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Hello Dr. Jacobs:
May I please have a reality check on a protocol targeted for "poor" responders:
1. BCP first, and then Lupron suppression to start
2. Get period, then on day 3 after period
3.start with Ganirelix @ 125mg daily but stopping Lupron
4. After 7 days of Ganirelix, add in 750 IU of Follastim
5. Two more days of 750 IU Follastim
6. Go down to 3 days of 675 IU Follastim, add in one vial of Repronex, continue Ganirelix
7. Go 2 or 3 days of 450 IU Follastim and one vial of Repronex, contineu Ganirelix
8. CD10/11 go to hCG trigger shot of 10,000 IU
; &nbs
p;
LEGEN
D
(for myself)
;
;
through
out the entire protocol, all Dexamethasone dosages are 0.75 on a daily basis
;
Lupron
= A GnRH agonist to suppress
;
Ganirelix
=
a GnRH antagonist prevents LH surges &n
bsp; &nbs
p;
Follastim=pure
FSH &nbs
p;
;
Repronex=combo
of LH and FSH &
nbsp;
;
S
O
the questions are:
1) why so many days of Ganerilx? About 11? is that much needed to really surpress LH surges??
2) why add in Repronex at the end which has a combo of LH and FSH, when you were suppressing LH in the first place....
3) huge volumes of Follistim to start...does that really recruit more follicles at the start?
4) dexamethasone...a low dosage steroid....helps with uterine lining??? Not sure of its role here...
Obviously, the E2 values in the bloodwork and u/s in the last 5 or 6 cycle days show how to further tweak dosages uniquely for each patient based on quantities and sizes of follicles....Surely, there are computer based modelings done to provide guidelines???
THANKS SO MUCH for your reality checking!
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