Long a protocol, High dose stimulation and AMH 7.5.. Has anyone else had a similar protocol??

[LadyM2019]

I’ve just turned 36 and my nhs consultant likes my embryo quality on the long protocol.

Im worried I won’t respond to such a high dose (450iu Meriofert), or my follicles will be empty… has anyone else been on a similar protocol? Can you please tell me the outcome?

I’m debating whether to go ahead with this cycle.

(We lost a pregnancy at 24 weeks a few months ago so the last thing we need is more loss/trauma!)

[Fertilityjourney]

Hello. Firstly I'm so so sorry for your loss.

I wasn't on the same protocol as you but just thought I'd comment as I am 42 years old and I responded better on a short protocol than long. E.g I got more eggs, my highest quality embryo and I also felt alot better on less drugs.

I read somewhere.(sorry can't remember where!) that going above 350 iu for stimulation isn't effective - that's the highest dose I had on long protocol.

Wishing you lots of luck. Xx

[Skittles11]

Hi. So sorry to learn of your trauma. I feel so much for you.

To answer your question - I have experienced empty follicles with no eggs collected following long cycle protocol with high stims of 450 Gonal F (my first cycle). However I was told that empty follicles are extremely rare so it would be unlikely for someone to experience this, however I also appreciate that your loss may mean you don't find statistics particularly reassuring (I know that's the case for me as I keep falling into groups where they tell me the risk is low!)

Anyway - I then tried short protocol with 450 Menopur and had 6 eggs, all mature, 4 made it to blastocyst. My cycle outcomes have varied enormously from each other.

I have been on 450 dose in each cycle (3 cycles) due to low ovarian reserve. I have at times considered a milder approach with less stim drugs as I have read that milder can be better for quality and still would not rule that out in the future. Good luck x

[MrsOrangejuice]

I'm so sorry for your loss - you must be very strong to be trying again and I wish you the very best of luck.

I had a very high AMH and was started on the long protocol on a very low dose and was told early on that my body had 'ignored' the meds. Covid hit, delayed by a year, and restarted on the short protocol and low dose and got very little response early on again. So they madly upped them and ended up on 450 gonal-f and stimming for 17 days. Finally responded towards the end and got 9 eggs. We then had to go private (NHS clinic had massive delays, even on transfers) and did another round - short again, started higher and then went quickly to max again for 17 days. Got 5 eggs and all to blast, currently expecting with one of those. No empty follicles either time - although I was told there were still small follicles coming through by collection - and high doses didn't seem to affect quality. I can't say anything about long vs short as I didn't get very far with the long and I don't know now whether the clinic cancelled that first go actually because of covid rather than giving it a bit more time. But just for me being on the higher/max doses for ages seemed to be the only way to kick my eggs into doing anything and didn't seem to do any harm at all.