2 failed IVF/PGD cycles- Dr. P. -help

[mydream]

Dr. P.
I am 38 years old and have 2 healthy boys both conceived naturally and quickly one @ 33 and one at 35. We are trying for a girl.
I have gone through 2 failed ivf cycles.
My highest fsh is 10.2
Both cycles on was on about bcp for about 8 - 10 days
Then Lupron, Gonal-F and Menopur. I usually stopped the Gonal-F after about 4 days. I stimmed for about 10-12 days with both cycles.
I was monitored daily for bloodwork and u/s and the doses changed according to those daily results.
First cycle 13 eggs retrieved- 9 mature, 7 fertilized, 5 girls, 2 boys - only 1 normal boy
Second Cycle- 6 eggs retrieved, 5 fertilized, only 2 made it to day 5 and day 6 biopsy- 1 boy, 1 girl- Both abnormal

What can I do or ask my RE?

Many thanks for your time.

[nuthinbutpink]

Why did you stop gonal-f after 4 days?? What dosages were you on of each?

[mydream]

Gonal-F- 150 with 1 Menopur ( 75 IU) and 20 units of Lupron - all 2x per day and 1/2 a pill of (0.25 dexemethasone) at night
So that was for about 4-5 days ..
I don't know why the Gonal-F stopped...

then I continued on Menopur (sometimes 150 IU and sometimes 225 which was 3 vials and 20 units of Lupron 2x per day and the 1/2 pill of dexamethasone at night
Stimmed for about 12 days

[jils04]

That is quite unusual ?

[mydream]

That is quite unusual ?

Jils04- which part? the whole thing ? or just the stopping of Gonal -F?

[jacqueline]

Well, while we are waiting for Dr. P, I will just jump in and say that even though your Gonal-F stopped, your FSH dose remained about the same. If you were on 150 Gonal + 1 menopur, that is 225 FSH. 3 vials Menopur is also 225 FSH, it just has the added LH. So for whatever reason, your RE thought you needed an increase in LH which is why he switched to Menopur from straight Gonal-F.

[praying for a miracle]

...You seem to have been on a low dose on Gonal F, so I don't understand why it was stopped...Is not like you had a big number of follicles....Interested to know the dr P. answer....

[jacqueline]

She was on 225 FSH 2x day which is a total of 450 per day, so I don't think that is a low dose. Continuing on Menopur 2-3 vials 2x day was also between 300-450 FSH per day total. But a lot of added LH, I am not sure why... would be interested to hear Dr. P's comments on that.

[mydream]

Me too..I hope he answers...
Thanks ladies!

[jils04]

Jils04- which part? the whole thing ? or just the stopping of Gonal -F?

The stopping of the gonal F. I'm def no expert but I've read that some women get low quality with too much LH too.
I remember an IG lady who cycled many times in the U.S using menopur and then got her BFP with just gonal F no LH here at sydney IVF. Its all just trial and error but I would like an idea as to why he stopped it and just used menopur.
Hope Dr P answers soon.

[Dr. Potter]

Dr. P.
I am 38 years old and have 2 healthy boys both conceived naturally and quickly one @ 33 and one at 35. We are trying for a girl.
I have gone through 2 failed ivf cycles.
My highest fsh is 10.2
Both cycles on was on about bcp for about 8 - 10 days
Then Lupron, Gonal-F and Menopur. I usually stopped the Gonal-F after about 4 days. I stimmed for about 10-12 days with both cycles.
I was monitored daily for bloodwork and u/s and the doses changed according to those daily results.
First cycle 13 eggs retrieved- 9 mature, 7 fertilized, 5 girls, 2 boys - only 1 normal boy
Second Cycle- 6 eggs retrieved, 5 fertilized, only 2 made it to day 5 and day 6 biopsy- 1 boy, 1 girl- Both abnormal

What can I do or ask my RE?

Many thanks for your time.WIth the elevated FSH level of 10.2, I agree with the micro-lupron flare part of the cycle ( assuming that you were taking 20 units of diluted lupron twice per day). I would suggest higher doses of FSH such as 2 menopur and 250 or 300 of pure FSH to start. You may also consider adding growth hormone. I would consider a day three biopsy as there are some embryos that may make babies but are not at the expanded or hatched blast stage in time for day 5 or day 6. I hope that this helps.

[mydream]

Thanks Dr. P..this does help
I was taking 20 units of diluted lupron 2x per day and anywhere from 150-225 units of menopur 2x per day...I was taking 150 Gonal-F in the beginning only- for about 4 days. What do you think of the estrogen priming protocol?....that is what my RE said he would try for my third cycle IF I decide to cycle again. Do you recommend DHEA?