Tuesday, May 6, 2014

IVF Protocols for DOR - Help, Please!

I already posted about my upcoming first IVF cycle, but of course I've been reading about this protocol extensively during my 2WW and am now wondering if it is the best approach.

  • 2 weeks of BCPs 
  • Menopur/Saizen/Follistim 
All of the reading I've done about various protocols suggests that the BCP can suppress response to ovarian stimulation, particularly in women with DOR.  I've read this is not true of the BCP overlaps with a GnRH agonist (e.g., Lupron, Buserelin) for several days prior to menstruation and the initiation of ovarian stimulation.  

Has anyone with DOR done this protocol?  Has anyone done it with the Lupron as a point of comparison?  If you have DOR, what protocols have been successful for you?

This is a helpful explanation from Sher Fertility:  
  • "It is both clinically beneficial as well as convenient to launch IVF cycles with the woman having been on at least 10 days of combined birth control pill (BCP) such as Desogen or Orthonovum 135. A word of warning:one often hears the expressed opinion that the BCP suppresses response to ovarian stimulation. This is NOT the case, provided that the BCP is overlapped with administration of a GnRH agonist (e.g. Lupron, Buserelin) for several days leading up to the start of menstruation and the initiation of ovarian stimulation cycle with fertility drugs. If the latter precaution is not taken, and the cycle of stimulation is initiated coming directly off the BCP the response will often be blunted and subsequent egg quality could be adversely affected. The explanation for this is that in natural (unstimulated) as well as in cycles stimulated with fertility drugs, the ability to properly respond to FSH stimulation is dependent on the recruited follicles having reached the antral phase of development by the time the cycle begins (or similarly, stimulation with fertility drugs is initiated)."

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