Flare Protocol Success

[firefly37]

Hi all,

I am due to start a "flare" protocol next month after failing to respond to a short protocol in December. My protocol is Decapeptyl and Pergoveris.

This is likely to be our last try as Pergoveris has cost us a fortune the last couple of months :(

I am looking for "flare" protocol success stories please as I am so anxious ....!

TIA x

Flare protocol seems fairly uncommon in this country - but I was put on it after a failed 1st cycle (I got 3, day 3 embryos but none implanted) and lots of previous failed IUI's.

The 2nd cycle they said my egg quality was much better and I got 4, day 3 embryos - 2 were put back and 1 took and I am now 32 weeks pregnant (the 2 other day 3 ones were frozen).

I was on different meds to you though - very high dose Menopur and Buserelin for the "flare"/boost and then a triple trigger (I doing 4 injections a day!) But I am older with low AMH and PCOS and probable endometriosis, so likely needed the high dose meds in order to get eggs that were good enough!

Thank you @IamnotwhouthinkIam and congratulations!!!!
I'm nearly 42 with 5pmol amh and fluctuating fsh between 6.6 and 15 at most... What were ur numbers?

Thank you. My bloods were actually last taken when I was age 37 and I didn't finally conceive until I was aged 40 - not sure how I got away with not repeating them!

I remember my FSH was okay at about 7 but my AMH was only 6.9pmol at age 37 (and I remember it was about 9pmol at age 35 when I first checked) - so I suspect by the time I conceived it was much, much lower than 6.9, even if it continues decreasing at a similar rate, rather than decreasing faster as you age?

Good Luck!

@firefly37

I’m also doing flare soon. I’m feeling very anxious. When do you start? Thanks

@2021ivfagain ... I started my injections yesterday so early days. First follicle scan on Monday 21st .. what is your AMH and FSH? Why were you put on a Flare? What meds will you be using?
Good luck x

@firefly37
My fsh was 6.7 when tested last August and amh is about 16. However, I’m 40 and 41 in June. I’m TTC my second and I’ve had a lot of stress so I think in my last cycle my fsh was higher. I had a really good cycle in November but a bad cycle in February where nothing fertilised. This has never happened before. I took dhea and felt bad on it but the clinic say all patients who are 40 and over go on it.

I’m emotionally worn out as had to IVF IMSI to conceive my son who is 15 months old due to mfi, but that was when I was 38 and did long protocol then.

Which clinic are you with if you don’t mind me asking? It’s so good to talk to others who are doing the flare.

I will be using 225iu meriofert and 225iu fostimon, zomacton alternating doses, buserelin spray from day one of period until end of stimming, hcg trigger gonasi. Also doing estrogen priming month before from day 21-start of period with norethisterone from day 14-25. I hate norethisterone as it suppresses ovaries. I think age is my problem now.

Last time they weren’t growing as fast so I stimmed an extra day and compromised egg quality. I feel so upset at present.

Good luck and keep me posted. X

@2021ivfagain ... aww I know what you mean about being emotionally worn out ... we have had so many issues with this last cycle.

Are you sure your AMH is 16? Or is it 1.6? AMH of 16 I think is abnormally high ... I am 41, 42 in two weeks (I so wish I wasnt!). My AMH was 5pmol (0.7ng) last September and my FSH yesterday (I had to test FSH before I could start stimms to ensure it was lower than 12) was 10.7 so I started last night.

We have had a nightmare the last few months ... my clinic is Gennet in Prague and they insisted on a hysteroscopy before I could start due to having had two previous c-sections. So I flew to Prague, had the procedure and all was perfect luckily ... We attempted stimms in November, but I then got a high temperature and had to cancel 4 days into stimms due to potential damage to the eggs. My partner had to fly back to Prague and buy more medication. We then started again in December but after 5 days of stimms, I had failed to respond and we were devastated (this was a basic antagonist protocol with Pergoveris and Cetrotide although we never reached the point of using the cetrotide). My partner then flew back to Prague and bought more medication for the now "flare" protocol which I think the clinic thinks is the only option I have left. I am taking Decapeptyl 0.1 for the flare and then Pergoveris 350 and that's it. My follicle scan is on Monday and I am desperately anxious of having no response again. We have spent around £3.5k so far on this cycle and havent even reached egg retrieval!!

What were your other protocols? What happened in November and February? x

@firefly37
No. It’s good. I had ovarian reserve test. My November cycle I had 15 follicles. That’s the thing. I’ve got good levels but I’m a more responder due to stress and age. My cycle in November was very good. I responded really well but had a lot of stress due to Dad’s stroke and my Mum’s health issues it has affected me.

@firefly37
November I had 15 follicles, 9 eggs collected, 8 mature and 7 fertilised and all 7 frozen on day 3. I’m doing embryo batching to PGS test. But they freeze on day 3 and then when collections are done they grow to day 5 and day 6 to test blastocysts. My consultant says my results are good but I’m not always responding very well. I think dhea messed up my last cycle and stress caused fsh to get higher.

I’m taking wheatgrass to bring it down again.

@2021ivfagain ... wow, that is a great AMH then!
Sorry to hear you have had so much stress ... when are you starting?

@firefly37
In February I had 13 follicles but growth was not as good. I needed estrogen priming but they did not do it due to success first time. I had 7 eggs collected, 4 mature and nothing fertilised. That was my worst result ever. I was so upset. I’ve heard that sometimes the short protocol is less effective. I’m hoping the flare is good.

Are you only taking 350iu total for stimming?

@firefly37
I also have issue of immature eggs. I have lots of follicles but sometimes less mature eggs. I was on the dual trigger which helped get an extra egg but they’ve taken that away as they want me to do the flare.

When did your buserelin start? Are you using nasal spray?

@firefly37
My consultant wants me to start again in April with norethisterone and estrogen priming next month. I’ve asked for melatonin 3mg as that is good for sleep!

I really hope this works. The disappointment is terrible. I’ve been a mess the last week.

It’s so expensive. Are you not using buserelin?

@2021ivfagain... Yes only 350iu of pergoveris and 0.1 decapeptyl... Both started last night. I'm not taking anything else until trigger which I would be in Prague for so they will give me that when I get there x

Decapeptyl is basically the same as buserelin but in the Czech they prescribe decapeptyl. Would it be less stressful to crack on with the 7 u have? U may have a golden one there x

@firefly37
Well my consultant says I need two good rounds to increase my chances as I’m PGS testing. They are only at day 3 so then they can be grown to blastocyst stage at the same time. It’s so hard this time around but it only takes one good egg! I know it’s a cliche but it’s important to hold onto that idea sometimes.

At least you know your fsh is in range which is excellent. It can be hard. I take wheatgrass in between cycles. I’ve had to double up on it! I stop it just before stims.

Have you got to travel to Prague for your retrieval? That must be difficult.

I’m so grateful to have my son but I just want him to have a sibling so much.

Good luck with your scan on Monday. Keep me posted. X

@2021ivfagain - hang in there, things are looking promising for you. We got lucky first time with my little boy in 2016 ... getting my little girl in 2019 was simply a miracle as far as I am concerned. We had 10 eggs retrieved but only 3 were mature ... I was so sure we stood no chance at all but all 3 fertilised and became day 5 blasts! I didnt test any of mine and had fresh transfers which both worked ... my two frozen transfers didnt work so I am sticking with fresh. I will be travelling to Prague for my retrieval but luckily the flights are easy and cheap. I hope you can take some time to chill x

@firefly37
Good luck with your scan tomorrow. I have read good things about the flare. Did you just take wheatgrass to lower fsh? I’m taking wheatgrass but increased it a lot and I think I took too much! I’ve now gone back to 30g a day instead of 40-60! Did you also take vitamin e? Thanks

@2021ivfagain I took wheatgrass... I took capsules and the daily recommended amount as per the bottle.
I'm terrified today... My scan in a couple of hours

@firefly37

Thanks. I’ve lessened the dose to 30g and feel better but always stop before stims.

The flare should help stimulate your ovaries. It’s only your first scan. I know how scary it is, but try to take one day at a time.

@2021ivfagain
My scan was not as good as I'd hope but certainly not the worst considering I failed to respond in December. My follicles are at 13, 11, 10, 9, 8, 5, 5 and 4. My last stims in 2019 I had 12 follicles so am down to 8 at the moment. The clinic are pleased with the initial progress for me so I'm flying to Prague on weds for next scan and next steps x

@firefly37

I think this sounds like a better protocol. It’s good you don’t have a lead follicle so you’re doing well. It seems like a steady growth. 8 follicles is still good.

It was good you got your fsh down. I always worry about that.

Good luck with your journey to Prague and retrieval. X

@firefly37

I hope your egg collection went well. I’ll be doing estrogen priming next month and stimming in April.

@IamnotwhouthinkIam
Hi. I’m starting to prepare for the flare protocol next month with buserelin. I notice you had success with it. From my information I have to take buserelin 4 times a day. It seems quite a lot when lupron is a lot less. Were you also taking a lot of buserelin? Thanks

No I didn't take it 4 times a day. I started Buserelin after I'd finished the Norethisterone tablets and started my bleed - the Buserelin was the extra stims (the "Flare") before I then started my high dose Menopur (450iu total in the evening, split into two 225iu injections).

From what I remember (can't find my dosing letter, sorry) I started Buserelin alone first on 0.5 ml (1 injection in the morning) for about 5 days or so? Then once I added in the Menopur, it was upped to 1ml (two 0.5 ml injections in the morning) - to do double duty as extra stims but also to stop me ovulating too early (it somehow does both so no Cetrotide type drug needed to do that in this protocol). So while I was eventually on 4 injections a day, it was 2 Buserelin and 2 Menopur. But your regime might be different if you are on a different stim than Menopur? Good luck!