A stupid question...

[Pookymama]

Hiya one and all, hope you're all coping well with the craziness that is tcc?

I have what I feel is a bit of a stupid question that I hope someone can answer even though our fertility nurse kinda already explained it I'm afraid I'm still a little uncertain...

So, I'm 33, have low ovarian reserve and 1 blocked tube. I have a pretty regular 26-28 day cycle.

During our round 1 and 2 of ivf our doctor put us on a short then an antagonist protocol (which seemed the same to me?). I responded well the first time but poorly the second time.

I will be starting my 3rd round in 21 days but on a long protocol with 2 weeks of burserin prior to a higher dose of stims. My question is, what difference/improvement does down regging make and how does shutting off the hormones/putting us into a menopause like state help?

Thank you for your patience with my silliness, just can't seem to get my head around something new right now it seems!

Big luck, love and best wishes to mamas papas and babies to be. Xxx

[Oliverl]

Hi pookymama,

I don't know the answer but would be interested to find out I am also on this protocol. I'm 34 and have a lower AMH xx

[Pookymama in reply to Oliverl]

Thanks for your reply Oliverl, it's crazy our bodies are going through all this and some of us are clearly unsure about what the various protocols do!

Hopefully we'll get some answers here cos I like to know the ins and outs of everything! 😂 xx

[emu2016 in reply to Pookymama]

I have a low AMH and was put on short protocol because there was nothing much to shut down given my eggs! So while this might confuse you more... what I wanted to say was every clinic is different. Every time I spoke to someone they're doing something in a different order or for long or shorter to me. What I did do was call my clinic and ask them to explain it as if I was 5. Because it was all so new and I didn't want to stress about it xx

[Pookymama in reply to emu2016]

Hi Emu, thanks for your response. Well your situation is exactly the same as mine - low AMH little to shut down, few eggs - that's why I was so confused about them switching me to long protocol from the obvious short, but they don't seem to want to tell me why.

I'm afraid that due to this protocol I'll have even less eggs to play with and would love some reassuring answers from my clinic to tell me otherwise but nada. I like to think they have good reasons for this protocol but I still feel uncertain. Xx

[emu2016 in reply to Pookymama]

It is so confusing. From your post and reading other comments I'm confused about my own cycle even though I shouldn't be... I'm having donor eggs... and buserelin. What on earth they are needing to shut down I've no idea! can only imagine it's to make completely sure I don't produce eggs. But it's certainly weird. We are very confusing creatures! x

[Pookymama in reply to emu2016]

It is deeply confusing. I'm definitely one of those people that likes all the info on things. It makes me nervous to go in blind which I think a lot of us feel.

If only our clinics would give us a thorough explanation we would feel so much better as it's stressful not knowing.

Yes, if you're having donor eggs then shutting your egg production down makes more sense.

I hope your cycle goes well.

If you don't mind me asking, how do you go about the donor egg process and how does it work? Xx

[emu2016 in reply to Pookymama]

It was a long journey; but one we knew had a chance of coming before we started our IVF with my own eggs. I did an awful lot of reading and joined the Donor Conception Network.

Our consultant had a number of routes to offer us: egg sharing; known to us donor; known to us donor for egg donation to someone else and we could get eggs from the system quicker; uk egg donation waiting list; egg donation overseas.

We didn't expect so many choices. Once we had chosen our route; we had to select our donor; had to have some counselling; got a treatment plan and now we're ready to go. I think the hard lest part of this journey was deciding to do it. Once we had; it was much swifter. x

[Pookymama in reply to emu2016]

Gosh, there are so many options!

Yes, I can imagine it's a very difficult decision to make.

I've already provisionally started thinking about it if ivf with my own eggs doesn't work but my dh isn't ready to consider it yet which I guess is just the way it goes in this process.

I wish you all the luck in the world with this cycle. Xx

[vic77]

I can't answer this either as I have had two shots at long protocol. I asked if possible to try short protocol 2nd time around and was told no. No real reason given. I will be interested in some of your replies xxx

[Pookymama in reply to vic77]

Thanks for your reply Vic. Did they tell you what the down regging was about then? Xx

[vic77 in reply to Pookymama]

Nope told us nothing we were clueless.i think Diana summed it up well below. I guess I just trusted they knew what they were doing. I am sure after our bfn I found sites explaining the differences between long and short protocols..sure you have probably googled this anyway xxx

[Pookymama in reply to vic77]

Thanks Vic, I'm just one of those people that likes to know everything in detail so thought I'd ask! Lol.😂 I'm glad it's not just me that isn't sure though xx

[vic77 in reply to Pookymama]

God no.we on 2nd cycle and still not sure..the wonderful ladies on here I am sure and answer the question..here is my fertility Google xxxxx

[Lizzielizzielizzie in reply to vic77]

I asked my clinic and the consultant basically just said 'this clinic traditionally prefers long protocol'... she didn't seem to have a good reason, but she's only been at my clinic for a year having come from Finland and I got the impression that if I pushed she probably could sign me up for short protocol. Which if I have to have a third go, I might ask to try, as I hate the buserelin side effects!

[Pookymama in reply to Lizzielizzielizzie]

Hi Lizzie,

It's strange how their so evasive about answering this question isn't it?

I wrote an email with some questions regarding the clinical reasons for trying this protocol. I know they've had it as the receptionist printed it and gave it to them but I haven't had a reply.

Maybe the truth is that they're not fully certain why certain protocols work, there's a lot they still don't know about the fine balance of fertility and it's a lot of trial and error.

What side effects did you have from the buserelin hun?

I'm on day 6 of buserelin and up til now I've felt ok, though last night I started to feel flu-like symptoms and have woken in a bath of sweat with a really sore throat this morning... I'm guessing this is more to do with the fact that I got saturated by a downpour of rain while out cycling yesterday rather than the drugs though... Tehe.

How're you doing with your cycle hun?

Hope all is well with you xx

[Lizzielizzielizzie in reply to Pookymama]

Night sweats were my worst symptom, made me tired and that doesn't help grouchyness! I quite liked the daytime hot flushes as I'm usually a cold person! After a few weeks I got quite depressed, like all the colour had been sucked from the world, and very snappy (but I'm snappy when tired anyway). But I was on it for a long time, six weeks or so.

[Pookymama in reply to Lizzielizzielizzie]

Well I had night sweats last night but as I say I think I'm coming down with something.

I've been really cold during the day times too but again might be the lerg creeping in.

Gosh, 6 weeks is a long time. I thought I was only on mine for 2 weeks prior to stims but it says 6 weeks on my medicine box so I presume I take it alongside stims? Tis all still strange to me. Xx

[Lizzielizzielizzie in reply to Pookymama]

I was on it for a week longer due to a failed trial egg transfer then they kept me on it whilst stimming, until right at the end. But everyone is different x

[Lizzielizzielizzie in reply to Lizzielizzielizzie]

Ps took me a while to realise the night sweats were a symptom, I just thought it was the warm weather setting in (it was April last year)!! I think we all find out new things all the time. This site definitely helps. And it makes you realise how different we all are!

Good luck with your cycle x

[Pookymama in reply to Lizzielizzielizzie]

Ah I see, yes I guess it is different for everyone but this forum is a fabulous source of info and support for us all.

Good luck with yours too xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi Pookymama. Not a silly question at all! The drug you have been prescribed (Buserelin) works on the pituitary gland in the brain, and tells your ovaries not to produce any follicles large enough for an egg to get into. As a result it is putting you into a false menopausal state, so you may get similar symptoms of mood swings, sweats etc. Your consultant probably wants to calm your ovaries down so that you don't produce too many follicles, as sometimes if there are too many, they fill with immature eggs once you have the "trigger" shot. Don't know, but I would think that is what the idea is. Good luck with it all and fingers crossed for success this time. Diane

[Pookymama in reply to DianeArnold]

Aw thank you Diane,

I had 9 eggs on my first short protocol, 5 of 19mm which fertilised, 2 immature and 2 that were fertilised by 2 sperm so we're no good.

I had less eggs last time but they were all of different sizes ranging from 8mm to 23 and by the time they took me to theatre for ec I'd already ovulated and there were only 3 follies of different sizes left so we cancelled the cycle.

So will I be likely to produce less follies again this cycle but of similar sizes as it's more controlled with the down regging?

To be honest, I know it only takes one but the less follies thing scares me as it feels like my chances are dramatically reduced.

I stopped taking the dhea etc as I felt it may have somehow made me have less follies/follie issues this time as I was taking it for 5 months rather than the recommended 3, but ive continued with the coq10, pregnacare and aspirin. Do you think this was the right thing to do?

Also, I believe you have a fertility nutrition list, if I email you could you possibly send it to me please?

Many thanks for your support Diane, I hope all is well with you xx

[DianeArnold Partner Nurse Fertility Network UK in reply to Pookymama]

Hi Pookymama. Yes, I would imagine that they are aiming for fewer, but better size follicles, so that just a few eggs will be collected, but should be mature - fingers crossed. Just check with your consultant re taking the low dose soluble aspirin. The other pills should be OK, and I can understand your worry about the DHEA, so unless prescribed, just go with the fertility drugs you are prescribed. You can email me in confidence at [e-mail] for anything else if you want. Good luck with it all. Diane

[Pookymama in reply to DianeArnold]

Ah ok Diane, thanks. At least I'll be prepared for less follies this time then. My consultant recommended I add the aspirin further to the early miscarriage I had last year, but I did find that I bled and bruised more at the injection sites this time, not sure if it's aspirin related?

I told my consultant that I was taking dhea at the treatment plan and she said that was fine. That was prior to my poor response though.

Thank you for your support Diane. Take care xx