Complete regime change for cycle 2?

[Roo45]

I know everyone's circumstances are different but I wondered if this had happened to anyone else. First cycle of IVF, under 35, MFI and put on long protocol with standard dose menopur. Ended up with 11 eggs 7 injected 5 fertilised and looked top quality on day 3 but by day 5 only 2 poor quality embryos that didn't take.

Had my follow up today and the consultant said whilst it's more likely a sperm issue they can't fully exclude an egg issue as some of my eggs weren't suitable for injection and have suggested higher dose menopur but a short protocol instead of long.

Has anyone else had a complete change of regime from 1 cycle to the next? I know I should trust the professionals but this cycle has taught me that you can't predict anything in IVF! I had thought as I don't have PCOS and normal AFC a long regime would be better as we would likely get more eggs and specifically chose a clinic that offered long protocol for that reason.

Hey! Sorry can't help much with changes but is there a reason you think long protocol for everything normal with you?

I'm 28, no PCOS and AFC of 34 and I'm due to go on short protocol in Feb. I was under the impression short protocol was the more standard one for if there weren't any other obvious issues?

Hey @willithappen, perhaps others can correct me if I've understood it wrong but my understanding was long protocol was standard unless there is a risk of OHSS (eg due to PCOS or high AMH) or low ovarian reserve which means you are unlikely to respond to high doses of fertility drugs.
I have read that generally most would get more eggs with the long protocol but a short protocol is better for some people (mentioned above) and there are theories that less drugs might mean less eggs but those eggs are likely to be better quality as they have been 'seletected' by the body. Again perhaps others are aware of evidence for this, the main evidence I found was published by create who only offer short protocols or natural or mild IVF.
Good luck for Feb. One definite benefit is the whole process is much quicker on the short protocol! xx

Long protocol is favoured by most clinics because the clinic is more in control of the process - by switching off your ovaries and then turning them back on in a controlled way with the stimming drugs means you are more likely to get follicles which are similar in size and grow together and yes you do tend to get more eggs for this reason. Whereas short protocol you can get a dominant follicle which has a growth spurt ahead of others and whilst it does recruit other follicles means that they may not all be similar in size or grow at the same rate so some may not mature to a size which is collectible. So often less eggs at the end of it

You can do long protocol if you have OHSS I believe but low dose stims would be required and even then I've known people get 30+ eggs but no embryos survive past day 3

I had a complete change of protocol from cycle 2 to cycle 3-5 (I was with Create and changed to natural modified and yes for me fewer eggs meant better quality - I'm pregnant with twins from the cycle we concentrated on just 2 follicles and 2 eggs)

Thank you @ivfbeenbusy and congratulations on your pregnancy xx

Thanks for exposing that, I honestly never knew!

I have an AFC of 34 when I was last seen so might be why I'm on a short protocol? Others at the same clinic as me I have found seem to also be on the short protocol.

@willithappen I would assume so, you can always check with the clinic I'm sure they will explain their reasoning? xx

I think it is hard because what suits one person won't always suit another and until you do it you don't know how the body will react!
I'm in 2 minds about whether to swap protocol as suggested or maybe ask to try a long protocol again with a slightly higher dose of drugs, but I have no way of knowing what would be best :(