Hi girls,
Am hoping I might get some insight into puregon and low response experiences. Last month I started a stim cycle and was put on Puregon (200 daily) and got 1 follie. On Day 9 the follie was 13mm, by EPU day it was 18mm. All indications were that it looked like a goodie as it had matured … but unfortunately it did not fertilise (via ICSI). Not sure how that happens given ICSI was used, Melb IVF does not offer any explanations either, other than there are many factors involved and it could be any number of them. Have gone back again this month and am on the same cycle, 200 daily dose of Puregon. Just had my Day 9 scan (am having scans on Day 9 as Day 8 fell on a Sunday on both occasions). Anyway, sure enough there is only 1 follie again, this time it is 10mm. Have been told to come back on Thurs for another scan and in the meantime still take the Puregon (200 daily) as well as Orgalutron daily for the next 4 days (which as some of you may know is $98 a pop with no form of rebate). So as you can see I truly am a low / poor responder to ovarian stim cycles (have tried gonal-f on higher doses last year … same sort of result). I’m turning 40 later in the year so don’t have time to waste and am getting a bit disillusioned with it all. Have been reading that some of you have had your cycles cancelled when you’ve only had 3 follies as this was seen as a poor result, so I’m not sure why they are still happy to proceed with my cycle when all I’m getting is 1 follie. Have also been thinking I may as well just do a natural cycle with ICSI as the medications don’t seem to be producing anything more than I normally would get. All up I have had 3 failed ICSI cycles so far and am now hoping this 4th one will produce better results … for no other reason but pure optimism. Would be interested in hearing from those of you that have had similar experiences … were you advised to proceed with a cycle with just 1 follie, was it successful? I know they say it takes just 1 egg … but realise that it also lowers my chances.
Hi lulu, as for proceeding with only 1 follicle I agree with you thinking about a natural cycle. My cycle was cancelled on day 6 with 550 puregon shots due to low E2 (no follies growing or very little) the clinic told me that when you dont respond the highest dose is usually around the 450 mark...I wish I had the answer for you, and am glad in a way I was cancelled and didnt keep on jabbing away only to grow 1 or nothing. I know some cycles naturally are good and bad, but if your consistently getting low or no follicle growth its time to re think the protocol. Lots of best wishes to you with whatever you decide...
Hi lulu70,
We are going through our 2nd orgalutran cycle now and are having a completely different response to my 1st cycle where i had 24 follicles and my E2 skyrocketed so i had to trigger early and only got 8 eggs as i didn't have time to let the smaller ones catch up.
This month i have around 20ish follicles but they have grown really slow due to a lead follicle and all on the right side are to small so we were given the choice to cancel with 6 follicles on the left side or give it another few days to see if those 6 increase in size i did have my dose increased to 225 and we will have to wait until wednesday to make the decision i would go to EPU with 5 or more but i would not with less as we need them to get to day 5 and not many do make it to day 5 but people say you only need one so it is a hard choice to make whay havn't they increased your dose?
Hi Lulu, sorry to hear that your stim meds aren't working like you would hope. While I don't have any experience with low response (I responded really well on fairly low doses of Gonal-F), I can comment about the ICSI failure. My first cycle didn't use ICSI and of my 10 eggs, 7 fertilised when they just let DH's little swimmers race for my eggies. Unfortunately our PGD results showed all embies to have chromosomal abnormalities. Our second cycle we used ICSI as we found out that it didn't cost us any extra, and we were told it would increase the rate of fertilisation. That time we got 21 eggs (slightly increased dose of Gonal-F) and after the ICSI only 10 fertilised. I was really shocked. Our first cycle was 70% fertilisation rate "naturally" so I thought the ICSI would increase that, so getting a less than 50% rate was surprising to me. Of our 10 embies all but one had chromosomal abnormalities again, so we've been extremely lucky that our one healthy embryo has implanted and is growing strong.
As for doing a natural cycle, do you know if you definitely ovulate when you are not on the stim meds? If you do, then I guess there would be no difference for you between doing a natural cycle and a stim cycle.
I really hope you have some luck soon and wish you all the best!
hi girls, thanks for the responses. i'm pretty sure i ovulate as they've never told me i have a problem with this. my cycle is bang on 28 days all the time. our problem is related to DH's low sperm count and poor motility.
i don't know why they haven't suggested i up the dose, maybe they are going off my lack of response to higher doses last year ?? i just wish they provided more info on why the most recent failed cycle did not go so well ... given i only had 1 follicle. When i was told it had matured to 18mm (which is supposed to be ideal for fertilising) i was pretty hopeful as most of my past follicles have only reached 14 to 16mm. They did not mention abnormalities, so i'm at a loss.
i guess i'm a little suprised that no one has mentioned the possibility of cancelling this cycle, seeing as it's produced only 1. i didn't think to ask until i started doing google searches on the topic today and noticed how many cycles get cancelled when there are 3 follies. and now that i've forked out almost $400 on orgalutron and will possibly need to buy more if my scan does not go so well on thurs, it's a bit too late to just say that's it i'm calling off the cycle ....
maybe i'll be pleasantly suprised after all of this and go wow .... all you need IS 1 follie ... it just would've been nice to get a few more so that i could at least freeze some. how annoying !!!
Lulu70-I forgot to mention we pay $62 for each orgalutran and claim half back through our private health fund and i was informed that orgalutran will be on the PBS list in august so will cost next to nothing.
And DH and i made a decision if i have a few follies that have reached the right size on the left ovary we will go ahead because we have waited so long and i don't want to miss a singel chance there just might be one good healthy embryo that makes it but if not i will do things differently next time i will never do another cycle if i have a lead follicel as it has made a huge difference by stopping all my follicles from growing on the right ovary and to be honest to have 20+ follicles and they are going to be wasted because of that lead follie is a real disapointment.
Good luck with your cycle i have my last u/s tomorrow so i am on eggshells waiting to see if the follies are big enough.
1 Follie ... again !!
Reply With Quote
Bookmarks