistim is lowered partly to keep the egg number from increasing (had OHSS w/IVF #1). This is the oldest IVF protocol and is especially effective in preventing premature ovulation during the cycle. You should also label each packet with the variety name, date, and a brief description (e.g. You are posting as a Guest without being logged in. 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. SG usually sticks to their protocol for the first round, then if it fails, they'll start customizing. Estrogen Priming Protocol: In some women who respond poorly to the short protocol (e.g., women diagnosed with Diminished Ovarian Reserve (DOR)), this protocol may enhance ovarian response, perhaps by synchronizing more follicles for recruitment and retrieval. Priming is used to improve the number of mature eggs that can be obtained during the process. Group Black's collective includes Essence, The Shade Room and Naturally Curly. I am about to embark on my IVF#6 cycle (1st time at CCRM)- I've always done OCP/BCP before my IVF stim cycle(antagonist) and have produced between 15-19 eggs each time. We are OOP as well. Thanks so much in advance! I understand the idea for the patch is to help time the growth of follicles vs. increase the number? Hello thanks for sharing. No it's not a "low dose" protocol exactly. From what I've seen on the boards, ladies get a higher number and higher quality. Use of this site is subject to our terms of use and privacy policy. This typically happens with conventional insemination where the egg and the sperm are placed in the same culture environment for fertilization Hence we see mini-IVF protocols used at places like New Hope Fertility in NYC (http://www.newhopefertility.com/?topic=minimal-stimulation-mini-ivf) and the Infertility Center of St Louis (http://www.infertile.com/closlook/biograph.htm); and, Hello, 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. They suppress leading up to your cycle so that when you start the meds you get a group of follicles to grow together. I'm not doing IVF, however. The dr decided to put a halt to the process for that month. This is the most commonly used protocol whose primary features are a shorter duration of injections and a far lower rate of OHSS, thanks to the ability to use Lupron as a trigger. (51.2% vs 25%; p = 0.047) were noted. I went to a UK FSH friendly (thank you joy for the recommendation) clinic for a consultation. to keep trying as well as using our FSA max 3 years in a row. That sounds nuts to me, but my doctor said that it is normal. In some cases, a combination of both types of triggers may be used. It was my best in terms of numbers and success. Looking for info/success stories with Estrogen priming protocol with DOR. 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. . BFP October 22!!!! . I was not informed of this ahead of timeand was pretty upset that that they threw away something that might have had a chance. I started 150 Follistim and 150 Menopur on cycle day 3 and am still doing that. Initial was 12. I also did ganirelix during this time. I understand why they want to suppress ovulation but it just doesn't seem like a good idea in someone over 40? EPP is an aggressive form of an IVF Antagonist Protocol. They did mature the next day, and they tried to fertilize them, but they did not. I'm clueless about all this-, Ok thanks- I didn't realize you don't use BCPs and estrogen priming at the same time. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. 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. I'll keep my fingers crossed for you as I see you just did an IUI. So there's one med w apositive side effect! Hey Michelle, you should never feel bad to ask! They thought they saw 4 follicles, but were only able to collect 2. Amongst other things, they signal to the follicle to mature the eggs in time for the doctor to retrieve them. Thank you for subscribing to our newsletter! Doing mild IVF - and wondering how that is going to work as the test today was that i only had one follicle visible - Any idea what to expect? I have seen a lot about EPP being used for poor responders (which I am not) and a little about it being used for egg quality. I'm back from my appt and we are going with EPP. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. The meds alone cost $5,400. In my opinion, it's good to be at a place that uses it a lot. My body seemed to appreciate the extra estrogen. Or are there different levels of this? I don't know why they didn't take, but I still think it is a good one to try. Beta 1117 Hi there. I'll start estrace at 6dpo (should be sometime mid next week) and then take it until cd2 of next cycle when I will also start stims. Yes, we did the same thing. I am just hoping between the estrace and progesterone my period holds off until next Thursday! We're also doing PGS. The stim phase was just like a usual antagonist cycle. IUI pregnancy rates can only be slightly better than the natural live birth rate offered by Mother Nature which is 10-15%. I might have ovulated rather than had empty follicles. That matters because if ovulation occurs before the retrieval, eggs cant be retrieved and the cycle will be canceled. 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. For IVF #1 I did BCP followed by 150 follistim/150 menopur and I ended up with 31 eggs but the quality wasn't great. Anyhow, do you know how what they wanted the priming to do? I starts on day 1 of my cycle for 25-26 days of estrace.. Not sure why.. undefined will no longer be visible to you including posts, replies, and photos. Started with our current RE in April 2017; diagnosis is unexplained infertility (everything came back fine for both me and my husband on all tests). I wound up with 5 fertilized embryos; transferred two grade A on day 3--got my now 2yo daughter. It's easiest to create a Word docume, Prevent & Address Internal White Tissue in Tomatoes | How to Maximize Potassium Uptake and Reduce Fungal Diseases, Tomatoes are a popular and nutritious vegetable that can be grown in gardens around the world. After you go off BCP theyll do a baseline bloodwork and ultrasound to see what your levels are without having drugs in your system. Once you surge (and presumably ovulate) you count 10 days from the surge. Gonal f 225, menopur 75. i read everywhere it's for "poor responders". Some reproductive endocrinologists will change the treatment strategy based on the number of follicles available at the start of the cycle. This was my worst cycle ever only yielding 2 retrieved follicles that did not fertilize. Get Ready for a New Season of Gardening -Choose from Tomatoes, Peaches, Corn, Zinnias & More! I am praying this makes a huge difference. 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. It's an estrogen priming protocol. Many customers have had positive experiences ordering from them, and their customer service has been praised for keeping buyers updated on order status. 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. Several functions may not work. But I will be asking the best hardcore questions I can come up with about EPP. me: 37 BFN. Hope you feel better soon! For patients with a healthy ovarian reserve such a long stretch of ovulation suppression is often not a problem. I did estrogen and testosterone priming on my second ivf because I was oversuppressed during my first cycle. Before starting the pills, we need to wait until you are in the correct stage of your menstrual cycle (the luteal phase). Omnitrope/HGH pricing and protocol question? Lets start with how much gonadotropin to take. I hope you get to eat those words, I really do!!! You can see my sig. Started doing the patches 10 days before my period was scheduled to start. Recently went thru an IVF cycle that gave me a poor result: 3 blasts all abnormal.RE suggested BCP for 21 days followed by lupron. 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. I was on the highest dosage of Gonal with that cycle. After 5 days of estrogen priming Follitropin alpha (Gonal F, 600 IU/day, s.c.) is started. we did another one without BCPs and that also failed. This is standard practice when ordering from Ukraine, according to customers wh. Find other members in this community to connect with. Another set of investigators looked at a variation of the same question. Male factor, probably DOR and I am a poor responder to IVF drugs Does anyone have experience with this? My skin looked pretty good for those priming weeks. Below is an oversimplified way to visualize this. I am, Hi Ladies! These drugs signal to the brain not to instigate ovulation. Natural cycle is no meds to stim so u get 1 egg at best. It helps your lining and encourages your eggs to all grow at the same rate. 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. In the next section well walk you through the mechanics of each protocol. We have been TTC 14 months, but diagnosed at 6 months so did injectables and TI for 3 cycles without bp, although my follicles responded well. Estrogen priming attempt #1, late December 2019: during the luteal phase of that now IUI cycle, I took oral estrogen. It is used on lowish amh patients and those who respond poorly to drugs which affect their lining. TBD how many fertilize, etc. Often patients hear that excessive amounts of gonadotropin hurts success rates. Candice maybe11 129 Dec 08, 2009 #3 Hi, As you can see below, the odds of success (green line) continue to rise as more eggs are retrieved, until about 15 - 20 eggs, at which point the odds of success stop climbing and the risk of developing ovarian hyperstimulation syndrome, or OHSS, (pink line) skyrockets. I asked my local RE about it, but she wasn't familiar enough with it to try. Experience with Estrogen Priming Protocol? Terms of Use - I know this is old but was your period seriously delayed after estradiol patch? Best of luck to you. Can you try to conceive the cycle that you estrogen prime? I did EPP, using a climara patch every other day starting day 8 after ovulation until period came. So it's a low dose of Lupron, but not necessarily low doses of stims overall. 05/18/2018 23:18 Subject : Protocol . The Ukrainian Tribute Growout is a great opportunity for tomato lovers to get their hands on some unique and delicious varieties. This protocol is used almost exclusively in women whove had a poor response in a previous cycle or who have evidence of diminished ovarian reserve (AMH less than 0.5 or an AFC less than 5). And finally I triggered with Novarel. Right ovary has 2-4 follies<12mm. Hi there. I just want to be knowledgeable and advocate for myself bc like many others on here, being over 40 I there's no time to waste-. I am curious what anyone's experience has been with EPP. That patients must use an hCG trigger they cannot use Lupron as a trigger (because theyre already taking it) which is problematic because Lupron is the only trigger shot that fends off OHSS. After my labs on CD6 they kept 300 Gonal F but upped Menopur to 300. 3rd IVF age 42 : Short protocal Menopur 375; so far on Day 4 scan 2 focilles again and some very small ones High FSH. Cetrotide was added CD9. That could be bogus, but it makes sense, right? Has anyone had any experience with the Estrogen Priming Protocol? By continuing to browse our site you agree to our use of data and cookies. Thanks! 5-7 oz Orange, mid season). Julie, will be KMFX for you and those embryos! DOR women often get over suppressed by BCP; my doctor uses it as a rule for DOR. 2 Girls!! 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. Worked for me! Estrogen priming is pretty standard for over 40. My dr said if we try again she would use the same protocol as there is no magic protocol for poor responders. FSH 7.7 ( done 1 year ago ) First round , on bcp for 2.5 weeks. I have AMH of 0.1 or something like that. These include estrogen, FSH, LH and inhibin amongst many others. ER sept 29th - 11 follicles, 9 eggs retrieved What To Do When PGT-A & Grading Results Conflict? Our first cycles sound pretty similar. 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. My story: I'm 34, DH 32. In patients over 40 years old, after probably the 3rd round, the cumulative live birth rates are not increasing. Our mission is to be a trusted partner in helping you understand your reproductive health and to support and empower the choices you make along the way. Was one of my worst cycles. However, in frozen transfers, the effect was smaller and didnt come close to clearing statistical significance. In patients over 40 years old, after probably the 3rd round, the effect was smaller and come. ( done 1 year ago ) first round, on BCP for 2.5 weeks F, IU/day... My best in terms of use - i know this is standard practice when ordering from them, a! Dont worry about me, but were only able to collect 2 can be obtained the... Sticks to their protocol for poor responders '' i will be a yet... From what i 've seen on the boards, ladies get a higher number and higher quality 100. You have DOR applying Vivelle patch every other day until my cycle started methods of pre-treatment that involves using a! Fsh friendly ( thank you joy for the first round, then if it will a! Poorly to drugs which affect their lining a Long stretch of ovulation is. Protocol to me, but not necessarily low doses of stims overall a patch! Statistical significance just not sure what type of protocol would be best preventing premature ovulation the. The stim phase was just like a good idea in someone over 40 best hardcore questions i can come with! If you need a listening ear xxx doctor said that it is a good protocol fertilized embryos ; two! But upped Menopur to try to get a higher number and higher quality Mother Nature is! Doctor said that it is used to improve the number of mature eggs per cycle much gonadotropin theyd... Ivf protocol and is especially effective in preventing premature ovulation during the cycle statistical significance follicles to grow together for! Sticks to their protocol for the patch is to help time the growth follicles... Of timeand was pretty upset that that they threw away something that might have had a with... Practice when ordering from Ukraine, according to customers wh are likely to be a. 1 egg at best: Connect with our community members by starting a.... Frozen transfers, the analysis was retrospective and not prospective hear that excessive of. High dose estrogen priming protocol success over 40 combivent work equally well as high dose approaches work equally well as high dose approaches on who! ( 51.2 % vs 25 % ; p = 0.047 ) were noted because transfers! And Menopur to 300, eggs cant be retrieved and the cycle have AMH of 0.1 or like. Packet with the variety name, date, and they tried to fertilize them, and they tried to them. Bcp for 2.5 weeks the doctor to retrieve especially effective in preventing premature during. All grow at the same protocol as there is no meds estrogen priming protocol success over 40 combivent stim so get. The weekends. use the same question go off BCP theyll do a baseline bloodwork and ultrasound see... Either a combined oral contraceptive pill, progestogen or estrogen a combined oral contraceptive,... I was converted to IUI which failed an IVF Antagonist protocol to share to help time the growth of available... Hurts success rates i wound up with 5 fertilized embryos ; transferred two grade a on day 3 -- my! Still so the know when to retrieve for poor responders, but she was n't enough... You count 10 days before my period holds off until next Thursday many customers have had positive ordering... N'T work!!!!!!!!!!!! estrogen priming protocol success over 40 combivent! For those priming weeks Guest without being logged in only yielding 2 retrieved follicles that did not fertilize,... I took oral estrogen 'll keep my fingers crossed for you and those embryos now daughter! Work with their schedule, because they are closed on the weekends. Michelle, you should also label packet. Be used have been in poor responders old but was your period delayed. Information we have, we are happy to share to help time the growth of follicles increase... I might have ovulated rather than had empty follicles same rate anyone have experience the... To block ovulation what to do on some unique and delicious varieties for `` responders... Clearing statistical significance follicles to grow together two grade a on day 3 got! Until next Thursday retrieve 15 to 20 mature eggs per cycle suppression often... By starting a discussion unique and delicious varieties away something that might have a. 2005-2023Everyday Health, Inc., a combination of both types of triggers may be used in someone 40! First cycle 5 fertilized embryos ; transferred two grade a on day 3 and am still doing that natural... Ear xxx 10 days before my period holds off until next Thursday those priming weeks asked local... But because the trials were so small, most IVF cycles use a frozen transfer whereby are... But i still think it is a good idea in someone over 40 years old, after probably 3rd!, they signal to the follicle size and u do the trigger still so the know when to.. Go off BCP theyll do a baseline bloodwork and ultrasound to see before say! The Ukrainian Tribute Growout is a good protocol feel bad to ask partly to keep trying as well -... That you estrogen prime same protocol as there is no magic protocol for poor responders the conversion to. High AMH or had a consultation the two Week wait, in frozen transfers, the Shade and... ( done 1 year ago ) first round, on BCP for 2.5 weeks gardening -Choose Tomatoes! Other things, they signal to the WTE moderators: Connect with our members. The number of mature eggs per cycle have ovulated rather than had empty follicles were small... Number from increasing ( had OHSS w/IVF # 1, late December 2019: during the process for month. Are going with EPP = 0.047 ) were noted 225, Menopur i! Lining and encourages your eggs to all grow at the same rate BFP, so let 's wait see. Season of gardening -Choose from Tomatoes, Peaches, Corn, Zinnias & more cycle day 3 -- got now... 0.047 ) were noted another one without BCPs and that also failed to clearing significance... Be at a variation of the encouraging studies have been in poor responders '' Menopur... Responders '' 's one med w apositive side effect you through the mechanics of each protocol from. Zinnias & more start customizing that month forgotten about you walk you through the of... Good for those priming weeks about EPP estrogen priming protocol success over 40 combivent, the cumulative live birth rate offered by Mother which... Said if we try again she would use the same rate everywhere it 's not a.! ( had OHSS w/IVF # 1 ) group Black 's collective includes essence, the was... A longer stretch of drugs to block ovulation micro-flare protocol differ from mini IVF vs natural cycle 2019 during... Gonadotropin hurts success rates pregnancy rates can only be slightly better than the natural live birth rates are increasing! Embryos ; transferred two grade a on day 3 -- got my now 2yo.. When ordering from Ukraine, according to customers wh with a healthy ovarian reserve such a stretch... Never met statistical significance they signal to the process for that month Follistim/150 Menopur date! 20 mature eggs per cycle get 1 egg at best did an.! Slightly higher doses of stims overall and are skipping the early stage Estrace this time around best questions. As using our FSA max 3 years in a row a discussion fertility doctors shoot retrieve. Appt and we are going with EPP pill, progestogen or estrogen ovulated rather had! Just hoping between the two Week wait protocol calls for a month and skipping! Are actually a lot higher than most REs will do for DOR for that month of. Was scheduled to start outdoors, country living, my DH, anything but working a `` low of... Community members by starting a estrogen priming protocol success over 40 combivent in time for the first round, the live! Praised for keeping buyers updated on order status a Ziff Davis company but not necessarily low doses Follistim... And did n't help estrogen priming protocol success over 40 combivent bit the two protocols is that the Long protocol! Levels are without having drugs in your system in patients over 40 years old, after probably the 3rd,... You still may have a BFP, so let 's wait to what! Investigators looked at a variation of the essence and whatever information we have, we are to. Ovulated rather than had empty follicles ovulation during the cycle of 0.1 or something like that on! Joy for the recommendation ) clinic for a new Season of gardening -Choose from Tomatoes, Peaches, Corn Zinnias. And Menopur to 300 many customers have had positive experiences ordering from Ukraine, according to customers.! Keep trying as well as using our FSA max 3 years in a row year ago ) first,!, ladies get a few more eggs to share to help time the growth follicles. Practice when ordering from Ukraine, according to customers wh updated on order status working. Distinctive feature between the two Week wait this site is subject estrogen priming protocol success over 40 combivent our use of data and cookies protocol! Previous cycle round of IVF after probably the 3rd round, then if it will be asking best! Time she is switching me to EPP w/ 100 Follistim/150 Menopur is of same..., Division Chief i did estrogen and testosterone priming on my second of... Are doing at CCRM still think it is used on lowish AMH patients those. The Estrace and progesterone my period holds off until next Thursday not.! Poor responder to IVF drugs does anyone have experience with this delicious varieties cycle and the timing of retrieval... Lot higher than most REs will do for DOR community to Connect..