7 day short OCP IVF cycle and/or Monash IVF?

[dusty]

DH and i are switching clinics to Monash IVF in Melbourne/Geelong and they are recommending a different protocol to the flare/boost cycle we have had in the past.
it starts with 7 day on OCP when you get AF with a 3 day overlaps of syneral at the end of the 7 days, then 2 days syneral before starting 9 days on puregon.
we are wondering if anyone has used this protocol, what results they got, etc.
i don't respond well to down reg and have been getting 4-5 eggs on a flare/boost. we are a little nervous heading down a new path on what may be our 5th and last stim cycle.
any feedback etc is welcome. also does anyone else go through Gab Kovacs and or the Geelong clinic?

[butterfly_warrior]

Dusty, it sounds similar to what my FS does with me - For the last cycle, I'd been on the pill for 7 days when he started me on lucrin. Three day cross over, stopped the pill, had another AF (I'm over that part, I can tell you!) and then later started puregon injections while the lucrin continued. As far as I know, it's just a regular down-reg cycle, just with less time on the pill before it. As for results - I hyperstimulated thanks to my PCOS and didn't get to transfer. From 32 eggs we ended up with 7 blasts in the freezer. If you don't respond well to down reg, I'm not sure that this is going to help much at all.

BW

[anney]

Hi Dusty,
Eary last year there was an article in the press re this new cycle that Monash were trialling. they spoke to Gab Kovacs as he is the "boss" and it seemed to say they were hoping it would be used as standard fairly soon. It sounds exactly like what you are describing and they said it was a down reg cycle but with less time on the pill.
Just for my own interest I spoke to my FS about it late last year, as we are with Monash and I wondered what she thought about it. she basically said it would have to produce consistently better results than a down reg cycle and it had not yet done that so they weren't changing.
Sounds like it would be a good thing for you as you don't respond well to down reg. - you may as well try something new. Dr Kovacs has been doing this along time and I have heard some great stories about him and he has been very nice the few times I have seen him. (saw him as a public patient when first being investigated for infertility) so I think you are in good hands.
good luck

[dusty]

thanks ladies
anney i guess i am a bit nervous of a 'down reg' type cycle as it seems to make my response very sluggish where as the flare/boost gets my E2 levels going well from the start - like you said BW this may not be the way to go for me. although the lucrin/syneral is only for a 5 days rather than the 7 with the normal down reg.
sometimes you wonder whether the protocol is being recommended so they can get more stats for their new protocols. the other thing the FS said was this new protocol was also good as it meant the patient can determine which date exactly they want their EPU so it can reduce their stress levels about possibly missing important events.
we have a wedding clash around the time of a normal EPU for flare but i maintain that IVF should come first rather than the other way around - but maybe the reduced stress is a good thing in the end?

anyone else done this protocol esp if you have a poor response to normal down reg cycles?

[butterfly_warrior]

So it's actually shorter between stopping the pill and starting stims as well? That could make a difference if everything isn't switched off so thoroughly, but I can understand why you're feeling a bit nervous about things. Even with my FS only giving me a short time on the pill, I still had around 12-13 days of lucrin only before I started puregon, so I guess it's not the same.

BW

[dusty]

*bump*
anyone else using Monash IVF and/or done the 7 day short down reg?

[anney]

Dusty,
you said -

sometimes you wonder whether the protocol is being recommended so they can get more stats for their new protocols

this was my thought exactly (but I did not want to say it as you were worried already). My FS said they really needed more people to try it to be able to say whether the results were better. The clinics are not going to get already desperate people paying big bucks to take a chance on an unproven protocol, if a normal long down reg is doing the job, so I don't know where they would get their study participants from.
In your case though, as a down reg is not for you, this could be the happy medium. I would ask them specifically why they think this is going to work for you? and if you think they are trying to make up numbers, ask them what the success rate has been on this type of cycle compared to the normal down reg or flare that you have been doing?

[dusty]

thanks anney
to be fair to my FS he did say we would stick with what had already worked for us (flare/boost) with the swap over of clinics but it was only when i asked about being able to go to an interstate wedding that he talked about the benefits of this short controlled down reg and that we could do that if we wanted. DH is pretty keen to stick with what has worked for us to date.
it seems there are not that many of us doing this new protocol yet.

[LJ*]

Hi Dusty,

I'm currently on my 2nd IVF cycle with Monash Richmond. This 2nd attempt is following the same cycle as the last (which was BFN). My FS does not put me on the pill at all as I have a previous historty of DVT blood clot. My cycle is;

- Day 21 of natural cycle have blood test to determine if I have ovulated
- Start synarel next day for 9 days
- Another bloodtest to determine when to start puregon injections
- Continue synarel and start puregon 3 days after bloodtest (so day 12 of synarel)
- Use synarel and puregon for another 7 days and have bloodtest & ultrasound
- If all goes well with follicle size EPU is 3 days later.

Not sure if this is similar to what you will be going through, but it's all I've ever experienced so don't know any different. On my last cycle I had 15 eggs collected but only 3 fertilised with ICSI (we have male factor infertility) and only 1 made it to day 3 transfer (no frosties).

Hope everything goes well for you with this cycle, maybe the different cycle is going to make all the difference. Good luck

[sabrina]

Hi Ladies,

I saw your discussions, I am going to have my first ivf cycle within a month and am really worried about all the medication effects and ohss. Would anyone like to share their experiences , as I am curious to know what ladies really feel/experience and not text book material. I feel overwhelmed as I already get severe PMS symtons in all ways.

Thankyou so much