Bad response to high dose of Menopur

[Butterfly83000]

I am 36 and have low amh 0.4 and just had my first cycle canceled for egg accumulation for ivf. They put me on 450 Ui per day of menopur. Normally I have 5 follicles grow naturally. This month only 2 and one very small grew. Biggest at 7mm at 7 days! So we canceled and converted to timed intercourse. Has anyone had the same experience and used a different protokoll? Like gonal f?

[StressedIRIS]

Hello, iam sorry for your cancelation. I also had very poor response on the same dose as you. Menopur 300 and benfola 150. At 6 days i had four eggs at 6mm and 8 mm but they continued the treatment and with high protein from my part no exercise apart from walking i managed to get 6 eggs at 13 days stimulation and 2 of them are now frozen at good quality. Maybe a natural ivf? That would be low dose stimulation for production of 2-3 eggs as with this are aiming for quality rather than quantity? Or maybe combination of menopur with another stimulant? What did your consultant suggest?

[Butterfly83000 in reply to StressedIRIS]

Thank you for your response hopefully this is it for you. It's just so hard to accept. Especially at my age. His answer was yes it's because of your low amh. It's such a bad answer. I need alternatives, anything else. I suggested myself to try gonal f. He said sure we can try it. i will check again my blood work and see if there is anything off than my low amh.

[Hope76]

Hi, yes this happened to me, I was on Menopur for first time despite having always been on gonal f & always responded well. A new dr at my clinic assured me Menopur is better for quality especially with older women. However I only had 2 responding follicles. Was a shock as usually had 7. Anyway we decided to take the chance with the hope of having 2 ‘quality eggs’ - big mistake. Only got 1 egg and the embryo was not good enough quality to transfer.

They told me results was ‘probably age related’ - although I argued point I felt I should never have been changed from gonal f. So next round we had with gonal f we had 7 responding follicles, collected 5 eggs. (Double transfer, grade b - BFN)

They were shocked in difference to my figures and agreed to give me a replacement cycle for the failed one down to Menopur.

Exactly a year after my last round yielded 5 eggs ... am in middle of the replacement Free cycle 😃. It was delayed even further due to covid. Obviously using gonal f again. However I have to say initially was disappointed as again only 2 responding follicles 🙈 (can’t blame Menopur this time, but maybe I will accept age factor now since am a year older, 44 - who knows though maybe depends on luck) ?

However we got 2 eggs, 1 embryo turned out to be top grade which has been transferred so maybe this is my golden egg 🤞🏼

Guess am trying to say worth a shot with gonal f but may be down to luck as they say every cycle is different.

Good luck going forward 🍀

[Butterfly83000 in reply to Hope76]

Your story sounds hopeful and your results are great. I wish you all the best. Yes maybe it's luck but I felt with this strong menopur the follicle did only grow 1mm per day which happens naturally for me. I asked the doctor to switch to gonal f and start with small doses as I read many women had more success. He said we could try that after menopur didn't had an affect on me. Menopur is basically fsh and lh. But my LH is OK. So why menopur in the first place? At 31 I had low amh 0.6 (when I found out due to chemotherapy in teens) I tried to do egg collection when I was single with low dose of gonal f and had 8 follicles but got canceled as only 3 were very big to trigger and she suggested to cancel. I wish I hadn't listened to her!! At least I would have maybe a good one on ice! Anyway it's the past hopefully gonal f will be good for me next cycle.

[24hopefuls]

Hi, yes this happened to me. It was my first most recent ivf cycle, I did long protocol with Buserelin to down reg, then 300 menopur and 75 bemfola. Follicle scans in the past have shown 7-9 follicles but scans during stims only showed 3 at the most. They upped my dose half way through to 450 and by stims day 8 I only had 1 follicle visible. We cancelled, i took the trigger and did timed intercourse. Plan now is to try short protocol on 450 stims dose from day 2. My clinic don't use gonal f so that's not an option for me. Did you do long or short protocol? Will you try a different protocol next? Will they try a different dosage for you next time?

[Butterfly83000 in reply to 24hopefuls]

I think it was a short one starting the second day of period. To be honest I suggested to start with low dosage with gonal f and he agreed. I feel my body just shut down and counteracted. If I start with low dose you can always increase. How strange they don't have gonal f. It's one of the most used ivf treatments. Where are you based? They put me on birth control for 2 weeks before starting stimulation.

[24hopefuls in reply to Butterfly83000]

Unfortunately I think ivf is a case of trial and error with medication and dosage. And each person reacts differently to another. I'm in the West Midlands, my nhs clinic has one of the highest success rates in the country so they must be doing something right without the use of gonal f lol. I think my body reacted the same way as yours and just shutdown, my follicle count reduced after increasing the dosage so I'm glad they have suggested a completely different protocol and dosage. Who knows how our bodies will react, I guess it's just part of the ivf journey. What are the next steps for you now? Has the Dr suggested what to do differently next time?

[Butterfly83000]

Yes I guess so that's true. It's

A journey with trials and failurs. We will try with gonal f and small dose of menopur. But still need to discuss in detail. I wish you the best of luck!

[Bells1993]

Hi, i am in the position. Two rounds in menophur and only 3 eggs max. Il always gone through with egg collection and had 1 embryo placed back in.

My third try, im going to be questioning what to try next!

Hopefully someone can answer this.

Ive heard there is a drug you can take with it, that tells your brain to produce extra stimulation to your ovaries ontop and has been successful in someone i followed on utube, but have no idea if the name of the drug.

[Butterfly83000]

I'm so sorry. But know you are not alone. I had the same issue.

Was it pergoveris? Do you have the link to the YouTube video?

Best of luck!

[Purple276]

Hi, I'm so sorry that your last round was worse after the high menopur. It's so frustrating when you don't have many follicles as every one counts!

Did you get 5 follicles through natural ivf? Did you get any to fertilise? I understand if you have a low f count going for quality over quantity can work. Plus your body is not being over stimmed helping the egg quality and improving implantation. Would be interested if you did this how it worked.

I suspect its about how we each personally respond so sounds like trying gonal F next time is a good idea and see if that improves. Really hope you get lots more eggs!

Good luck xx

[Butterfly83000 in reply to Purple276]

Hi purple! Thanks so much.

I had 5 follies just when I went for a normal ultrasound before I started stims. I know it's not much but for me it is. I guess it's a trying out the first couple of rounds what works on you. I have only tried one cycle with menopur and got canceled after 7 days. And every cycle is different. I hope it will work as I really don't know how I will cope with it.

Xxx

[Purple276 in reply to Butterfly83000]

It is difficult especially when you see others talking about getting 15/20 eggs. I'm so sorry that your first round was cancelled but my thought was that I just wanted to see how many eggs and if any of them could be fertilised so I at least knew of that part was working. The further along you can get the more info you have.

I'm 38 and over the last year my follies have gone from 6 to 8 to only 3 follies at a scan before ivf so did 300 menopur and 150 bemfola. They did spot 7 after the first Stim scan but told me that 4 of them were so tiny and they didn't respond. I got 2 eggs, only 1 was viable after fertilisation but it did make it to a 5 day Blastocyst and was a good quality. Sadly didn't implant but gives me hope that even with the small numbers it's worth a go. Relieved my clinic let us continue with the low number seen on the scans.

I can't decide if to try gonal F to get more eggs or go more natural cycle and accept that I will only get 1/2.

Keep the faith that it can take a few goes before they learn what gets the best from your body and keep us updated with how you get on with the next round. Much love xx

[Ivfgotadream]

At such low AMH would you be better off going to a clinic which specialises in low AMH and offers natural or natural modified IVF? I say this only because most other clinics have a minimum number of eggs they’ll proceed with as you know but this other clinic doesn’t - I only collected 2 eggs and am now 12 weeks with twins. This was our best cycle compared to others where we pushed to get 14 eggs but the quality was awful. Often fewer eggs equals much better quality

[Butterfly83000 in reply to Ivfgotadream]

Hi ivfgotadream. Congratulations to you, such great news! Do you have low amh as well and what about your age if I can ask? Which protokoll did you do? I am based in the middle east and I couldn't find a clinic who only does that. But here a lot of women have DOR at a young age as they marry within their families (cousins etc) but this clinic is Spanish and my doctor is happy to start with lower dose. They do egg collection as well if you have only 1 follicle. It's really up to me. This one I canceled myself as I saw absolutely no response. The doctor agreed.

[Ivfgotadream]

Hi mine is a little low for my age 12.9 at age 37 - my protocol was a natural modified - so tamoxifen tablets daily from cycle day 3 (similar effect to clomid) ana then 150ml Bemfola only every other day from cycle day 3 and that’s it! X