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Guidance on changes to be encountered in IVF procedure - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infertility Problem
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User :   This is for a reproductive endocrinologist.
I am 42, and just started a traditional ivf cycle, but i want to change the protocol from the typical 10 units of Lupron with BCP, to 20 units of micro lupron, which i found out was better for poor stimmers. my current doctor specializes in mini ivf, which i have tried a few times and still have one frozen embryo. After some advice yesterday from an acupuncturist whom is also an MD, and some further reading...see paragraph below..., i feel this is the best protocol for me. Can i still save this cycle...s it possible to switch to the micro lupron during my current cycle, after i've already started with the reg lupron? i won't be able to get in touch with the recommended specialist for micor lupron flare until monday, but i don't want to lose this good cycle. I really don't want to continue with this protocol if it will make me over suppressed which happened once before... only 6 eggs retrieved last year in nov after a very high stim protocol which also included the initial 10 units lupron. can i decrease the lupron to 5units until then, or should i stop it completely?
current protocol: On BCP for 14 days now...due to continue until oct 25.
Lupron 10 units three days now....will switch to 5 units once i get a bleed
Due to start gonal f 450 units on Nov 3
i got the following from this site, which explains why i want to switch WWW.WWWW.WW it is under diagnosis and them poor responder
A modification of the flare protocol by pretreating patients with birth control pills and lowering the doses of agonist to microdoses has eliminated the negative effects of the flare and resulted in a better recruitment of oocytes and indeed significant improvements in pregnancy rates.
A new approach to the poor responder involves the use of GnRH antagonists ...Ganirelix Acetate Injection, Cetrotide. With this protocol, gonadotropin
User :   or FSH is started on the second or third day of the menstrual cycle with no birth control or agonist pretreatment. High doses of FSH are utilized to maximize egg numbers. When the lead follicle reaches an average of 13 to 14 mm in diameter, an antagonist is administered to avoid a premature LH surge while gonadotropins are continued. Some patients benefit by avoiding birth control pill pretreatment and or agonist pretreatment and produce significantly better eggs on such antagonist protocols. Currently, however, this protocol should be considered investigational, as there are no randomized trials showing a benefit of antagonist protocols over the traditional approaches used for poor responders.
Doctor :   Hi
Doctor :   Thuis Dr. XXX
Doctor :   I am reading ur querry
User :   Ok
Doctor :   All right This is completely beyond my scope of answering
User :   i understand
Doctor :   You need to consu;t Specialist in reproductive medicine
Doctor :   Gynecologist
Doctor :   BEcause of complex nature of regiment i could not suggest any new ideas which might interfere with your plans
User :   i can't do that until monday but i need to know waht to do until then. can you give this question to someone more suitable?
Doctor :   We have specialist in Gynecology and reproductive medicine, and you can request do that online and we will work with Gynecologist
User :   ok, how do i do that?
Doctor :   Go online and request specialty consulation
User :   ok
Doctor :   for specialist conssultation look at the link that i gave u right now
Doctor :   u can request the e opinon from this doctor and he will get back u u on your email
Doctor :   are u there ?
Doctor :   i hope i have helped you
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