Dominant follicle disaster

[Greenfig123]

After having several cycles and thinking that long protocol was the best option for us, I had a dominant follicle at baseline. After bloods, I was given the ok to continue but unfortunately I ended up with one big follicle and five others that didn’t do much. Guess going ahead was the wrong decision! Just wondered if anyone has experienced the same, and had had a better cycle afterwards?

This is the first time this has happened. Pretty gutted as have previously had a much better response with long protocol (blastocyst each time). Clinic suggested collecting the one egg, but I asked for further options as this didn’t seem worth it. Switched to IUI and currently waiting for result.

[Greenfig123]

Should add that I’m 43 with low AMH… 😒 Plan is to push ahead with a few more cycles despite the odds 🤞

[Greenfig123 in reply to Greenfig123]

Also just to add that I normally get 4 follicles (lowest had been 3 and highest was 5).

[Poonam1987]

hi there !

Similar situation to you and due to the low AMH they suggested I go ahead with this cycle as i wasn’t likely to get much better results. We managed to get one fertilised egg so let’s see.

[Greenfig123 in reply to Poonam1987]

Good luck with your cycle. Hope the fertilised egg is a good one!

[Endofitall]

I have dominant follicle issues, early recruitment and Low AMH and usually have max of 4 follicles. I had a really bad one in January which made a huge cyst and had the cycle cancelled before EC. Next cycle all was well. Make sure you get a baseline scan before starting stims.

[Spicycurry]

Yes. I experienced this and it’s to do with fsh. I did estrogen priming. Unfortunately, this means you need the right protocol which can be difficult.

[Greenfig123 in reply to Spicycurry]

Thanks! Do you have any protocol ideas that I could bring up with my doc? I have asked about oestrogen priming but he doesn’t believe in it as he has ‘never seen it work’. Tried HGH, which didn’t seem to do a lot for me, so have stopped it.

Having follow-up with him next week. I haven’t had my FSH mentioned, but presumably it’s bad! My doc did previously say that I didn’t have dominant follicles, so hoping that this will be a one-off and that could still go with long protocol.

[Spicycurry]

I know someone who was 44 and did estrogen priming for short proctocol. It helps by lower fsh so that when the follicles grow more grow more evenly to avoid dominant follicle and to ensure more grow from start. I would avoid the flare protocol. Also make sure your partner does IMSI and he has a sperm analysis because at 43 you need a lot of things working for you. It is possible but you need the right protocol (short but estrogen priming). Are you with CRGH?

[Greenfig123]

My partner has had a dna fragmentation test, which came back fine. He has produced a couple of dodgy samples, but his sperm results generally fine too, which means I’m the main factor.

Will mention the priming again, but the doctor didn’t seem to think it would help.

Not sure if my clinic does IMSI but will ask. We were supposed to be trying ICSI to help with some abnormal fertilisation we experienced in the last couple of cycles (this previously hadn’t been an issue).

I’m with King’s fertility.

[Greenfig123 in reply to Greenfig123]

Also, did the estrogen priming work for the 44 year old who you know?

[Spicycurry in reply to Greenfig123]

Yes it did. She did embryo batching for her second child. Even though her partner’s sperm was good, she still used IMSI to ensure no poor sperm slip through the net! I did estrogen priming at 41 but after us both having covid it affected fertility. Also I went on the flare protocol and it had a poor outcome. I ended up going back to embryos I created at 40 for my second just before my fsh got bad. But at 40 I was able to lower fsh with norethisterone, ubiquinol and wheatgrass. At 41, egg quality changed quickly due to rising fsh levels. So I would say you need to act quickly with estrogen priming, short protocol (avoid flare), IMSI for sperm to increase chance of fertilisation even if your partner is ok.

[Spicycurry]

I found CRGH Portland to be very thorough.