Long Term TTC & Assisted Conception June/July 2014

[CatyO]

WW - All the best vibes for your embryos and fongers crossed for the transfer next wednesday, are you planing to have more than 1 embryo transfered? About the gonal f dose, yes l would like to be on a higher dose, as last year l was on 112 iu and did 4 eggs, 3 good ones. This time around lm on 200 iu, what makes me think l will make 6 if im lucky. The thing is that often l hear women that did 18, 14 eggs and they were on a way higher dose... Anyway i will see what happens...

AFM - here we go again, CD1 for me. I start tomorrow with gonal f. Fingers crossed this works this time around

[juniper76]

WW - All the best vibes for your embryos and fongers crossed for the transfer next wednesday, are you planing to have more than 1 embryo transfered? About the gonal f dose, yes l would like to be on a higher dose, as last year l was on 112 iu and did 4 eggs, 3 good ones. This time around lm on 200 iu, what makes me think l will make 6 if im lucky. The thing is that often l hear women that did 18, 14 eggs and they were on a way higher dose... Anyway i will see what happens...

Crap, I had a whole long reply typed out, pressed the wrong button and lost it and now can't remember how it started... So here's the less eloquent version:

Don't self-medicate. Do not use a higher dose than prescribed. Going from (approx) 100iu to 200iu is a reasonable step. Jumping from 100iu to 300iu (or more) would be reckless. Your FS doesn't care how other women have responded to any given dose, they only care how YOU respond. You may end up at those higher doses eventually, but jumping straight to them is risky. You don't want to end up with your cycle cancelled due to over-stimming. And you definitely don't want to end up seriously ill with OHSS! For someone with a normal AMH, 200iu is the high end of normal for dosage. It's usually (not exclusively, but usually) only poor responders (with low AMH) who go higher...

It's also worth noting that an increase in dose doesn't always result in more eggs. I've always had pretty much the same response, regardless of dose: 6 eggs at 225iu, 5-7 eggs at 325iu and 5 eggs at 450iu...

Another point to consider is that there are some doctors who believe a dosage over 200iu correlates with a decrease in egg quality. It's a bit of a contentious issue, and it's not clear whether it's the dosage itself or the type of patient who uses a high dosage (ie DOR), but there are some who do believe limiting the dosage to 200iu produces the best quality eggs...

You may also want to consider that getting more than a dozen eggs is also linked to reduced egg quality. A lot of those women with 20+ eggs only end up with a few embryos due to the poor egg quality. The goal here is as many viable embryos as possible, not as many eggs as possible.