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For my patients who are over the age of 35, I routinely use a microdose flare protocol Our pregnancy rates in that age group are almost as good as for our younger patients. Remember, age has a great deal to do with egg quality.
Good luck.

So do you disagree with the theory that initial high doses of androgens (produced with MDL flare) could be detrimental to egg quality? I have had two twin miscarriages. I know at 39 only 20-30% of my eggs are good but 4 out of 4 makes me think it could be possibly more than just bad luck and that a protocol change might be worth a try. Can you give me any advice or do you need to know more about my case? I have no known issues other than age. We do IVF/ICSI due to male factor (low count, good motility, low morphology). SCSA is in excellent range. Would it be worth another try with the same protocol?

jmr67,


Did you also use LH during your stimming? I too am concern about the flaring effect of natural LH from the administration of microdose lupron. I would also like to know what Dr. Jacobs thinks of the impact that endogenous LH (produced from MDL) has on egg quality.

jmr67, also

Have you had a full term pregnancy? Did you test for any immune issues or use decadron, baby aspirin, or herparin during the cycle? I have heard that these things have been instrumental in preventing miscarriages in women with a history of m/c after IVF. I am sorry to intrude but I am around your age and am having my 1st IVF with the MDL protocol. Did you use MDL all three times?
Thank you very much.

Only about 1/3 of the eggs a woman make sin her life are capable of a successful pregnancy. The numbers get worse after the age of 35. We do not see a problem caused by the flare of both FSH and LH useing the microdose protocol. However, I use only FSH for stimulation. I do not use any product which has LH as a componant. We do not see a higher miscarriage rate.
Good luck.

Thank you Dr. Jacobs - that helps a little as I used Repronex which I believe has LH in addition to Gonal-F. I was wondering if you could respond about the part where I wrote I had 2 twin miscarriages and was thinking 4 out of 4 eggs might be more than just bad luck with the eggs. Do you agree there must be something else going on? Was wondering if you had any advice - try again? I know you may not have enough detailed information about my medical history but just in general 4 out of 4 bad seems like more than bad luck to me.

Chase - yes I used MDL flare all 3 times. Please check my profile and email me personally - I think we could possibly be alot of support for each other!

although we usually do not perform an evaluation for recurrent pregnancy loss until 3 miscarriages, I would not object to such an evaluation for someone who requires IVF and has had 2 consecutive IVF losses. For more information about recurrent pregnancy loss, please see our web page, <www.texasfertility.com>.
Good luck.