Which protocol for low amh/ slow responder?

[Jules0277]

Anyone tried multiple Ivf cycles with low amh/ slow responder to meds? Which did you find worked the best and produced the best quality eggs or a higher number?

[ClarabGlasgow]

I have mostly read that short protocol is the preference and actually hear that lots clinics are doing that as standard. I have been through one cycle (short) sadly not successful but they told me they’d try long if we go again. Good luck xx

[Jules0277 in reply to ClarabGlasgow]

Thanks for replying. I’ve done 3 short protocols so definitely want to try something new next time. We’re trying again in April. x

[Dunla]

Long protocol was a disaster for me on first cycle, only one egg retrieved. Then had several short flare cycles which did yield relatively better egg numbers given my low AMH x

[Jules0277 in reply to Dunla]

Thanks for replying. If you don’t me asking, how quickly did your follicles grow on the short protocol? I’m usually nearly 2 weeks. x

[Dunla]

I think it was 10- 12 days if my memory serves me right x

[Hidden]

Hi Jules I first tried short protocol max dosage of Menopur I had poor response and cancelled cycle with one follicle. Next tried dhea for 3 months 21 day Protocol suprecur, fostimon followed by Menopur with lower dosage and managed to retrieve 6 eggs and one made it to last 5 xxx

[Hidden in reply to Hidden]

Sorry last sentence was meant to say one embryo made it to day 5 blastocyst stage, embryo didn't take but long protocol was better results for me xx

[Jules0277 in reply to Hidden]

That’s amazing. I’m hoping our new clinic will suggest something different like that. I’m thinking the high dose isn’t good for the egg quality. Is it classed as a standard long protocol? I’m taking dhea too, what daily dosage were you taking? Was it successful? Did you have any to freeze? xx

[Hidden in reply to Jules0277]

Yes second round was long protocol. I'm taking 25mg of dhea 3 times a day. Unfortunately there wasn't anything to freeze so we are trying again on the same protolcol again. Wishing you all the best with your next steps xx

[Jules0277 in reply to Hidden]

I’m taking 50mg at the moment, I took it last year (75mg) but found symptoms were worse, my cycles were very long and had I experienced hair loss. Do you stop taking dhea when you stim? I will definitely mention long protocol as an option when I go for the consult xx

[Hidden in reply to Jules0277]

I'vebeen advised to take dhea up until egg collection xx

[Marta37]

Mine was successful with short protocol and a mixture of menopur and gonal f.

Good luck with your cycle! Xx

[Jules0277 in reply to Marta37]

Oh that’s great to hear. What is your amh and how many eggs did you retrieve on that cycle? Was it successful?

[Marta37]

Hi Jules,

My amh was 1.1. I got 7 eggs, only 5 mature, they became 3 blastocysts. I first transferred the two with higher grade (failed cycle) and then the BB blastocyst (who became my 6 months old)

I also used aspirin, heparin and prednsolone to support implantation (I also have lups condition on top of POF)

[Jules0277 in reply to Marta37]

Hi Marta!

Did your Doctors advise you to take aspirin? I’ve heard mixed things about it and asked my doctor on the last cycle but they weren’t overally positive about it. I assume heparin and prednesolone was prescribed to you?

Do you think it was the mixture of menupur and gonal f that helped? Had you done other cycles before? Sorry for all of the questions!! x

[Marta37]

Hi Jules

No worries at all! I had so many questions too. I took aspirin as in my case it was appropriate (has lupus and other antibodies positive that could prevent implantion). I had another friend who took aspirin too and she does not have any issue. Having said that I would not self medicate and discuss it with doctors. Mine were not super keen on the use of prednislone as research has not confirmed ita benefit but they said that it would have e not had a negative impact (at the beginning of the pregnant).

I had two fresh cycle - the first one with gonal f only and on a long protocol - which resulted in 2 egges only - transferred on day two. I then had a short protocol with gonal f and menopur which gave me 7 eggs (only 2 mature). The successful cycle was a FET with my only blastocyst left.

I think that the mix of gonal f and menopur and the fact that it was a frozen cycle (so my body could recover from the stimulation) helped a lot.

Are you nhs funded? I was and although it was great to have the opportunity, I found that at times the doctors were a bit too conservative in their approach as they can only go with evidence based approach.

[Tezzabell86]

Hiya Jules

I have a low AMH for my age of 31 of 6.1 and I was put on the short protocol for my first round of IVF where they collected 7 eggs, 4 of them were fertilised and only 1 of them made it to blastocyst stage of day 5 and the others were slow coaches. So I had the one embryo that got to blastocyst stage transferred and I’m now 15 weeks and 2 days pregnant on my first attempt on IVF. Sorry if it isn’t much help.

Terri xx

[Jules0277 in reply to Tezzabell86]

Hi Terri

Wow that’s amazing, congratulations!!

We always have something to put back, just waiting for one to hold on!! All have been 2 or 3 days they didn’t let them go further than that due to our low numbers.

Did you take any supplements before your Ivf or just the usual multi vit and folic acid? I’ve started taking dhea again. Were you using gonal f or menupur? I’ve tried both at 375mg daily dosage. Menupur worked better.

Hope all is going well and you’re feeling ok.

x

[Tezzabell86]

I just took folic acid. I was on menupur a high dosage though. Yeah all going well with the pregnancy. I’m 15 weeks pregnant now and glad the sickness is settling down nowxx