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Long or short IVF protocol

(12 Posts)
Avocadosmoothie Tue 09-May-17 18:49:50

Hello, I am due to start IVF in July, my appointment to sign the consent forms and agree which protocol is next month. I'm trying to get an idea of what to expect on protocol and although of course I ultimately need the doctor to advise me I would like to hear if anyone could comment on which protocol is more likely.

I am 29, AMH is 56.44, antral follicle count is 34. What do you think?


sparechange Tue 09-May-17 18:54:08

Have you got PCOS? Your AMH and AFC are both high...

If so, you're likely to be an over-responder which puts you are high risk of OHSS.

Which clinic are you going to? My guess would be they'll put you on long protocol but if you have a clinic that offers mild stimulation or modified natural antagonist short protocol, that might be better

Avocadosmoothie Tue 09-May-17 19:21:21

Hi, I'm going to Manchester Fertility clinic. My private consultant said I am 'boderline' PCOS and my NHS consultant said he's not sure whether I have it or not. I have slightly raised androgen levels which too point to PCOS but I have v regular periods and do ovulate. So I'm not sure!

Veinarde Tue 09-May-17 19:53:26

Looks like I have a similar profile to yours with AFC of 40 and AMH of 33. Ive been told I have polysystic-like ovaries but not the syndrome as I ovulate and regular periods. On the initial consultation I've been told it will most likely be a short antagonist protocol. I am getting a final protocol next Tuesday! Will keep you updated!
Good luck xx

Avocadosmoothie Tue 09-May-17 19:57:39

Veinarde - v similar!!! From what I've read I was expecting short. Would be v interested to hear how you get on - pleas keep in touch! Do you know how at risk of OHSS you are?

Avocadosmoothie Tue 09-May-17 20:13:09

Veinarde, do you know if you were initially told short because of your AMH or AFC?

Veinarde Tue 09-May-17 21:37:56

I am not sure exactly but I think it's because of high AFC, my Dr mentioned he wanted to avoid OHSS by trying get fewer eggs. Apparently i am at risk sad I also hear on forums too many eggs = worse quality, but maybe it depends person to person!
When is your next appointment? What is your diagnosis? We are unexplained.
I am quite excited to be starting the process already - have been waiting for long.

Avocadosmoothie Tue 09-May-17 21:47:52

We're technically unexplained however a few of my results e.g. High AMH, high AFC, raised androgen level point towards PCO but I've never been diagnosed. My next appt is June 2nd - to sign consent forms and decide protocol. How long have you been trying? How are you feeling about the whole process?

Veinarde Tue 09-May-17 22:32:06

We've been trying for just over 2 years now. We started when I was 29 and my hubby was 33. After a year of getting BFNs I asked for blood tests, which all came back fine. My DH's morphology came back 2% but all other parameters were really great, so we were sent off to try naturally. In the meantime DH started taking supplements which after retesting increased his morphology to 5%. I went to do AFC tracking scan at CD 12 to have a piece of mind- consultant saw large follicle ready to ovulate and reassured me there aren't any problems.
I found this all diagnostic process very confusing, first we were told everything is fine - so I was quite positive, was trying to 'relax and let it happen'. Nothing happened so I really had to face the reality that I am not getting pregnant naturally. Upsetting shocking at first, but now I am at peace with it. Stress is only making things worse isn't it! I am more curious about the process rather than worried. A queue for the NHS treatment turned out to be more than 6 months so we decided to go private first (chose Klinikk Hausken in Norway). We are going to try and make a mini holiday out of it.
Are you doing anything to help bring those androgens down? I heard myo-inositol is recommended for PCO, helps with egg quality as well. I started taking it recently.
Good luck with your treatment, let keep in touch and see how we are progressing! X

sparechange Tue 09-May-17 22:38:18

OHSS risk is based on your estrogen levels in your blood tests while you are on stimulation
And estrogen is produced by follicles, so the more follicles you have, the more estrogen in your blood and therefore the higher the risk

If you are at risk (some clinics will quantity that as estrogen over about 12-15,000, where are others are happy with you being at 20,000) you should discuss the possibility of them freezing all the embryos and then giving yourself a month for bloods to return to normal before doing a frozen transfer

I would ask them at your next meeting what their protocols are for managing OHSS risk in over-responders...

welshweasel Tue 09-May-17 22:38:50

Very similar results to me. I did short protocol with menopur (then added in gonal f) plus cetrotide. Was started at very low doses to avoid hyperstimulation. The first 7 days I basically didn't respond at all so they increased the dose and eventually added in gonal f. Think I stimmed for 18 days (average is 10) but got 16 eggs, 4 blastocysts and a baby! Good luck.

Veinarde Wed 17-May-17 17:14:54

Nice to hear a positive story welshweasel!
I was prescribed 150 Menopur to start with smile can't wait for my AF now Hehe

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