Advice needed please ... IVF drug protocol with low AMH

[Amelia1984]

After six failed cycles of donor IUI my wife and I are moving on to IVF next month. We’ve had our drugs delivered to day and wow what a package !

My clinic have suggested 300IU fostimon then after so many days to start 150IU Meriofert with 150IU fostimon and use Testogel.

My AMH is 2.1 age 35 and I’m just nervous as with my previous experience of stimulated IUI, I found as the drugs increased my response was poorer. However saying that I’ve never been on a mix of two stims or more than 150IU.

Is then anyone out there who has had success on a mix of stims of this amount (doseage) and a low AMH but got a positive response ?

Your experience is helpful .. thank you in advance

[LeBonBon]

Starting your cycle is always a mixture of excitement and nervousness! I have just done the exact protocol that you’ve described, and after 4 previous IVF fails using other protocols/meds, we had our first ever BFP two weeks ago. I can’t say if it was down to this combination of meds or not, but it’s the best and furthest we’ve got. It’s kind of been a trial and error and adapting procedures to try something different after each fail and this procedure worked for us. I’m 37 and have an AMH of 6.5.

Wishing you the best of luck on your upcoming cycle - will be keeping my fingers crossed for you 🤞xx

[Amelia1984 in reply to LeBonBon]

Hello,

Thank you so much for your message and a huge congratulations to you!

You have given me some hope (Thank You!), which is always a good thing on this journey. I’ve read so much about woman with low AMH and more positive responses from lower dosage of drugs, that I just wanted to see if anyone out there had success on what my clinic are suggesting for me. As I haven’t ever been on a high dose, I feel I should trust them and try it, though I have my reservations simply because of the not great responses I’ve had previously when they increased my does (again only to 150IU).

May I ask how many follicles you had on your baseline scan and how many you went on to have when stimulated? During my 5 stimulated IUIs I never went on to have more than what was ever seen on my baseline, and I only ever had two that grew big enough each cycle. How many follicles to you have retrieved?

Congratulations again, lovely news

[Franco81]

Hi Amelia

It’s all so nerve wracking isn’t it, and to be honest I’m not sure we’ll ever know what works or not but I feel changing things worked for me.

I had two fresh cycles on Menopur both BFNs then on our third cycle I we used a mixture of Gonal F going on to Menopur and although I produced around the same amount of eggs (5) this time we got our BFP. We also used Testogel for the first time this round and I took clexane as well. My AMH was 6.3 and I’m 38.

At our first scan they only saw three follicles which I was upset about but they kept me on stims for longer and somehow some smaller ones grew (we lost the original ones as they got too big) and we ended up with six follicles producing 5 eggs. We got three blastocysts from them and I’m currently 18 weeks pregnant with twins!!

I hope this gives you hope as I never had high numbers and I’d never had any glimmer of a BFP before this round. I’m not sure what worked but I’m convinced the changes we made did something and it sounds like you’re following a similar process.

Wishing you all the luck in the world for this round xx

[Amelia1984 in reply to Franco81]

Hello,

Thank you kindly for your message and telling me about your journey and a Big congratulations! Twins as well, double the excitement !!

It does give me hope to hear your story thank you and more confidence in the plan our clinic have chosen for us. I just get very scared of the drugs and that I will loose follicles and not gain them, although we want to give this protocol a chance as I've never tried it before.

May I ask how many IU you were on? Was it 300IU? I'm not too worried on making lots of follicles, as I never have, I'd be happy with 2/3 and ecstatic with anymore... I just hope I grow good ones and I've done many things for my egg quality for the past 18 months so hopefully this has some help with this.

Wishing you a wonderful pregnancy journey x

[Franco81 in reply to Amelia1984]

Yes I was on 300iu of Menopur the first two rounds then 300iu of Gonal F for a week moving on to the same of Menopur after that for our third round.

I too was nervous about the change as I didn’t know how I’d respond but I guess the quality was better this time somehow.

I hope it goes well for you xx

[Ash2016]

I haven’t used this combination - will be trying a combination of atoms on cycle 4 in January. I have had three failed cycles one other combinations. I also have low amh. During my last cycles it varied from 6-10. I tried short protocol, long protocol and low dose stims and to be honest my reaction to the the low vs high was pretty much the same. I had the same concerns as you but there wasn’t actually any real difference in the end (although the long protocol was pretty much a disaster!) good luck with your cycle x

[Amelia1984 in reply to Ash2016]

Hello,

I'm sorry to hear you've had failed cycles and similar to me no joy so far. Thank you for sharing your experience so far and it is interesting to hear that you haven't seen much difference between high and low doses.

I wish you a successful cycle in January and hope you get that BFP! x