x2 cancelled cycles due to OHSS risk should I give up?

[Allguys]

Hi Dr P
I have tried ivf/pgd twice now and over stimulated both times 45+ follicles. I have polycystic ovaries but without the full syndrome. I have 3 boys 14,12 & 3. This last cycle in June I was down regulated for 3 weeks then on 150iu merinol alternated with 75iu each day and still over responded!! Could you help???

[Dr. Potter]

Hi Dr P
I have tried ivf/pgd twice now and over stimulated both times 45+ follicles. I have polycystic ovaries but without the full syndrome. I have 3 boys 14,12 & 3. This last cycle in June I was down regulated for 3 weeks then on 150iu merinol alternated with 75iu each day and still over responded!! Could you help???

You need to be tested for insulin resistance if you haven’t been already. Metformin can often help normalize the response. A couple other approaches that can be useful in such situations is either an antagonist cycle with lupron trigger or a long antagonist cycle where you are completely shut down with antagonist prior to stim. Both of these approaches can be combined with all freeze if need be. There is always a way to work around this in my experience.