Microdose Lurpron vs. Long Protocol
3 Replies
yf - May 2

Hi Dr. Jacobs:
How would you determine whether a patient is a poor responder.

I am now 34 years old, started IVF a year ago. I had my first IVF on 2 units of Repronex with 2 Gonal F, 17 eggs retrieved, 9 fertilized.

2nd Cycle, 1 Repronex and 3 Gonal F, 10 eggs retrieved, 5 fertilized.

I talked to another physcian who recommended micro dose Lupron, but my current physician does not believe micro dose will help me. He suggests going back to the first protocol and use endometrial co-culture this time.

What would be your thought on the different approaches?

Thank you.

 

Barry Jacobs, M> D. - May 3

It sounds as though you respond to stimulation reasonably well. I use the microdose flare protocol for poor responders. With poor fertilization rates, you may have a sperm problem, or it could be a lab issue.
Good luck.

 

yf - May 3

Hi Dr. Jacobs:
Thank you for your comment.

If there is no concern about overstimulating in my case, shouldn't I be using the micro dose? The more the merrier if this protocol can bring about more eggs. My second cycle results in only 5 fertilized eggs, and RE was able to only select 2 for transfer.

Do you think the micro dose will improve the maturity of eggs as well? I learn that if the cytoplasm of the egg is immature, it affects the fertilization rate.

 

Barry Jacobs, M. D. - May 3

Yu do not want a severe hyperstimulation syndrome. It is life threatening. Since I do not know the details of your stimulation protocol or you response in any detail. I cannot provide a meaningful recommendation.
Good luck.

 

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