quick question: meds for low stim cycle

quick question: meds for low stim cycle

Antonialisa
Antonialisa

December 15th, 2011, 11:54 pm #1

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
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BroodyHen
BroodyHen

December 16th, 2011, 12:30 am #2

it sounds like your follicles are all about the same size, and if that is the case then you may not need the cetrotide at all. still, i would probably get the it - you'd hate to get caught without it over the weekend if you end up needing it. i don't know about the menopur, though.
exciting - sounds like a promising cycle...!
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alima
alima

December 16th, 2011, 1:28 am #3

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
I would get the cetrotide. Your LH may surge unexpectedly without it. You should start cetrotide when your largest follicle becomes 13mm, and that should help to keep the LH down. The other thing to note is if you are doing TI, you don't need necessarily need the cetrotide as you can BD when you have your LH surge, but the cetrotide allows all the follicles to grow evenly so you would prevent a dominant.
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summerwind03
summerwind03

December 16th, 2011, 2:50 am #4

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
for two reasons. One, it's very uncommon to use it on a TI cycle. Two, you're using estrogen, which should help keep you from surging too soon. Good luck. (Call your clinic, if you're concerned. They should also have extra meds, if you end up needing them unexpectedly.)
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SMRC
SMRC

December 16th, 2011, 12:20 pm #5

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
If so, you could call the nurses this morning to ask them what the chances are that you'll need those extra drugs? I have done this before with them. I took ganirelex once on a TI cycle with cooper to try to give my follicle a chance to get a bit bigger before ovulation. GL. The last minute drug stuff always stresses me out! The above poster is right that your local monitoring clinic likely has an extra store if you get stuck. SMRC
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Antonialisa
Antonialisa

December 16th, 2011, 3:00 pm #6

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
Thank you for your responses.

This is a case where events rendered the question obsolete. This a.m., u/s showed a 17mm follicle and all the others stopped growing at 10mm or smaller.

Funny, I started 150 units gonal f on day 3 and had 6 growing for a long time(albeit one a little larger). On regular Check cycles which often include a tiny boost of 75 units daily toward ovulation, I sometimes get 2. But now in the mock IVF cycle, only one. Very puzzling.



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Joined: August 23rd, 2011, 3:50 pm

December 16th, 2011, 4:42 pm #7

I have a quick question for those who have done low stim cycles. I'm currently doing 150 units daily gonal f, beginning day 3 along with estinyl. This is an IVF mock cycle but with TI. I have several follicles growing, not super quickly (all were 10mm or under on day 10, estradiol under 400, LH was only 3). Tomorrow is day 12.

My question is: will I need to take cetrotide or menopur for such low stims? Or would such a cycle just proceed to trigger when the follicles are the right size? Just need to know if I should get these drugs tomorrow when I can before it closes for the weekend.
Antonialisa post has me wondering. Is the Estinyl used to stop a dominant follicle from the get go? I know it's used to lower fsh, but that hasn't been my problem. My fsh has been below 8, but for the last three months I have had a 10mm on CD2. At SIRM I used half doses of Ganirelix to keep everything slow and steady from the start. Does Check ever do this?
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Antonialisa
Antonialisa

December 16th, 2011, 5:59 pm #8

Others should weigh in who have greater expertise, but here is my 2 cents on your question.

Estinyl has a suppressive effect, so it might be able to keep one from growing a dominant follicle. This was not my experience this cycle, but I thnk it might be possible, especially at higher doses. There are EPP protocols out there which may also accomplish this.

However, one very important benefit of estinyl for me has been to keep my cycles in synch. I used to have CD2-3 larger follicles like you, recruited during the luteal phase of the last cycle. By Day 2-3, my estrogen was higher and the FSH was not elevated, because it was suppressed by the estrogen produced by the follicle(s). The main problem with this, as I understand it, is that you ovulate too early and the lining isn't ready. It's not just thickness but it also changes over the cycle - it is out of phase. So your whole cycle is out of synch month after month, and it is extremely difficult to get pregnant.

With estinyl, I have more follicles, and they are just small and antral-sized on day 2-3 as they should be.

Dr. Check thinks that with "corrected cycles," women like me just can get pregant through TI and we need only wait patiently for the golden egg meeting healthy sperm in a perfect cycle.

I should note that before going on estinyl, I was able to achieve very good cycles with Chinese herbs which also lengthened them and had me ovulating at a more normal time. Not for everyone, I know.

I thought you were doing IVF (or maybe IUI). Did you start with large follicles?
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Joined: August 23rd, 2011, 3:50 pm

December 16th, 2011, 6:34 pm #9

I did IVF with Check in early November. I I had an 8 and 10mm on day 2. The ultrasound tech made a mistake and put the results in as centimeters. It appeared on the paperwork at .1 and .08 mm. I tried to explain to the nurse that I knew the tech said I had an 10 and 8 but I don't think she believed me or wasn't willing to go above and beyond her job to verify. I've since had the Ultrasound center correct the mistake, just so we could learn from it in the future. It's just that everything fell on the weekend so I couldn't get the mistake fixed in time to change the outcome of that cycle. Sorry, I'm a little bit bitter about it.

When I went to retrievel I had one mature and three at 12mm. Obviously the one took off, but the others kept gradually growing, just couldn't keep up. I'm just wondering if there is anything they could have done to slow up things right away, had the mistake not happened. I spoke to Dr. Check about it right before retrievel but his response was that since I only had the one mature, I should do natural cycle next time. Not sure that sets well with me when the potential is there for more then one.

Also, I've been seeing a Napro Dr. to increase my odds when we are on break cycles. I had an ultrasound done with her the cycle right before IVF and now again this cycle. All three cycles I've had low estrogen and reasonably low fsh and a 10mm on day 2 and 3. So I'm not sure what is making that one follicle take off. Anyway, this month the Napro doctor had me take Letrozole and then after 3dpo I start 2000iu of HCG every other day. Supposedly when we did the monitoring cycle I O'd to early and I have a LPD. We went straight to ivf intially so this medicated TI thing is new to me. Probably just a waste but RE's don't seem to address LPD or at least not for me.

Sorry to barge in on your thread. Thanks so much for the response. It gives me some ideas to discuss with Dr. B after the holidays and before moving on with ivf.
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Antonialisa
Antonialisa

December 17th, 2011, 1:18 am #10

That's frustrating about your last cycle. Sorry. The lawyer in me thinks you could go after the u/s folks for ruining your cycle and costing you $$$ but I guess you'd have to know whether they would have cancelled the cycle had they known your true day 3 stats at Cooper for sure. It's amazing what you can accomplish with a strongly worded demand letter on a law firm's letterhead but maybe I'm just ranting at this point.

Perhaps it is too obvious to mention, but have you eliminated the possibility that you have a 10mm cyst? I think that some cysts grow and shrink through the cycle. Did you check it out during the luteal phase?

Do you mind if I ask what your protocol looked like at Cooper? Also, what is your age and AFC and your highest FSH? Would you ever use Cooper again?

Please let me know how these other treatments go for you. I think we need to be our own best advocates if we want to get anywhere.

Good luck to you.
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