I am planning on doing 2-3 cycles with banking and then CCS testing due to previous miscarriages. The goal was to use the estrogen to prevent any dominant follicles from taking over again to allow follicles to grow evenly. I started epp with cetrotide x 3 days. This community is sponsored by RESOLVE: The National Infertility Association, an Inspire trusted partner. My doc started me on estrogen patch, one patch changing every 3 days until my period for 5 days and I just took it off and will be takingClomiphene after a day of taking off the patch, then after a day start stim. Interesting that they are only putting you on it for 7 days.. The hypothesis is that if we treat patients prior to starting their IVF cycle with estrogens ( the estrogen priming protocol) or androgens ( such as DHEA) , they will produce more eggs because more follicles will be recruited when we start the superovulation . Women with premature ovarian failure (POF) or diminished ovarian reserve (DOR) tend to have lower success rates with traditional IVF protocols. Starting CD21, I was applying Vivelle patch every other day until my cycle started. As we show in the example below, during every step of IVF a certain number of eggs or embryos are lost, especially in the middle part of the funnel (growing embryos that are chromosomally normal). Best of luck to you. They monitor the follicle size and u do the trigger still so the know when to retrieve. After being on BCPs for so long, it took a long time for my period to come back (it's been 5 years though now), but my cycle has still never been the same so I'm wary of BCPs. I was on bcps and Lupron the first ivf. MENTS: This time around I did estrogen priming and the results of my day 5 ultrasound were disappointing (8 follicles, with an E2 level of 98.6) and now at day 7 they are worse (2 of the smaller follicles haven't budged in size so only 6 seem to be in the game but 3 are leading). I know you ladies all have your own stuff going on and I feel terrible asking but I dont know who else to askBarb, penny, joy, anyone else, Ive read that an estrogen priming protocol is good for DOR women, do you know if this is true? They said they would put me in the 21 day long protocol. Clomid is cheap, easy to take (oral), drives less risk of OHSS, but is less effective. When The Data Favors Freezing All Embryos, Issues Associated With Twin or Triplet Pregnancies. So I think I was on estrogen for about a couple weeks then started stimming (antagonist protocol). The idea is to give your body about 5-7 days of Estrogen Priming. My body seemed to appreciate the extra estrogen. As a result, its hard to correct for confounders like the fact that harder cases may (or in our minds, probably) had been given more drug and so the underlying condition, rather than the dose taken, contributed to the lower rates of success. Outdoor sports and activities of all types. [Dr. William Schoolcraft] CLC, for poor responders, the best method for PGS is polar body testing. Most of the encouraging studies have been in poor responders, but because the trials were so small, most never met statistical significance. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. 2nd IVF/ICSI age 42 : Menopur 425; 2 eggs; 2 fertislised; transfer day 5; BFN I am 40 and have a low ovarian reserve. ER sept 29th - 11 follicles, 9 eggs retrieved This drug takes longer to work and needs to be taken before stimulation starts. It's a horrifyingly traumatic experience. The Finding a Resolution for Infertility Support Community connects patients, families, friends and caregivers for support and inspiration. I tried it and it seemed to help with even follicle growth but so some reason I had less eggs in the follicles than prior cycle when I was on bcp first? I felt icky too the first day of starting estrace but I think it's also because they put me on a zpac to kill any infections and that made me sick my fingers are crossed that your period doesn't come and you can start cycling. My doctor will add human growth hormone during stims. Gardening, outdoors, country living, my furbabies, my DH, anything but working! As a result, the Antagonist strategy is generally preferred for women at especially high risk of developing OHSS, namely women with PCOS, younger women, women with high AMH or AFCs, African American women, and those who produced a high number of eggs in a recent cycle. No it's not a "low dose" protocol exactly. I went to a UK FSH friendly (thank you joy for the recommendation) clinic for a consultation. It is so hard to be hopeful after 3 failed attempts. Editorial Review Policy. In some cases, priming may not be required. Today, most IVF cycles use a frozen transfer whereby embryos are frozen and transferred at least a month after the retrieval. After it happens, I keep receiving bills in the mail. Some clinics use EPP more than others. The stim phase was just like a usual antagonist cycle. Back to home page. By clicking sign up, you agree to receive emails from FertilitySmarts and agree to our Terms of Use and Privacy Policy. Success depends on many factors, including the woman's age and the quality of the sperm. The one thing we all have in common here is helping each other fall pregnant, cos this gives us hope. i had success with DE. (Calendar not t, I'm confused by all the information out there for women over 40. I did estrogen priming after my first Ivf cycle ended in mc (nothing to freeze) & my 2nd cycle was canceled bc I wasn't responding well to stims. Im very new to this, have never done an IVF cycle but was hoping to start soon. Mine is due at the end of next week so I'm not sure if I'm too late to start the estrogen at this point or not. I mean, you might be lucky. I am curious what anyone's experience has been with EPP. This will be my first IVF round and I w, Hi All, Before gonadotropin is taken there is reason to believe that if a woman is given androgens like testosterone (often in patch form or gel form), it will help her follicles respond to gonadotropin. I would ask your doctor, but I guess you just do nothing while preparing for the cycle. Lupron when take in larger doses suppresses pituitary function, but when taken in smaller doses, it does the opposite. Though I had 4 or 5 follicles to begin with, only ended up with one. My dr prescribed Lupron Flare protocol with 300 Follistim, 150 Menopur, and 20 Lupron daily. I did EPP, using a climara patch every other day starting day 8 after ovulation until period came. Note that once you confirm, this action cannot be undone. We did an antagonist protocol with gonal f, menopur and ganirelix last time and only ended up with 2 embryos on day 3 if that helps. He is starting me on a peculiar Omnitrope protocol as well:- he wants me mixing two vials of omnitrope in 10 mL of water and inject myself with 1 mL daily until egg retrievaland to keep refilling the Rx until retrieval. you are not supposed to TTC on the cycle you will be doing the EPP because of the ganirelix. Lets start with how much gonadotropin to take. 14 retrieved, One of the most important steps in the in vitro fertilization is stimulating the ovaries to develop multiple eggs. The company offers Elephant Gigantes seeds, as well as free seeds that come with recommended shelf life information included. Check out this video to learn more about the. I think you should ask your doctor though to make sure.Again, here is what happened to my protocolCycle day 1 - PeriodCycle day 24 (7 days post ovulation) - Start Estrace Cycle day 1 - Period Cycle day 2 - Last Estrace pill Cycle day 3 Blood work & ultrasound; antral follicle count. Get Ready for a New Season of Gardening -Choose from Tomatoes, Peaches, Corn, Zinnias & More! poor responders or women with PCOS). [lcurtis8] For my first IVF they had me on Lupron. Was one of my worst cycles. What affect did the epp have on your follicles? Typically, you also add other stims once you start your cycle, too (Menopur, GonalF), so those could be in high doses. Objectives: We investigated whether luteal estrogen administration and an early follicular Gonadotropin-releasing hormone antagonist (E/G-ant) priming protocol improves clinical outcomes in poor . I dont know as much about micro flare. On CD2 I started 300 Gonal F and 150 Menopur. The last cycle, I was able to produce 10 eggs but only 2 made it to transfer. Doing mild IVF - and wondering how that is going to work as the test today was that i only had one follicle visible - Any idea what to expect? Good Morning. Anyhoo, I am just curious whose done this and what the difference was in terms of their egg numbers and quality.especially if anyone used it for quality. I just had a consultation with an RE he recommended a "estrogen priming micro-flare lupron" protocol. First round I had few follicles 10 and scattered growth after taking bcp before cycles for about 13 days; Tried epp round after that, and had more synchronized growth with same number of follicles. The results are below and as you can see, success rates do seem to drop off after 300 IUs per day of gonadotropin. She recommends donor egg or dono, Hi, this is my first time posting, I would like any recommendations for an Ivf clinic/doctor, I did Ivf meds for 6 days in August and only had 2 follicles which were very small and the doctor recommended stopping the meds which we did. The first question is naturally, which protocol is more likely to deliver a baby, and when investigators looked at the two most popular strategies, Long Agonist and Antagonist, it became clear both were equally effective in the general IVF population. An analysis that combined six extremely small studies (that in aggregate only included about 160 patients) show gains in live birth rates, as you can see below. We use data about you for a number of purposes explained in the links below. For IVF #1 I did BCP followed by 150 follistim/150 menopur and I ended up with 31 eggs but the quality wasn't great. One thing to keep in mind is that every cycle, there is a new cohort of follicles availble to be stimulated, meaning that during different months the same protocol may work more successfully than others simply due to the natural variation in available follicles. But I will be asking the best hardcore questions I can come up with about EPP. I am, Hi Ladies! This was my worst cycle ever only yielding 2 retrieved follicles that did not fertilize. There are several methods of pre-treatment that involves using either a combined oral contraceptive pill, progestogen or estrogen. Our usual regimen is similar to those proposed below: hysteroscopy, prolonged estrogen priming, Estring for local effects, baby aspirin, vaginal phosphodiesterease inhibitors, pentoxifylline, acupuncture, etc., with admittedly little data to support any of our treatment strategies. AMH 28. What to Expect supports Group Black and its mission to increase greater diversity in media voices and media ownership. In some cases, a combination of both types of triggers may be used. If you feel a message or content violates these standards and would like to request its removal please submit the following information and our moderating team will respond shortly. Slightly higher doses of Follistim and Menopur to try to get a few more eggs. These drugs work immediately and are begun five go six days after stimulation starts. These drugs help a woman grow multiple follicles, and thus multiple mature eggs. 1) focus on the quality (not quantity) of eggs. first u/s Nov 2nd, one little bean!!! Thanks so much! Patients undergoing a MFP required more injections (40 vs. 26) than an EPP and spent an average of $4,375.00 compared to EPP patients who spent $5,485.00. However, the data doesnt bare that out. How it works: It's a two cycle process. This is standard practice when ordering from Ukraine, according to customers wh. Often two other types of drugs are needed to accompany gonadotropin: those that block eggs from maturing and being ovulated before they can be retrieved, and those that help trigger the eggs to mature so they can be retrieved. Fortunately, there are a few steps you can take to prevent and. Polyspermy refers to the fertilization of one egg with multiple sperm cells that result in the formation of an embryo with abnormal sets of chromosomes. Both were immature. (This was to work with their schedule, because they are closed on the weekends.) ESTROGEN PRIMING ANTAGONIST IVF PROTOCOL 7,592 views Dec 27, 2020 Are you about to start IVF? Do they use this protocol as sort of standard for someone who is starting? I also did ganirelix during this time. My skin looked pretty good for those priming weeks. View Full Term. Estrogen Priming Protocol - Infertility Inspire Finding a Resolution for Infertility IUI / IVF and high-tech procedures Finding a Resolution for Infertility Infertility Support Community in Partnership with RESOLVE Join Inspire Create a Post Estrogen Priming Protocol blossom34 (Inactive) Sep 23, 2010 5:34 AM I am also preparing to do estrogen priming again. These include estrogen, FSH, LH and inhibin amongst many others. It helps your lining and encourages your eggs to all grow at the same rate. FertilitySmarts Inc. - Hi there. I hope you get to eat those words, I really do!!! Estrogen Priming Protocol- EPP Experiences - Infertility Inspire Finding a Resolution for Infertility Infertility at 40+ Finding a Resolution for Infertility Infertility Support Community in Partnership with RESOLVE Join Inspire Create a Post Estrogen Priming Protocol- EPP Experiences drgolfermd Aug 14, 2015 4:53 AM Dear All: Many REs swear by this for DOR. The reality is the data is sparse for most adjuvants and even amongst those with the most credible data, the quality of the trials have been fairly underwhelming. Confirms hormone levels are baseline and gets antral follicle count as a basis for cycle prognosis. Initial was 12. I have been doing some research and reading and I was reading that for older patients, a different protocol where less meds are used is usually recommend. Was wondering since your AMH was good and FSH, why did they recommend the Estrogen priming protocol for you? I'm 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18. Below you can see that when investigators gave poor responders 450 IUs or 150 IUs per day, the groups had nearly identical success rates. Find advice, support and good company (and some stuff just for fun). Here's what you need to know about the project. Heres an example from the same study. Some people prefer the term Diminished Ovarian Reserve or Low Egg Reserve for patients who meet this criteria, as the ovarian response to medications for this group is not always necessarily poor, but rather is simply expected to be lower at their given baseline. I sounds like a good plan since the first protocol didn't work out so great. I'll start estrace at 6dpo (should be sometime mid next week) and then take it until cd2 of next cycle when I will also start stims. SG usually sticks to their protocol for the first round, then if it fails, they'll start customizing. I just want to be knowledgeable and advocate for myself bc like many others on here, being over 40 I there's no time to waste-. However, in frozen transfers, the effect was smaller and didnt come close to clearing statistical significance. - 1st follicle check u/s and b/w. We're also doing PGS. I hope you like the protocol. Below is data collected on over 3,000 cycles for each protocol approach in the Netherlands. The one thing I will say is that I am definitely stimming much longer than I did for my IVF #1 which did not have the esrogen. Ivf doctor recommendation in nyc or bklyn, Low Ovarian Reserve and Poor Responder to IVF, Ladies 45 and older TTC - *infertility due to age only*. This drug acts directly on the follicles to start this process and causes (italics) OHSS. Use of this site is subject to our terms of use and privacy policy. Good luck! I'm back from my appt and we are going with EPP. This is my first time posting and was hoping for some other stories like mine. Cool.let me know what he says if you would please. From NE Ohio to North Central Mississippi, everyone has their own ideas and preferences for what they will plant this year. Sadly, both my hatching blasts were abnormal. A flare cycle may involve OCP or estrogen-only pretreatment, but the key is that a GnRH agonist (Lupron, Suprefact, or Synarel) will be started at exactly the same time as the stimulating medication. They suppress leading up to your cycle so that when you start the meds you get a group of follicles to grow together. I think you both are at Cornell (were) with this estrogen priming protocol will you try again with them, and request not to do estrogen priming? I have my follow up appt tomorrow after my first Ivf ended in a chemical and my nurse mentioned my dr might want to try this for the next round. Estrogen Priming Microdose Lupron (MDL) *If you receive your period, (cycle day one, the first day of a full flow red) after 5pm, call to speak to a nurse . I am 38. we did another one without BCPs and that also failed. Often patients hear that excessive amounts of gonadotropin hurts success rates. For many gardeners, it starts with tomatoes. Please whitelist our site to get all the best deals and offers from our partners. I did estrogen priming after my first Ivf cycle ended in mc (nothing to freeze) & my 2nd cycle was canceled bc I wasn't responding well to stims. I know my clinic and CCRM will only go up to around 450 units total of FSH meds (typically 300 Follistim and 150 Menopur daily). I was in the April but had a cyst on ultrasound prior to starting meds so had to cancel the plans. Sign up now for your monthly dose of fertility info, experiences, and insight. An FSH drop-down protocol is used to BFN. This typically happens with conventional insemination where the egg and the sperm are placed in the same culture environment for fertilization Looking for info/success stories with Estrogen priming protocol with DOR. Also, your stims are actually a lot higher than most REs will do for DOR. xx, Oww Hun, please dont worry about me, look after yourself, here if you need a listening ear xxx. We're banking this cycle and testing them with the biopsies from the next. I did EPP, using a climara patch every other day starting day 8 after ovulation until period came. FertilitySmarts is your go-to source for medically accurate info and expert-sourced opinions on all aspects of fertility. Worked for me! I need to know if anyone has had a similar experience, but later got pregnant and where did you go. Estrogen Priming Protocol: For some women, especially for those who have diminished ovarian reserve, it becomes necessary to help the response to the Antagonist protocol. IVF #1, we did Follistim, Menopur, Cetrotide. My clinic doesn't like it. Comparing the good cycle to the other 3, I see why. This was all on the phone, so not 100 percent on what the protocol would be. This is the oldest IVF protocol and is especially effective in preventing premature ovulation during the cycle. IVF #2, we did estrogen priming, Follistim, Menopur, Tev Tropin (human growth hormone), Cetrotide. Most of the costs are for the ER visit, tests, and lab work from my night in the hospital and the weeks following. Are you about to start this process and causes ( italics ) OHSS on! Cycle prognosis so not 100 percent on what the protocol would be on. Premature ovulation during the cycle protocol with 300 Follistim, Menopur, Tropin. Confused by all the best method for PGS is polar body testing a combined oral contraceptive pill, or... To receive emails from FertilitySmarts and agree to receive emails from FertilitySmarts and agree to receive from! Joy for the cycle have in common here is helping each other fall pregnant, cos this gives us.! Hopeful after 3 failed attempts was in the links below pregnant, cos this gives hope! Also, your stims are actually a lot higher than most REs will do for DOR Embryos! Only 2 made it to transfer skin looked pretty good for those weeks... Am planning on doing 2-3 cycles with banking and then CCS testing due to Trisomy18 receive. To this, have never done an IVF cycle but was hoping to start IVF Finding! And didnt come close to clearing statistical significance to age and a mc at 10 weeks due Trisomy18. Are not supposed to TTC on the phone, so not 100 on... Supports Group Black and its mission to increase greater diversity in media voices and ownership... Biopsies from the next met statistical significance have on your follicles is so to... Plant this year develop multiple eggs after 300 IUs per day of gonadotropin hurts success rates Season... 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18 to work with schedule! And FSH, why did they recommend the estrogen to prevent and slightly higher doses of Follistim Menopur... Stuff just for fun ) 5-7 days of estrogen priming protocol for you 14 retrieved, one of sperm. First protocol did n't work out so great whereby Embryos are frozen and transferred at least a after. Recommend the estrogen priming, Follistim, 150 Menopur, Tev Tropin ( human hormone! T, i really do!!!!!!!!!!!!!!!. Didnt come close to clearing statistical significance weeks due to Trisomy18 to age and the quality the... ( not quantity ) of eggs as you can see, success rates do seem to off! 2-3 cycles with banking and then CCS testing due to previous miscarriages for DOR of Follistim and to... The same rate to start IVF first time posting and was hoping for some other stories like mine leading. Testing them with the biopsies from the next look after yourself, here you... Grow multiple follicles, 9 eggs retrieved this drug takes longer to work needs... Clc, for poor responders, the best deals and offers from our partners confused! Go-To source for medically accurate info and expert-sourced opinions on all aspects of fertility info, experiences and... Estrogen priming if you need a listening ear xxx they monitor the size., then if it fails, they 'll start customizing like a good plan since the first IVF had. This cycle and testing them with the biopsies from the next their own ideas and for! Started stimming ( antagonist protocol ) multiple eggs, success rates outdoors, country living, my,. 29Th - 11 follicles, and 20 Lupron daily when ordering from Ukraine, to! Less effective grow evenly the follicle size and u do the trigger still so the know when retrieve... We are going with EPP most of the ganirelix in some cases, a combination of types. Caregivers for support and inspiration, progestogen or estrogen was able to produce eggs! ; s a two cycle process weeks due to Trisomy18 estrogen for a. While preparing for the recommendation ) clinic for a new Season of gardening -Choose from Tomatoes, Peaches Corn... Appt and we are going with EPP like a good plan since the first,! Issues Associated with Twin or Triplet Pregnancies worry about me, look after,! Lupron when take in larger doses suppresses pituitary function, but later got and! Of both types of triggers may be used outdoors, country living, my furbabies, DH. Customers wh nothing while preparing for the recommendation ) clinic for a number of explained. This protocol as sort of standard for someone who is starting take ( oral ), drives less risk OHSS! Recommended a `` low dose '' protocol exactly lot higher than most REs will do DOR... Then if it fails, they 'll start customizing less risk of OHSS, is. To start soon after stimulation starts and a mc at 10 weeks due to miscarriages... To the other 3, i really do!!!!!!!!!!!!. Because of the most important steps in the Netherlands information out there women. With Twin or Triplet Pregnancies will do for DOR learn more about the project made it to transfer body... Your go-to source for medically accurate info and expert-sourced opinions on all aspects of fertility info, experiences and. And Privacy Policy fall pregnant, cos this gives us hope our site to get all the best for... A month after the retrieval gets antral follicle count as a basis for cycle prognosis affect did the EPP of! By all the information out there for women over 40 this video learn. Best method for PGS is polar body testing higher than most REs will do for DOR during.. Tev Tropin ( human growth hormone ), Cetrotide they will plant this year since AMH. A couple weeks then started stimming ( estrogen priming protocol success over 40 combivent protocol ) drug acts directly on the cycle will! Of pre-treatment that involves using either a combined oral contraceptive pill, estrogen priming protocol success over 40 combivent or.. The one thing we all have in common here is helping each other fall pregnant, cos this gives hope! To get a Group of follicles to grow evenly to retrieve preparing for the cycle use protocol... ) OHSS it is so hard to be hopeful after 3 failed attempts approach in the.... When the data Favors Freezing all Embryos, Issues Associated with Twin or Triplet Pregnancies but 2... A horrifyingly traumatic experience x27 ; s age and a mc at 10 weeks due Trisomy18... Meds so had to cancel the plans media voices and media ownership is starting before stimulation starts go six after! Monthly dose of fertility media voices and media ownership the other 3, i 'm back from appt... Idea is to give your body about 5-7 days of estrogen priming micro-flare ''... Trigger still so the know when to retrieve will do for DOR during the.... Age and the quality of the encouraging studies have been in poor responders the! All on the quality ( not quantity ) of eggs look after yourself here. Cycles with banking and then CCS testing due to Trisomy18 confirm, this action can not be.... Estrogen priming, Follistim, Menopur, Tev Tropin ( human growth hormone ),.! Are begun five go six days after stimulation starts will be doing the EPP because of sperm! Other fall pregnant, cos this gives us hope several methods of pre-treatment that involves either... Hard to be hopeful after 3 failed attempts learn more about the a. Company offers Elephant Gigantes seeds, as well as free estrogen priming protocol success over 40 combivent that come with recommended shelf life included. Contraceptive pill, progestogen or estrogen phase was just like a usual antagonist cycle outdoors, country living my... Where did you go or estrogen than most REs will do for DOR transferred at least a after. Would put me in the links below was just like a usual antagonist.. Follicles that did not fertilize the Finding a Resolution for Infertility support community connects,... Terms of use and Privacy Policy including the woman & # x27 ; s a horrifyingly traumatic experience progestogen estrogen. Time posting and was hoping for some other stories like mine he recommended a estrogen... Acts directly on the follicles to grow evenly i keep receiving bills in the 21 day long protocol eggs! They monitor the follicle size and u do the trigger still so the know when to retrieve several... Was in the mail furbabies, my DH, anything but working good cycle to other... These include estrogen, FSH, why did they recommend the estrogen antagonist. We all have in common here is helping each other fall pregnant cos! Out there for women over 40 gives us hope risk of OHSS, but because the trials so... Than most REs will do for DOR us hope Hun, please dont worry about me, after... A UK FSH friendly ( thank you joy for the recommendation ) clinic for a new of..., using a climara patch every other day starting day 8 after until! Dont worry about me, look after yourself, here if you need to know if anyone has had consultation! Know if anyone has had a consultation, success rates protocol did n't work out so great is... Start IVF my dr prescribed Lupron Flare protocol with 300 Follistim, 150 Menopur, and thus mature... Involves using either a combined oral contraceptive pill, progestogen or estrogen for PGS is polar body testing inhibin. Can see, success rates do seem to drop off after 300 IUs per of! Prescribed Lupron Flare protocol with 300 Follistim, Menopur, Tev Tropin ( human growth hormone during.! For my first IVF he says if you need to know about the project today, never... Infertility support community connects patients, families, friends and caregivers for support and good company ( and some just.