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SarahW - September 10th, 2009 12:08 PM

Hi Can you tell me if the above protocol is preferable to the standard Lupron flare protocol in someone of my age (41 - with a good rew failures/chemical pregnancies behind me!) I am also having full immune tx. I understand the Lupron dose is 40micrograms (or 0.05 Buserelin) twice daily for this prortocl, is ths correct? Does it generally keep ovulation away at such a low dose? Why, if at all, is the above protocol seen as a good one for women like me? Thnx so much

B. Jacobs, M. D. - September 12th, 2009 8:11 AM

I use a microdise Lupron flare protocol for all of my patients who are poor responders, including my patients in your age range. Please be aware that one of your great issues is the age of your eggs..
Good luck.

SarahW - September 13th, 2009 4:32 AM

Thnx Dr Jacobs - yes I've done a fair few cycles and you are right, age is now my biggest enemy! One last question if I may - there is no Lupron in the UK, I understand that in this protocol the equivalent dose of buserelin is 0.05 twice a day. Is this correct and does it need diluting like Lupron do you know? (it is not difficult to draw this up out of the bottle) Any help you can give would be so much appreciated as this protocol is less used here and I think I would like to try it for my last go before DE.

Many thnx

Sarah

B. Jacobs, M. D. - September 13th, 2009 8:38 AM

I have no experience with buserlin, so I cannot provide a valid answer to your question.
Good luck.

SarahW - October 5th, 2009 4:00 AM

Thnx for all of your help Dr Jacobs.....one final question! When would you start oestrogen tabs with the MDL? Is it on day one of the post-BCP bleed? ie same time as the Lupron but just before the stimulating drugs?

B. Jacobs, M. D. - October 6th, 2009 6:33 AM

For my IVF stimulation protocols, I do not use an estrogen product until after egg retrieval.
Good luck.

SarahW - October 6th, 2009 1:06 PM

Thnx.....do you start the day after retrieval or the day after transfer? 2mg or 4mg a day? I am a little unsure as to why it is needed if I have a good lining usually but I understand we all need oestrogen at this time as well as progesterone, is this right? (and why?!)

B. Jacobs, M. D. - October 8th, 2009 5:46 PM

The estrogen after retrieval is to supplement what the ovaris is supposed to make. When we perform the retrieval, a lot of the cells that make estrogen come out with eggs. I start either estradiol patches 0.1 mg 2 changed every other day, or tablets, 2 mmg daily.
Good luck.

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