protocol for IVF with high FSH
2 Replies
Marika - October 18

Hi Dr. Smith:
I am 41 with an alternating FSH of 26 and 5. I've had 4 clomid IUI cycles, 2 using Bravelle, with poor response. I am going for an IVF with my RE in NYC in November. What protocol should I be expecting, somthing like a blend of 400mg follistim with something else , right? Please advise, as I am self-pay and want to make every cycle count!
Marika

 

Dr Smith - October 18

There is no set protocol for women with low ovarian reserve. Different REs like different protocols. The bottom line is that none of the protocols will significantly change the number of eggs retrieved. The stimulation medications modulate and sustain the growth of the follicles that began to grow on that particular cycle, but they DO NOT change the number of follicles that began to grow in the first place. Hence, the term "poor responder" is a misnomer. Your follicles grow, therefore by definition, you are responding appropriately to the medications. You need to be realistic. Your ovarian reserve is low as reflected by your high FSH (26). Your FSH may go up and down, but once elevated, it means the reserve is low. Chasing after cycles with a lower FSH will not change this fact. At 41, you are getting the one-two punch. Just when you need to have more eggs to compensate for the high number of genetically abnormal eggs, your reserve gets low and, even with stimulation, only a few follicles grow. I know this news is hard to take, but Dr Doom 'n' Gloom calls 'em as he sees 'em. That being said, I hope things turn out alright on your upcoming cycle. Best of luck.

 

Marika - October 18

Thanks Dr. Smith! I will just "go with the flow" then and just hope/pray for a good response!

 

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