Need to decide about next protocol...

I FINALLY had my followup appt. for my July cycle with Dr. B today. I don't even know where to start. Basically, after a slow start, I responded better in the 2nd cycle than the 1st. For both cycles, I was on repronex with ganerelix added to prevent ovulation. First cycle, they only got 4 eggs-ended up with 1 very good embryo and 1 crappy one. This cycle, I ended up with 6 eggs, ended up with 2 very good embryos. My E2 was higher for this cycle too. He said he didn't know why I didn't get pg. Duh.


I asked about changing the protocol. He said sure, we can try it. He suggested qid lupron (4x a day), repronex, with follistim. I asked him if he thought it would make a difference. He wouldn't give me a straight answer. He said it might or might not. I wanted him to say that some women respond better to some protocols. But he made it sound like no matter what I try, I'll get few quality eggs. My FSH was lower than 5 last time and it's never been high. My age(37) and my weight (a lot more than 37) are the only things working against me.

Should we take the chance and go with a different protocol? The repronex-only protocol is so much easier and practical....3 weeks of bcps, then stim with repronex. done. I just don't know what to do.

Also, he made it sound like this 3rd try would be it. What? Why? I know plenty of women who have done more than 3 ivfs before success.

I'm more confused than ever and feel like he didn't help at all.

Re: Need to decide about next protocol...

I got the same response from a different RE. That they would not recommend another try after 3 and I keep saying the same to myself...why? I see so many people with less response than I going for round 5 or 6 (though not sure if I have that in me). I would probably seek a 2nd opinion before heading to round #3. Can't hurt, you don't have to go with someone new but it might help you make the right decision. Good luck!!!

Re: Need to decide about next protocol...

I did that exact protocol with menopur as opposed to the repronex. It was a pain (literally) b/c there were so many shots but I had a much better response. My first ivf was menopur only. I only produced 2 follies after 8 days of stim and was converted to IUI. My next QID lupron cycle I had 13 eggs retrieved, 11 fert and 6 make it to 3 days with 2 implanted and 4 frozen. Of course I got a bfn with that cycle and it looks like with my first frozen too but at least I made it to ER/ET.

Re: Need to decide about next protocol...

Re: Need to decide about next protocol...

My 1st IVF cycle which resulted in 13 retrieved and only 4 fertilizing (no ISCI) with only 2 very poor quality embies on a day 3 transfer resulted in a chemical. on the Ganarelix/ Follistim/Menopur..The following cycle, we switched to Lupron/Bravelle & Menopur and added ISCI and we had 27 retrieved , 13 fertilized and transfered only one on a 5day with some to freeze (all hatching blasts ) which i am now 26 weeks pg. with a singleton...I definately think the switch in protocol made all the difference in the world for me (ISCI was done just as a side step, we have no MF at all)...The quality was 150% better than the 1st cycle...Good luck, whatever you decide

Re: Need to decide about next protocol...

I am 43 I did a much higher dose of follistum this time got 5 eggs 4 fert 2 went in on 3 day transfer. I use SIRM Dr Braverman in Woodbury.. My chances I was told were 13%.. This is my 3rd IVF with him and 11th IUI ?(I lost count) Never once did he say to stop or give up on me. He always made me feel that he would do anything to get me pregnant.. I feel like he treats everyone this way.. I actually know he does because the way his patients greet him and he greets them.. I actually went for a second opinion this very month to NYU. Supposidly one of the best Dr's in the COUNTRY?? (according to New York magazine) I was ready to start my protocal I finished the BCP and he refused to treat me for my issues (NK cells and blood clotting) he told me he would send me to another place to get treated for that thenhe can my retrieval... Guess where he wanted to send me !!!!!!!!!! SIRM.......!!!!!! Dr Bravermann!!!! I freaked out called Dr Braverman Hysterical crying (I felt like the pratagul (sp?) son) He took me right in and SQUEEZED me in to this cycle and i did my IVF with him AGAIN!!! I will not go any where else. Even if this is not what I hope for.. He will do my donor eggs if it comes down to it.. I LOVE HIM.. And thats how I want to feel about my IF DR.. Good luck I pray your journey is smooth..

Message edited 10/7/2008 8:19:34 AM.

Re: Need to decide about next protocol...

Since AF made her appearance this morning, I need to move fast on my decision. You've all given me some things to think about. The nurse is going to call today to discuss the meds today, so I'll bombard her with my questions. Shannon--great idea to ask her to talk to the docs about it. My schedule and obligations are overwhelming now and I can't take any days off this month, so a 2nd opinion isn't in the cards if I want to get this cycle going. I can't do a december cycle, b/c i'll be away on a class trip with my school (oh joy).

I'm leaning toward doing the lupron cycle. The words, "you never know" keep swirling around in my head. Worst thing that'll happen is I don't respond and it gets cancelled, right? At least i'll know.

Re: Need to decide about next protocol...

Hey there. We are going to be doing this together!!! I'm on CD 1 too today!

I've done 3 IVF cycles with 3 different protocols with very similar retrieval results and 3 different outcomes. I really think it is just a hit or miss with this stuff. Unfortunatley.

First cycle I did BCP's, Lupron and Follistim. 11 eggs. 2 fertilized. -BFP

2nd cycle I did BCP's, menopur and ganerelix. 11 eggs, 3 fertilized and 2 made it to day 3. - BFP but m/c

3rd cycle, BCP's, repronex and follistim intramuscular and then ganerelix. 9 eggs, 3 fertilized. Transfered 2 and froze on. BFN.

This time we're going back to menopur and ganerelix but I'm doing them IM so, we'll see what happens.

Good luck!

Re: Need to decide about next protocol...

Re: Need to decide about next protocol...

I have to say, I was seeing Dr. K for my IVF treatment and then switched to Dr. B and he said he wouldn't have changed a thing Dr. K did. They sort of stick together.

I tried to change my protocol for my 2 different IVF cycles and actually the first protocol ended up working out better.

I was on (I can't remember the dosage) 3 vials of Gonal-F and 1 of menopur. Then they changed to 3 of Gonal-f and 3 of Menopur (with menopur at night and Gonal-F in the AM) and I had a better response with less meds and taken at the same time.

Did you ask him if you could try different brand? Like Gonal F and Menopur?