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Flare protocol or short lupron protocol, any experience?


Forum: Trying to Conceive with Medical Assistance

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  #1  
May 4th, 2012, 12:59 PM
Joliving4Jesus's Avatar Mega Super Mommy
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Well I was supposed to go in Monday for my day 3 blood work and orientation, af decided to show 3 days early on my vacation, most likely due to my hysteroscopy last month so I had to go in today for my day 3 blood work and I got to talk to the medical assistant a bit who told me that I'll be doing a flare/short lupron protocol, anyone do this protocol? I thought the most common starter for first timers was the long lupron method, so not sure why this was chosen for me and I don't know much about it, any advice? I still go in Monday for my orientation and I am sure I'll have more questions, I just hope this is the best method for me.
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  #2  
May 6th, 2012, 11:06 AM
Joliving4Jesus's Avatar Mega Super Mommy
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No experiences with this?
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  #3  
May 6th, 2012, 11:25 AM
KMH KMH is offline
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I know it has been talked about and it seems like someone else has done it, but I have been racking my brain all day and can't think of who. I'll keep thinking, and hopefully whoever it was will jump in soon!
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  #4  
May 11th, 2012, 04:21 PM
kbpeanut's Avatar Platinum Supermommy
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Location: north county san diego, ca
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Hi Joanna,
I hope you don't mind my popping in. I'm a lurker here, but regularly, I am a co-host on TTC #1 board. I have been TTC my first for 3 1/2 years, and late last year stepped into the world of MA. Anyhow, I noticed this post, and noticed that you didn't get any feedback, so thought I would comment. I really hope you don't mind.

Tomorrow is transfer day for me for my Lupron Flare IVF cycle. My first IVF cycle was a luteal estrace start/follistim cycle which failed before we got to retrieval (my body ignored the antagon and started to pop before the trigger). Anyhow, for my second IVF cycle, my RE switched me to the micro Lupron flare protocol. DH and I are both 37, and I have diminished ovarian reserve and he has a very small bit of MFI (low morph).

We had to wait several weeks before our estimated start date due to a stubborn ovarian cyst. All this time I was on estrace BID. When that finally went away, I started the microLupron on CD 18.

CD 18-19: microdose Lupron 10IU/BID -- two injections/day (am/pm) with normal insulin needle.

CD 20-32: Follistim 425/SID -- one SubQ injection/day with Follistim pen
CD 20-33: microLupron 10IU/BID -- two SubQ injections/day with insulin needle
CD 20-30: microHCG 10IU/SID -- one SubQ injection/day with insulin needle
CD 31-32: microHCG 10IU/SID -- one SubQ injection/day with insulin needle

CD 33: Ovidrel trigger x2 -- two trigger injections
CD 35: Retrieval

CD 35-??: Progesteron 400/BID -- 2 vaginal capsules/day (am/pm)

So, that's how my cycle went. It was pretty brutal on my abdomen (that many shots/day got to really irritate my belly after a while.). Plus, we had some issues with a malfunctioning Follistim pen, so several of those days were up to 8 needles (including monitoring b/w).

I go tomorrow for transfer...my RE is VERY pleased. When we first started MA, given my Dx, she wasn't even convinced that we would get any eggs. I proved her right the first time around, I was a very slow responder, then I popped on my own. She wasn't about to try that again, especially since she knew we were paying for 100% of this out of pocket (our insurance covers nothing). She actually thought we would have almost no chance of concieving using my eggs, and that donor eggs would be our only option. We're still giving this a shot though.

And this microLupron cycle seems to be headed in the right direction. At retrieval, they got 6 eggs out of my 10 (8/9 viable) follies. Of the 6, 5 were mature, and all 5 fertilized with ICSI. On Day 3, of the 5 that fertilized, 4 were still going strong, and one dropped out. Tomorrow is transfer, and the embryologist thought one or two more might drop out, but we should still have 1-2 really strong ones for transfer.

So, first, I think this protocol worked best for me. I'm not sure why, but this is working when the other did not. I also think it's probably relevant to mention that I stimmed for perhaps longer than average because i'm a slow responder. It took several day for my E2 levels to start to go up, and for my follies to grow.

I hope this information was helpful! I am more than happy to answer any questions you might have about the protocol...if I can be of any more help, feel free to PM/email me at any time! I only pop in this board once in a while, so PM is best way to ensure I will respond to you!

Bestest of luck to you, hon!
xx

PS. My FF chart is also in my siggy, and I have everything marked on there as well
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Thanks *Kiliki* for my amazingly perfect siggy!


05.24.2011


Our TTC Journey | Pregnancy Journals: Nugget (or here) and Baxter (or here)
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  #5  
May 12th, 2012, 09:36 PM
Joliving4Jesus's Avatar Mega Super Mommy
Join Date: Sep 2007
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Quote:
Originally Posted by kbpeanut View Post
Hi Joanna,
I hope you don't mind my popping in. I'm a lurker here, but regularly, I am a co-host on TTC #1 board. I have been TTC my first for 3 1/2 years, and late last year stepped into the world of MA. Anyhow, I noticed this post, and noticed that you didn't get any feedback, so thought I would comment. I really hope you don't mind.

Tomorrow is transfer day for me for my Lupron Flare IVF cycle. My first IVF cycle was a luteal estrace start/follistim cycle which failed before we got to retrieval (my body ignored the antagon and started to pop before the trigger). Anyhow, for my second IVF cycle, my RE switched me to the micro Lupron flare protocol. DH and I are both 37, and I have diminished ovarian reserve and he has a very small bit of MFI (low morph).

We had to wait several weeks before our estimated start date due to a stubborn ovarian cyst. All this time I was on estrace BID. When that finally went away, I started the microLupron on CD 18.

CD 18-19: microdose Lupron 10IU/BID -- two injections/day (am/pm) with normal insulin needle.

CD 20-32: Follistim 425/SID -- one SubQ injection/day with Follistim pen
CD 20-33: microLupron 10IU/BID -- two SubQ injections/day with insulin needle
CD 20-30: microHCG 10IU/SID -- one SubQ injection/day with insulin needle
CD 31-32: microHCG 10IU/SID -- one SubQ injection/day with insulin needle

CD 33: Ovidrel trigger x2 -- two trigger injections
CD 35: Retrieval

CD 35-??: Progesteron 400/BID -- 2 vaginal capsules/day (am/pm)

So, that's how my cycle went. It was pretty brutal on my abdomen (that many shots/day got to really irritate my belly after a while.). Plus, we had some issues with a malfunctioning Follistim pen, so several of those days were up to 8 needles (including monitoring b/w).

I go tomorrow for transfer...my RE is VERY pleased. When we first started MA, given my Dx, she wasn't even convinced that we would get any eggs. I proved her right the first time around, I was a very slow responder, then I popped on my own. She wasn't about to try that again, especially since she knew we were paying for 100% of this out of pocket (our insurance covers nothing). She actually thought we would have almost no chance of concieving using my eggs, and that donor eggs would be our only option. We're still giving this a shot though.

And this microLupron cycle seems to be headed in the right direction. At retrieval, they got 6 eggs out of my 10 (8/9 viable) follies. Of the 6, 5 were mature, and all 5 fertilized with ICSI. On Day 3, of the 5 that fertilized, 4 were still going strong, and one dropped out. Tomorrow is transfer, and the embryologist thought one or two more might drop out, but we should still have 1-2 really strong ones for transfer.

So, first, I think this protocol worked best for me. I'm not sure why, but this is working when the other did not. I also think it's probably relevant to mention that I stimmed for perhaps longer than average because i'm a slow responder. It took several day for my E2 levels to start to go up, and for my follies to grow.

I hope this information was helpful! I am more than happy to answer any questions you might have about the protocol...if I can be of any more help, feel free to PM/email me at any time! I only pop in this board once in a while, so PM is best way to ensure I will respond to you!

Bestest of luck to you, hon!
xx

PS. My FF chart is also in my siggy, and I have everything marked on there as well
Thank you for all that info! Does the flare protocol usually start around CD 18? They are starting everything with me on CD 2, lupron on CD 2, then follistim with the lupron on CD 3, I know it may have been modified due to our different situations, I have a lot of follies seen on my scan and they are actually trying to watch me for OHSS so I am starting low doses of everything.

I hope this protocol brings you much success this time around! I wish I could have given this info to my good friend before her IVF, she has diminished ovarian reserve and just spent $15k and it failed, they only got 2 eggs, none of them fertilized ...though she got pregnant naturally 5 years ago and has a 5 year old daughter, she has now given up because there is no more funds to do it again, from what I've read, the flare protocol would have been her best shot and I don't think they used that on her.
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Last edited by Joliving4Jesus; May 12th, 2012 at 09:38 PM.
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  #6  
May 13th, 2012, 11:21 AM
kbpeanut's Avatar Platinum Supermommy
Join Date: Jul 2009
Location: north county san diego, ca
Posts: 13,284
Hi! I only started then because the RE wanted to start with a clean slate, and it took until CD 18 for my ovarian cyst to clear up. I think your protocol sounds like what mine should have been, except for the low doses (i was on pretty high doses), but the cyst was messing things up.

I really hope this protocol works for you! I not only had a great (for me) response, but also had 4 (of 5) really good quality day 5 blasts. We transferred 2, and froze 2 totsicles. Here's hoping you also have great success!

xx
__________________

Thanks *Kiliki* for my amazingly perfect siggy!


05.24.2011


Our TTC Journey | Pregnancy Journals: Nugget (or here) and Baxter (or here)
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