Posted by Theresa on May 25, 19100 at 17:21:00:
In Reply to: Dr. Spandorfer, thanks but please clarify.... posted by moll on May 25, 19100 at 14:57:36:
Needless to say, I am not a dr, but have just had a failed IVF at 40 (with early m/c) on a down reg protocol with 6 amps of Gonal F and we retrieved 4 follicles (though they then all went on to fertilise, and transfer and were grade 2 embies). I have high E2 and we did down reg cos of higher success rates. For next cycle my dr (at Cornell) is recommending I do a flare protocol with microdose lupron and 8 amps of G-F and co-culture. Even if you don't have high FSH/E2 I think you are right to want the most aggressive medical protocol which this would be. You don't say how many follicles were retrieved in your other cycle -- but there are plenty of women at your age who only produce 1-2 follicles, so you don't seem to be a poor responder.
But, my dr said that up to 75% of eggs of women over 40 could have genetic abnormalities. So I agree that you want at least 5 good quality embies to have a decent chance. You might want to go back to your dr and ask him a bit more about this. Good luck.
Theresa
: In my post below, it seems you think a 43 y/o patient who produces 4 good embryos on long lupron/6amps gonal-f is not a "poor responder." How many embryos would you then consider a "poor response"?
: Dr. Kligman in chat said a 43 y/o needs 5-6 transferable embryos to achieve maximum chances of 16% at Cornell. Anything less than that decreases her chances. So I'm between a rock and a hard place.
: Given this, could I still be a candidate for a flare protocol, like microdose lupron?