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Dr. Jacobs,
I had ask you a question awhile back about what the numbers from my CCT test meant. Day 10 Estradiol was 224(up from 39 on day 3), LH was 13 day 10, and FSH was 5.45. At that point you told me you do another test to check ovarian reserve but it looked like I would be a good responder.
My question to you is my clinic uses the microflare protocol for women over 30 with no exceptions(or so I have been told) If I am not a poor responder wouldn't the regular protocol be better for me? Do you use the microflare for everyone over 30 or do you use the testing to determine the protocol you use on a by patient basis?
Thank you,
Sylvia
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I am not completely rigid. As a rule, I start my patients who are 37 or older on the microdose flare prptocol. I did have to cancel one, because she was over responding. I re-started her on a long Lupron protocol, and she is pregnant. I have had a couple of patients in ther earley 30's I started on a long Lupron protocol, but they needed a micro-dose flare.
Good luck.
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Sorry for the barge -
What is the microdose flare protocol?
I was 37 when I began ART and was started on Clomid. I reluctantly did 2 cycles of this before I begged and pleaded for a more aggressive protocol, and was put on Femara + Gonal-f (no supression). With no factors other than age, would a microdose flare protocol or Lupron protocol be better (more successful) for me?
Why do some clinics automatically do certain protocols in older women?
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The long Lupron and micro-dose flare protocols are used for IVF, not ovulation induction. The micro-dose flare avoids the mild suppression of ovarian response frequently caused by the long Lupron protocol. Women with good ovarian reserve tend to over respond on the micro-dose flare protocol.
Good luck.
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 | ga - November 15 |
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Hello, I am 32 years old with unexplained annovulartory fertility. My RE has told me that my problem is that my brain does not talk to my ovaries. My insurance does not cover IUI, injectivles, or IVF so we have been trying clomid as an outside chance that it could work. My doctor said that since he saw some folicular activity that there was an outside chance that clomid could work on me, but most likely I would need the shots. I was on clomid for 6 months and only ovulated one time. So now I have moved on to the shots. My doctor said he would try an old protocol on me that does not require the IUI. He said that I would take BCP for 2 weeks and then do the Repronex injectibles and skip the lupron because it is cheaper and since my problem is annovulation and everything else looks good that this is a valid protocol for me. For religious reasons we did not want to do IUI or IVF. I was reading stuff about ovarian reserves and when this is good to try, but am still unsure.....do you think this could work for me?
GNA
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It sounds like there may be some unanswered questions about your infertility, as a couple. I do not know which ovulation dysfunction you have, so I am not certain as to the apprpriate protocol to use. Clomid is a very poor choice. If your pituitary gland is functional, Femara (letrozol) may be helpful. If not, you really have no choice other than an FSH product. For more in formation, I invite you to see our web page, <www.texasfertility.com>.
Good luck.
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| gna - November 16 |
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My problem is that I do not ovulate. He said he thinks it is due to depression or stress. I have had many things happen this year that could be the reason (my husband got transfered, moved, new job, my father got very sick and died). He also said that since I was really underweight when I was younger that it could have messed my brain up. I have no tube blockage or POCD or endo or anything else like that.
So my questions is do you think this protocol will work for me. Taking BCP for 2 weeks and then doing the repronex and maybe an HCG shot if I need it and he laso mentioned prometrium at some point? He said it is an old protocol that could work & that IVF and IUI were not even offered when he first got in the business. We wanted to save some expense so he suggested to not do the lupron...and see how this goes. I am 32 now- do you think this is a good decision? Or do you think the full Lupron protocol would be better for me.
Thanks for your response.
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Dear Doctor:
I am 43.3 trying for #1. Had two m/cs in 2004 and 2005 and a failed IUI in March/2006. My Day 10 FSH was 10.6 and E2 was 140 (Day 3 stats were 4.8 and 16 respectively). Husband's SA shows count and motility norma, 12% morph Kruger standard.
I am in desperate need for help.
Two REs I have consulted have two different proposal :
Re#1: birth control pills for two weeks, micro flare lupron protocal, Follistim, ICSI and Assisted Hatching
RE#2: no birth control pills, Estrace, Follistim, Antagon, PGD, and possible ICSI.
Which one would be more effective in my situation?
Thanks a million for your time and help!
Sunny
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Each RE will use the protocol with which he/she has had the most success. I use a micro dose flare protocol for my patients over the age of 37. Please note that at the age of 42, your odds of a healthy pregnancy from IVF is poor, unless you use an egg donor.
Good luck.
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