Slow (or No) response to Gonal-F FSH injections?

**sammy88** · September 24th, 2007, 03:18 PM

Hey Ladies,

Wondering if anyone could share their experiences with me....

My story is....
I have PCOS, tried Clomid and had no response to it. Had a lap & Hyst and everything was OK.
Am currently taking Gonal-F injections hoping a follicle grows....
I started injections on Day 4 @ 75iu.
BT on Day 9 and estrogen was 208.
Continued on 75iu per day.
BT on Day 12 and estrogen was 215.
Continued on 75iu per day.
BT on Day 15 (which was yesterday) and estrogen was 258.
So I have increased my Gonal-F to 112.5iu.
Next BT on Day 18 (which is Wednesday).

Has anyone else had a really slow repsonse at first?

Thanks
SAM

**butterfly_warrior** · September 24th, 2007, 04:10 PM

Yep, me. I think a slower response with gradual increases is probably better.

I had no response to 5 days on 15IU of puregon, was increased to 300IU for 4 days - and then ended up with a massive over-response and OHSS. Something to avoid at all costs!

Trust your clinic, and be relieved that you are likely to avoid OHSS doing it this way. The first time through with injections is always a bit of an experiment.

BW

**sammy88** · September 24th, 2007, 04:57 PM

Hi BW,
Thanks

SAM

**belin** · September 24th, 2007, 06:12 PM

Hi Sam

I too have had slow progress.

we are in our first cycle of ICSI, with no known fertility concerns, we are a same sex couple and so need some help to conceive our bub.

I am on day 11 of puregon - started at 150 iu , went to 200 last Friday and tonight are going to 250 iu.

I currently have between 6-8 follies ranging in size from 6-10mm - we need to get them to at least 18mm before we can take the next step.
I have a another scan and bloods on Wed.

Our clinic have said that it is not uncommon for the first cycle to be a bit trial and error/wait and see game because everyone reacts differently to the drugs, and most clinics like to take it slow to avoid OHSS.

I suppose we just need to keep positive and try to be patient - which I know is easier said then done!

Sending you lots of positive thoughts and hopefully we will both get some good news come Wednesday.

**briggsy's girl** · September 24th, 2007, 06:44 PM

sammy, are you using synarel or lucrin as part of your protocol at all? some people (me for instance)react too well to the synarel/lucrin and dont respond to the fsh injectiond - its not common, but i had mt protocol altered abd much better response to different protocol...

**Baby Bliss** · September 24th, 2007, 07:23 PM

I did, and eventually (very slowly!) got to my IUI. Second cycle, I started at a higher dose and it was a little faster process. But I didn't overstim!

**Willow** · September 25th, 2007, 09:15 AM

Yep, I had a very slow response to Gonal-f initially.

We were doing IVF so our dose started at 150iu, after 7 days estrogen was low (didn't get the exact figure) so my dose was increased to 300iu and 5 days later estrogen shot up to 6,000.

By the time we went to epu a few days later estrogen was around 10,000 (my Gonal-f dose was decreased again at some point before epu, but I can't remember exact days or doses now).

On u/sound we had 7 good sized follies but collected 14 eggs, all of which fertilized.

It can turn around really quickly once they get the dose right for you - good luck!!

**sammy88** · September 25th, 2007, 11:18 AM

Hey Girls,
Thanks so much for your responses. You have put my mind at ease

BG, nope I am not having synarel or lucrin because I am only doing IUI at this stage.

Belin, sending you lots of positive baby vibes too. I really hope that it works out for you.

SAM

**briggsy's girl** · September 25th, 2007, 01:26 PM

if it's for IUI they will be trying really hard to make sure you don't get too many follies, so it will be super controlled so that you don't have your cycle cancelled. goodluck with it hun

**Lynn** · September 25th, 2007, 09:03 PM

Hi Sam,

I did FSH injections/IUI and it was slow to start with. I thought that it wasn't going to work like the Clomid (my body didn't respond to Clomid) but then all of a sudden the estrogen surged and we did the IUI on CD28. I have PCOS so have long cycles anyway. I started on 50 then went to 75 and only had the one follie. We caught it.............luckily. Good luck to you!

*las* · September 25th, 2007, 09:35 PM

Yes

First 2 cycles were cancelled after 3-4 weeks of stimming. Third cycle he put me up to 450ui and I only need to stim for 10 days and we were ready. He was sure the PCOS was the reason, maybe for you too??

Good luck!

**butterfly_warrior** · September 25th, 2007, 09:50 PM

PCOS is usually the reason behind an unpredictable response to FSH. The problems really start when level sky rocket like mine. We say my FS yesterday and he's still talking about what my levels did on my stim cycle in March - it's a scary little reminder of just how bad it can get. My FS was saying that slow and steady like a plane taking off is much better than a rapid rise like a rocket taking off. Gives better egg quality, he says.

BW

**Willow** · September 26th, 2007, 08:18 AM

My FS was saying that slow and steady like a plane taking off is much better than a rapid rise like a rocket taking off. Gives better egg quality, he says.

BW I'd heard this too so was a bit concerned when they doubled my dose straight away - I can only assume my levels were still pretty much baseline before the increase. I also had elevated FSH levels a few months prior to our stim cycle (most likely due to my damaged ovary and surgeries etc) which can prevent a response to the FSH stimulation.

Thankfully it didn't affect egg quality in our case! Stimming over an extended period can also affect egg quality so it's like being stuck between a rock and a hard place sometimes I guess.