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. I did estrogen and testosterone priming on my second ivf because I was oversuppressed during my first cycle. In the case of the fresh transfers, you can clearly see a similar effect to what investigators found above: success rates drop with more drug. we did another one without BCPs and that also failed. The meds alone cost $5,400. I will probably stim for 12-13 days! Find advice, support and good company (and some stuff just for fun). I am 38. Good luck & stay positive!! This helps to improve the outcome of the IVF cycle in patients who respond poorly to traditional IVF protocols. 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. EPP results: 17 retrieved, 13 mature, 8 fertilized with PICSI, 2 hatching blasts on day 6 have been biopised. November 8 - we're having twins:) Wow!!! Anyhow, do you know how what they wanted the priming to do? This is done by administering estrogen, typically via an estrogen patch or an injection, sometimes along with additional Gonadotropin-releasing hormone. Editorial Review Policy. Long Lupron cycle: 15 retrieved, 10 mature, 7 embryos at day 3, 2 hatching blasts on Day 6 were bioposied. Similarly, when an investigator named Revelli decided to swap out a few days of gonadotropin for clomid in this poor responder population in Italy (and thereafter resumed gonadotropin at low levels), he saw similar rates of success to more conventional levels of gonadotropin use. Avery & Sydney born June 12/11 at 30w1d. Around 50-60% of couples find success with IUI after 5 cycles, which is about a 10-20% success rate per cycle. When do you start your next cycle? Our last cycle was such a bust! I dont know as much about micro flare. A third option, the Flare protocol is used less often and only in very specific patient types (often poor responders). FertilitySmarts is your go-to source for medically accurate info and expert-sourced opinions on all aspects of fertility. me: 37 I think if I hadn't EPP, I wouldn't have had to stim so high. Today, most IVF cycles use a frozen transfer whereby embryos are frozen and transferred at least a month after the retrieval. Advertising Policy - They said that they look at FSH less now as they find it too unreliable. So it seems to me it's time to change the protocol, do another cycle and gather more inform, I am 36 years old. Does anyone have experience with this? Ideally, between 15 - 20 mature eggs would be retrieved, though getting a number that high is uncommon. Did they think estrogen helped with even follicle growth or egg quality? The idea is to give your body about 5-7 days of Estrogen Priming. I had 5 follicles but only one matured so I was converted to IUI which failed. One thing to keep in mind is that every cycle, there is a new cohort of follicles availble to be stimulated, meaning that during different months the same protocol may work more successfully than others simply due to the natural variation in available follicles. The data supporting the use of growth hormone in poor responders leading up to gonadotropin use is more convincing. 9 Over the next several days you will have ultrasound and blood tests periodically and given instructions on the dosage of FSH to take Usually first i had success with DE. 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. 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. Anyways, just wanted to mention that in case you want to ask your RE about it. Ugh, that made me feel like I was hit by a truck. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. I did a low stim ivf (225 menopur & 100 mg clomid) with human growth hormone which is what my fertilty clinic does for women over 40 and poor responders. I also did human growth on 2 cycles and didn't help a bit. My clinic doesn't like it. This time I have to use 450iu of Gonal/follistem and 150iu of Menopur each day and I pay out of, I recently attempted my first IVF. It was day 3 of my period. I was on BCP for 20 years (have been off for several now) and it took me a long time to normalize after coming off them. Please enable JavaScript in your browser to load the challenge. We're also doing PGS. I dont know much.But my RE will do EEP for my second cycle..I'm just reading alot on the net, http://estrogenprimingprotocol.blogspot.com/. . Hottest Topics -- Last 30 Days Though I had 4 or 5 follicles to begin with, only ended . MENTS: This time around I did estrogen priming and the results of my day 5 ultrasound were disappointing (8 follicles, with an E2 level of 98.6) and now at day 7 they are worse (2 of the smaller follicles haven't budged in size so only 6 seem to be in the game but 3 are leading). That sounds nuts to me, but my doctor said that it is normal. You can be assured it is a good protocol. It all depends on your tests and what specific information they have for you. Experience with Estrogen Priming Protocol? Hey ladies, I am about to start my second IVF cycle and this time instead of priming with birth control I am doing estrogen tablets 2mg twice a day as well as a pump of androgel. Estrogen priming is pretty standard for over 40. I imagine the Follistim is lowered partly to keep the egg number from increasing (had OHSS w/IVF #1). I stimmed for 13 days. . Outdoor sports and activities of all types. New doctor recommended EPP to promote more even follicle growth. The first question is naturally, which protocol is more likely to deliver a baby, and when investigators looked at the two most popular strategies, Long Agonist and Antagonist, it became clear both were equally effective in the general IVF population. You should also label each packet with the variety name, date, and a brief description (e.g. For patients younger than 35 years old, doing up to 5 cycles increase the chances of success, the cumulative rate will still be reasonable, it will be around 63%, according to a study from 2009. This is called multi-follicular development and its a pivotal step in a successful IVF. TTC with DOR (Diminished Ovarian Reserve), the most helpful and trustworthy pregnancy and parenting information. IVF Compared To Other Fertility Treatments, The Steps and Decisions In The IVF Process, Pregnancy Testing, Early Pregnancy and Delivery, The Impact of Donor Eggs, Donor Sperm or A Gestational Surrogate, The Impact of A Patients Condition or Diagnosis, Fertilization With Conventional Insemination vs. ICSI, Which Patients Benefit From Which Approach, Growing Embryos To Cleavage or Blastocyst Stage, Exceptions Where Cleavage Stage Makes Sense, PGT-A and PGS Genetic Screening of Embryos, Benefits of PGT-A (or PGS) Genetic Testing, The Negatives of PGT-A (or PGS) Genetic Screening. 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. Group Leaders arent expected to spend any additional time in the community, and are not held to a set schedule. Or are there different levels of this? I was at the max stim dose to get the response I did. Also covering add-ons like human growth hormone. Lupton trigger. Changed MD's and now this is the protocol they have in place for me. 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. Some clinics use EPP more than others. They thought they saw 4 follicles, but were only able to collect 2. For many gardeners, it starts with tomatoes. 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"). From NE Ohio to North Central Mississippi, everyone has their own ideas and preferences for what they will plant this year. My doctor will add human growth hormone during stims. DH: 36 Some reproductive endocrinologists will change the treatment strategy based on the number of follicles available at the start of the cycle. There are two downsides to this protocols: The long duration of injections (they start the previous cycle) and. These drugs perform the opposite duty of suppression. This comes from a 38,000 patient European registry. So it's a low dose of Lupron, but not necessarily low doses of stims overall. 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. But not all patients respond equally to ovarian stimulation using these hormones. More than I wanted, I think! Ramped up to cycle on BCP for two weeks and Lupron 10 units 2x/day on stims. Any success stories for low responders of Estrogen Priming cycle? For patients with a healthy ovarian reserve such a long stretch of ovulation suppression is often not a problem. I think you both are at Cornell (were) with this estrogen priming protocol will you try again with them, and request not to do estrogen priming? Our first cycles sound pretty similar. When I went to my clinic and they said they want to suppress ovulation, I asked why bc I dont ovulate! We are going to bump up my gonal f too. These include estrogen, FSH, LH and inhibin amongst many others. Until then, its hard to make a definitive call on whether these drugs work. Comparing the good cycle to the other 3, I see why. This is not recommended for shared computers. Beta 2093 HI.. hope all is well. Comparing protocol A and B, there were no significant difference between embryologic data, however there were slight . 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. Estrogen priming through luteal phase and stimulation phase improved ovarian responsiveness and this may lead to an increase in pregnancy rate in poor responders with failed cycle. [Dr. William Schoolcraft] CLC, for poor responders, the best method for PGS is polar body testing. Any 43+ Have Successful IVF with Own Egg? However, the data doesnt bare that out. For free! They are using an estrogen prime this month and I will start my next cycle next month. SG usually sticks to their protocol for the first round, then if it fails, they'll start customizing. I'm 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18. I used two patches a dayandchanged the patches every third day. Second, this study was only done in cycles using a fresh transfer. Cetrotide was added CD9. I'd love to hear from women of "advanced (advanced !) After my period started, my doctor kept me on the patches for five more days. Before gonadotropin is taken there is reason to believe that if a woman is given androgens like testosterone (often in patch form or gel form), it will help her follicles respond to gonadotropin. ET oct 2nd - 2 embryos transferred The deadline for sending in seeds was October 15th, but there are still plenty of ways to get involved. Estrogen is administered during the luteal phase of the previous menstrual cycle to "prime" the FSH receptors which enhances the response to FSH. There are two types of gonadotropin FSH and LH and most data shows you need both during an IVF cycle. Best of luck x Reply Quote 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. :-/. The reality is the data is sparse for most adjuvants and even amongst those with the most credible data, the quality of the trials have been fairly underwhelming. Fortunately, there are a few steps you can take to prevent and. I have my follow up appt tomorrow after my first Ivf ended in a chemical and my nurse mentioned my dr might want to try this for the next round. And I think EPP is the standard at CCRM as well for DOR ladies. Estrogen Priming Protocol: For some women, especially for those who have diminished ovarian reserve, it becomes necessary to help the response to the Antagonist protocol. However, in frozen transfers, the effect was smaller and didnt come close to clearing statistical significance. And finally I triggered with Novarel. Estrogen priming has worked both times for me. First round I had few follicles 10 and scattered growth after taking bcp before cycles for about 13 days; Tried epp round after that, and had more synchronized growth with same number of follicles. I was recently on micro dose EP protocol and while I had sleepy follicles wake up, they didnt grow. Below you can see that when investigators gave poor responders 450 IUs or 150 IUs per day, the groups had nearly identical success rates. Is a micro-dose lupron protocol considered a low-dose protocol? (Not so) Short summary - DH and I have been ttc since May 2015, two early m/c. I never hoped so I never even asked that question. I know you ladies all have your own stuff going on and I feel terrible asking but I dont know who else to askBarb, penny, joy, anyone else, Ive read that an estrogen priming protocol is good for DOR women, do you know if this is true? I did estrogen priming after my first Ivf cycle ended in mc (nothing to freeze) & my 2nd cycle was canceled bc I wasn't responding well to stims. Find other members in this community to connect with. As a result, most fertility doctors shoot to retrieve 15 to 20 mature eggs per cycle. Why so many days of esterace( 15-16 days before starting/adding promethium for 10 days) then the stim cycle, 3. I am praying this makes a huge difference. Check out this video to learn more about the. | Contributor. Estrogen Priming Protocol- EPP Experiences. So I think I was on estrogen for about a couple weeks then started stimming (antagonist protocol). 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. 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. Confirms hormone levels are baseline and gets antral follicle count as a basis for cycle prognosis. I just had a consultation with an RE he recommended a "estrogen priming micro-flare lupron" protocol. This drug works indirectly by prompting the brain to produce more gonadotropin to signal the ovaries to grow follicles -- so it's not directly stimulating the ovary. Please re-enable javascript to access full functionality. TBD how many fertilize, etc. Good luck! As a result, a woman needs to start the process with many eggs. What affect did the epp have on your follicles? He also said he would start with BCPs to suppress ovulation- he explained why, but at my age that just doesn't sound like a good idea to be suppressing anything. It's a horrifyingly traumatic experience. ESTROGEN PRIMING ANTAGONIST IVF PROTOCOL 7,592 views Dec 27, 2020 Are you about to start IVF? I hope your's goes lots better than mine! But I will be asking the best hardcore questions I can come up with about EPP. We strive to provide you with a high quality community experience. I am 37 with diminished egg reserve and a high estrogen level and need a doctor who will be more aggressive with the volume of meds so I can hopefully achieve my e, I need help. (This was to work with their schedule, because they are closed on the weekends.) Thank you for subscribing to our newsletter! A flare cycle may involve OCP or estrogen-only pretreatment, but the key is that a GnRH agonist (Lupron, Suprefact, or Synarel) will be started at exactly the same time as the stimulating medication. They studied what happens when you replace gonadotropin with clomid (a cheaper, less potent alternative) for a few days before the retrieval. It's a sort of "slow burn" methodology the hope being that they slow you way down and protect egg quality while allowing you to stim longer. Spandorfer said it would not suppress me to much not sure about this, need to speak with him further. This website uses cookies for functionality, analytics and advertising purposes as described in our. Implantation Calendar: What is Happening During the Two Week Wait. My doc started me on estrogen patch, one patch changing every 3 days until my period for 5 days and I just took it off and will be takingClomiphene after a day of taking off the patch, then after a day start stim. Good luck! It's that time of year again when gardeners all over the world are planning what to grow in their gardens. Hi @cmugnolo, you have a similar situation to mine perhaps. You currently have javascript disabled. first u/s Nov 2nd, one little bean!!! Thanks for sharing. So, I'm 39 with Amh of 0.07 (undetectable) and FSH of 9. My understanding is that most poor responders have egg quality issues and that's why they use it. I understand why they want to suppress ovulation but it just doesn't seem like a good idea in someone over 40? Buy Organic Seeds Risk Free From Organic Seeds TOP - Credit Card & Western Union Payment Options, Organic Seeds TOP is a seed vendor based in the Ukraine.

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