Long protocol for low AMH/ older age

[Janefx40]

Hi all

So backstory: 2 fresh IVF cycles in 2018 (one DD). FET (miscarriage), fresh IVF cycle (BFN). Now aged 44 (yes I know I'm crazy to be doing this but we feel we should at least try to give DD a sibling)!!

I did a consultation with a new IVF clinic yesterday and they suggested putting me on a long/agonist protocol. All 3 of my previous cycles have been short protocols due to me being older. I'd not really heard of using a long protocol in this situation but the consultant said this is increasingly common.

Have any of you who are older or have low AMH been put on a long protocol?

Thanks

Xxx

Hi! I've also been told my next cycle will be a long one. I also have low AMH. I previously did 3 short cycles but sadly I've never had any success. I have moved from the UK to the Netherlands and it may be that long cycles are just the way they do it here (they are terribly ridged here and have bad success rates but I have no choice). The only benefit I can imagine is that in the past my follicles have grown at very different rates. In my last round I had 3 above 23mm and 10 below 12. With only 7 follicles in the right range I ended up with 5 eggs. Perhaps stopping the ovaries helps to get them to grow at similar speeds when they are 'fired back up'. I should really ask the consultant for a reason but with the worry that the answer will be "that's how we do it here" I prefer thinking there is a good reason. Good luck! Xx

Hi @Matilda128 thanks for the response. Yes the consultant gave me exactly the reason you mentioned - the aim would be to get all follicles to the same size. This makes sense except I just don't know why this has never been suggested before, I was at a great clinic before and always did fine on egg collection considering my age etc so wasn't really looking to change protocols necessarily. This is our last attempt so am nervous about switching. Best of luck with your cycle. Sounds like you have a great number of follicles! I only had 6 with 4 smaller xxx

Yes, I was 37 and very low amh, high fsh. Long protocol and it worked first time luckily.

I'm so happy to hear that my reasoning is similar to what you've been told @Janetx40. My clinic in the UK avoids it because they think you risk that the down-regulation makes the follicles grow slower and therefore you need more stimming days (which may impact upon quality). I'm starting down-regulation next week Tuesday so we may find out soon (you only get a green light to start stimming when you call when with day one and there's still space). If you are really not happy please stand your ground. Tell them that you don't want to make changes. It is your body. I have had to argue so many times with my clinic but ultimately they always gave in. I guess for them it's also not worth pushing patients to do something for which they'll receive complaints later. Follow your own instincts. Good luck xxx

Thanks @Matilda128 and best of luck for Tuesday. Let me know how you get on. I really hope this is your time.

I'm not necessarily against trying the long protocol just a bit nervous. I am more concerned that they are now saying they will only put one embryo back. At 44 even my blastocysts have something like 75% chance of not being viable. My previous clinic would put back 3. Lots to think about.

@Autumnsun1985 thank you for your response and I'm so glad it has worked for you xxx

I have low AMH 0.4 and am looking to start a ICSI cycle in October but have been offered two different protocols and struggling to chose one and hoped for some advice or input if anyone has had a similar protocol.

Protocol 1 is at SERUM
Clomid 50mg x 3 pills per day
Menopure 225 iu ?
Folic acid 5mg per day
Melatonin 2mg per day at bed time

Protocol 2 is at REPROFIT
Menopur 300

Hi @Victoriashope - I'm sorry I don't know the answer but wanted to respond anyway to give the thread a bump.

My AMH is a little higher. I was on 225 Meriofert, 225 Fostimon, Zomacton 4ml every other day for stims plus DHEA x 3 per day.

Best of luck with your cycle

Xxx