How many eggs did you get on your fresh cycle? What dosage of gonal f were you on? And have you had any of the thrombophilia tests to check there are no issues with your FETs?

Definitely don't take menopur, it has LH in it and you don't need any more of that. And don't think down regging is recommended with PCOS either - you want to wake your ovaries up, not put them to sleep!

Well all stims switch off your LH receptors so you get a fall in it - otherwise you'd ov. I think it's only if it's very low that it becomes a problem - do you remember the number? Also what is your fsh? And your tsh? How old are you?

In terms of your egg quality I don't know much about it but many people on here recommend a book called it starts with the egg - there are lots of recommendations for supplements etc to improve egg quality. The main thing with stims is not to go on too high a dose too quickly, and it sounds like you didn't fall into that trap which is good.

Has your DH had any analysis done on his sperm?

Long protocol definitely not recommended for PCOS for two reasons

1. the higher doses of stims usually needed for long protocol are def not advised for PCOS due to risk of OHSS
   
   
2. long protocol removes the option of a buserelin trigger, which again can be important if at risk of OHSS
   
   The HFEA guidelines on OHSS state short protocol should be used for high responders. The Wikipedia entry even says antagonist protocol is best to minimise the risk of OHSS
   
   LH wise if you're on short protocol an FSH only stim is generally better especially if you're PCOS, because without down regging you're already producing natural LH before you add in the Cetrotide to slam on the brakes. And in PCOS where LH levels are often naturally higher more LH is the last thing you need. My LH levels were so high we actually started Cetrotide at the same time as Gonal-F, because the Dr didn't want to risk LH levels climbing even higher and risking premature luteinisation
   
   stealth and I both have PCOS, both see the same consultant, both did short protocol with Gonal-F only, and both got loads of mature eggs and good quality blasts
   
   I know our Dr uses Menopur in a long protocol cycle, where you need some LH because down regging removes it completely. Luveris presumably allows the Dr to control the amount and ratio of FSH : LH because you're adding it in separately. But I would imagine this is only really an issue in a cycle where you've been down regged
   
   He also says you shouldn't trigger until 10 days of stims as a general rule - particularly for high responders low and slow is better than stimming too quickly.
   
   I stimmed for 8 days at 150iu Gonal-F, 4 days at 75iu and then coasted for 2 days with no stims at all. Got 28 eggs, of which 22 were mature, of which 19 fertilised, of which 9 made it to blast for PGS testing, of which 6 were chromosomally normal

Nothing was done as the evidence base is not yet there to support the proposition that low LH during a cycle results in adverse outcomes. This article sums up some of the research well:

www.ncbi.nlm.nih.gov/pmc/articles/PMC3136063/

there seems to be a single study that supports the view that low LH impacts egg quality - it was done in Australia. Google is your friend

But it's certainly not standard to supplement with LH during a cycle. Perhaps you can bring the literature in to see your doctor. Have they made any comments on why you had a relatively poor rate of fertilisation & embryo development?

Without knowing your fsh/LH ratio pre stims it's hard to make any judgement of what impact PCOS might have had. However PCOS does seem to be linked generally with poorer quality eggs and lower success rates. Are you taking metformin? What is your bmi?

Ps just so you have my stats - I started off on an ovulation induction cycle. Stimmed on gonal f for 11 days at 75iu, then converted to IVF as too many follies. Had 3 days at 150iu then dropped back to 112.5iu for another 6 days. So had 21 days stimms. Collected 37 eggs, 33 mature, 31 fertilised, 30 made it to day 3 and 20 day 5 blastocysts, of which 10 were chromosomally normal (had them PGS tested).

Oh you are a thin PCOSer like banana and I. Definitely follow all the egg quality stuff - I didn't do any of this but banana can tell you all about it.

I would recommend seeing if you can get a gp to prescribe metformin - at worst case it will be ineffective but may help. Oh and it goes without saying that if you can get your weight up it will help - optimal fertility is meant to be around bmi 21 so even if you can nudge it up to 20 that's helpful. I ate lots of good fats like avocado and peanut butter and really tried to make sure I was eating a lot, plus dialled down my exercise intensity as I find it almost impossible to put on weight when I'm doing lots of cardio.

Did you try Clomid and/or ovulation induction before IVF? Did you ov regularly naturally?

Good luck! It's such a mindfuck - so many variables to control. Your protocol is really important so you're doing the right thing hunting for information.

Low LH would presumably be much more preferable to high LH

High LH and risk of premature luteinisation is definitely not good for egg quality

My LH was admittedly very very high. My FSH : LH ratio is classic PCOS, with LH hovering around the 20-23 mark, which is not far off surge range.

FSH is likely to be low with such a high AMH - my AMH was recently measured as 62.2, (so similar to yours - although as you know 8 months prior my AMH was undetectable!) and my FSH has been lurking around the 5 mark or thereabouts

High FSH is a problem for poor response to stims but by definition PCOS puts you at risk of the opposite end of the spectrum, so poor response isn't likely to be too much of a concern