Antagonist Cycle

[Cuddlepie]

Just came back from FS appt and have asked if any change of protocol is necessary, such as Antagonist or Flare cycle. He said yeah it is worthwhile to try. But I didn't get the feeling of he has any strong opinion of his instead just go with what I said.

So just want to see how you girl think. Because on one hand, I'd like him to exercise his mind to finetune anything he thinks can be done, but on the other hand, 'if it is not broken', why change it?

All my last 3 stim cycle was on Lucrin to downregulate and then puregon, I seems to have good results. First cycle, 15 eggs, 2nd, 8 and 3rd 9 eggs.

Based on this result, is it worthwhile for me to change to Antagonist cycle? Or I am just doing it for the sake of it. FS did mention it will be a patient-friendly cycle and less injection, but I really don't mind the injection as far as that is the best approach. He also mentioned everyone's reaction toward this is different, so you won't know until you try it.

I'd like to know:
- is this protocle tend to generate better result for older women?
- under what circumstance it is recommneded?
- what are the drugs involved?
- is it similar cost invovled as a normal IVF cycle?
- what's your experience on it especially you've also done down-reg cycle? Any good results?

I know we might have touched this somewhere else in the thread, but some opinion on this would be great!

thanks heaps

[Aleenta]

Hi Cuddlepie,

I did antagonist after i overstimmed doing down-reg and had to cancel the cycle. The biggest advantage I think is that the whole cycle takes a lot less time. I can't remember why my FS recommended it - I think maybe it's commonly used for people who overstim?

I always think it can't hurt to try something new... I am sure if your FS didn't agree with you he would have said for sure.

In terms of results I am not sure as the only EPU I made it to was on antagonist so far - I got 8 eggs - 6 made it and now in TWW of my last 2 (have transferred 2 at a time).

I think cost was about the same - we have ICSi as well. The drugs I had were Gonal F, Ovidrel for Trigger plus I had 3 shots of orgalutran (which I hate to say are soo painful - but i got great advice of here which was to inject very very slowly - which made a huge difference) Then I had horrible Crinone after ET.

Hopefully someone else has made it to epu on both protocols so they can give you a better comparison.

Best of luck to you
x

[Cuddlepie]

Aleenta, thanks hun for answering all my questions...isn't that interesting? I thought this is an alternative for people who have poor respond...anyway, I agree with you about trying sth new, I don't have anything to lose anyway.

Best of luck for this cycle and let me know how you go and I hope this is the absolute last cycle you need to endure...

[nicjay]

Hi Cuddlepie,

I've done 2 IVF cycles late last year, 1st one down reg and 2nd one flare. I haven't done an antagonist at all so can't help you there. My 1st cycle was pretty much a disaster, started on 125IU Puregon and got no response after 9 days, we upped the dose to 250 after that and still only got one follicle which took ages to mature. The cycle was cancelled and we did IUI which was a BFN.

My clinic nurse then suggested I might want to try a flare cycle instead. They recommend this cycle for older ladies and ladies who are poor responders (like me). It uses the body's own FSH as well as the drugs to make the ovaries produce more follicles, so tends to give better egg numbers in the above group of ladies. The only down side was that the pregnancy rates tend to be lower for this type of cycle, but my nurse was of the opinion that this was only due to the age group that tend to use it ie. older ladies who have a lower chance of falling pg anyway. The other advantage for me apart from giving the old ovaries an extra kick in the pants was of course the shorter length - no down reg phase, so approx the same length as a normal cycle. We had Xmas looming, so wanted to get in as much as possible before the end of the year and the safety net.

The drugs involved for me were Puregon and Synarel (could also use Lucrin if I wanted though, the only reason I didn't was that I had some Synarel left from the down reg cycle) and Pregnyl for trigger. I started sniffing Synarel on day 2 and Puregon on day 3 and continued with both until trigger. The cost was exactly the same as the down reg cycle. We got a better result, but still not fantastic - 3 follicles, with one egg collected. Maybe I am not a good example of it working better in terms of egg numbers but our little egg fertilised and we got a BFP from that cycle, so while I guess the cycle wasn't a great success in IVF terms, it definitely got the desired result

Apart from the obvious reason for being pretty happy with the flare cycle, I liked it better than the down reg just because of the shorter time frame. The down reg phase is just so long and frustrating I think, I really didn't like marking time for that extra month KWIM? And of course you can fit more cycles into a year so the short cycle has safety net benefits as well if you need more than one stim cycle which I hope you don't!

Good luck with it all and HTH

[Cuddlepie]

Megsmum, congratulations! What a great result! Who needs thoese IVF stats if that one and only egg can get your BFP? so thrilled for you and thanks for go into the details to explain to me...

So I guess flare cycle is slight different from Antagolist cycle are basically both short cycles, the only difference is the drug used are different, right?

Thanks ladies, I am feeling more confident of this protocle now...short cycle is definiately good for our older ladies...

[nicjay]

Thanks Cuddlepie, we were pretty thrilled with the result as you can imagine

So I guess flare cycle is slight different from Antagolist cycle are basically both short cycles, the only difference is the drug used are different, right?

Yep, sounds about right to me! Probably less jabs in total with an antagonist than with a flare using Lucrin too, even though you mention that it doesn't worry you.

GL

[Bel]

Hi my friend CP,

These 2 little ones growing in my tummy now are the result of my 1st antagonist cycle.

I had the same sort of drug protocol as the other ladies here had mentioned, cost wasn't much different than a down reg cycle but I tell you for me personally, I would rather do an antagonist cycle any day.

I found it so so so much easier on my body. I actually continued to feel human through the cycle only getting a bit uncomfy just before EPU.

I just felt so positive about the cycle the whole way through and found that the embies we produced were really good quality. So much so that the embryologists were dead against putting 2 back in on TF day cause they said they were so good and there was such a good chance of them both taking (am glad they have since be able to say to me "I told you so"!!!)

So while it is completely your decision which way you go and different things work for different people, I had a really good experience with antagonist.

BTW...you are always in my thoughts and I really pray this next cycle is the one.

Big hugs
Bel
xxxx

[Cuddlepie]

Thanks Bel, I didn't know that it was a antagonist cycle, so good to hear that how many people got pregnant from this protocol, I know Nic and Mon also used this...this just gave me so much hope you know how devastated since last failed cycle.

I guess I am still pretty flat and just thought trying this is better than doing nothing...now I am kind of looking forward to start this...what are the chances of getting OHSS? I know you had a mild one didn't you Bel?

[Bel]

CP.. I don't want to scare you or anyone else but I had severe OHSS this cycle. Myself and my FS truly believe it wasn't the type of cycle that caused this though as I was on the same low dose of FSH (188) as I had always been on previously.

We put it down to a combination of things
1. I had just lost 5 kilos
2. This was my 1st stim cycle since having lap surgery to remove previously unknown about endo and to drill my ovaries
3. Using pregnyl after EPU.

On the day of TF, my FS did an US to make sure I had no signs of OHSS. My 2 little ones were put back in and I had a 2nd injection of pregnyl.
I think what happened was these 2 implanted straight away as one had hatched and one was starting to hatch and my hormones just started going crazy from these 2. On top of that the pregnyl was just to much.

So, to sum up my rambling!!! In knowing what I know now and with what I have been through, I would still do another antagonist cycle again if I was to need to use IVF in the future.

Hope this helps you a bit more.

Thinking of you

Hugs Bel
xx