Respond too Fast

[Luvmyboys]

Dr P,

What does it mean if you respond too quickly to stims?

I cycled with you in June and we are coming back for our FET! But, this has been bothering me ever since we cycled!

I was on 150 Lupron and 75 Menopur. I was on meds for 9 days and we ended up with 14 retrieved. The follicles grew really big quickly though...my e2 was around 3,300 and they ranged in size from 22-27! I'm wondering what we would do next time? Whether it would be better to stim on an even lower dose or if we would start higher and then taper way down to try and recruit more follicles (my AFC was 25, so I'm thinking we could possibly have gotten more eggs?).

Just curious what causes such a fast response?

[Dr. Potter]

Hello- for your next cycle, we would do a quick taper and consider having you stay on 10U Lupron rather than decreasing to 5U Lupron.

Hope this helps, we look forward to seeing you soon.

Best,

DP

[Luvmyboys]

Thanks! I realized I had a typo above - it was 150 gonal f. So, I'm guessing my own hormones jumped in and caused the follicles to grow even faster? So, the higher dose with quick taper would recruit more and the higher dose of Lupron would suppress my own hormones, right?

Thank you! We will see you soon!

[Dr. Potter]

Thanks! I realized I had a typo above - it was 150 gonal f. So, I'm guessing my own hormones jumped in and caused the follicles to grow even faster? So, the higher dose with quick taper would recruit more and the higher dose of Lupron would suppress my own hormones, right?

Thank you! We will see you soon!

This is basically correct. Because with gender selection, we have to not only discard the abnormal embryo but also discard half of the normal embryos (as they are the opposite gender) we want to maximize the recruitment phase and thereby maximize the number of embryos of the desired gender.

[Luvmyboys]

Thank you! Unfortunately, our FET resulted in a chemical.

I will be going back to see you in May and I'm hopeful we can make it work with a fresh transfer.