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Tweet - August 30th, 2006 8:20 PM

Hello Doctor - I am 38 yrs. old - Day 3 FSH 5.7 - Estradiol 59.

1st IVF in 2003 - Daughter. 2nd IVF - Very Early M/C at 10 weeks. 3rd IVF - Negative.

1st cycle I responded wonderfully to medication (retrieved 14 eggs - 8 fertilized). 2nd cycle - not as well (retrieved 7 eggs - 3 fertilized) 3rd cycle changed protocol - didn't respond well (retrieved 4 eggs - only 2 fertilized).

We have just begun our 4th and final IVF cycle with a new protocol. I finished 5 weeks of BCP's on Sunday and went for my ultra-sound and labwork yesterday. I began Lupron injections this morning (20 units 2x per day) and will begin stim's Friday (225 units Bravelle 2x per day - and continue Lupron).

During my ultra-sound yesterday I asked whether they saw any "resting follicles" and I was told they didn't expect to see any because I just finished BCP's and haven't started my menstrual cycle yet. (They saw maybe 2-3 on one ovary). Is this true? This seems to contradict what I have read regarding antral follicle count. My estradiol yesterday was 30 and they told me that is perfect for where I am at in my cycle.

I am concerned because I haven't responded well and then to not see any antral follicles makes me wonder if this cycle is bust before we even begin. My nurse has assured me I have nothing to worry about and that everything looks great... but, I am confused! Any insight? Would have the BCP's effect my antral follicle count? Would not having started my menstrual cycle effected the antral follicle count?

Thank you for any insight! I greatly appreciate it!
Tweet


B. Jacobs, M. D. - August 31st, 2006 6:28 AM

There should be antral follicles, even on birth control pills or Lupron. They may be very tiny, and difficult to see. Personally, I think a micro dose flare protocol may work better for you. Lupron actually decreases the response of ovaries to FSH.
Good luck.

Tweet - August 31st, 2006 11:49 AM

What would be considered the "Microdose Flare Protocol?" ... I began Microdose Lupron (20 units 2x per day) yesterday... and will begin stim's (Bravelle 225 units 2x per day - for 10 days) tomorrow as I continue Lupron. My protocol states "Microdose Lupron Protocol"... what is the "Flare"? Thank You For Your Time! This site is great! Tweet

B. Jacobs, M. D. - August 31st, 2006 6:17 PM

If you are takig 20 units of Lupron, that is not a microdose protocol A micro dose protocol uses micro units. The flare protocol starts administration of Lupron on the day you start administering FSH.

KarenGH - May 2nd, 2011 1:55 PM

Based on her posts, it appears that she is doing 20 U of MDL (microdose lupron), two times per day. Many doctors give the MDL for a day or two prior to starting stims. The lupron will initially trigger a surge in the body's own production of FSH and LH, so the lupron can take the place of stims for a couple of days.


20 U of microdose Lupron = 1 U of regular Lupron
The microdose Lupron is diluted and is therefore at a lower concentration. So you say you are taking 20 Units (based on the dosing needle). It is 20 units of microdose (diluted) lupron, but it is referred to as 20 units.

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