Meriofert and Gonalf high stims experiences?

[Otessa85]

Hi All. Worried IVFer here - about to start our second fresh cycle after the last one ended in miscarriage and BFN. I suppose I’m feeling anxious because of how desperate we now feel after such a tough first cycle. My question is about stims drugs. Last time I was on 300 menopur but this time I’m being put on 450 meriofert and gonalf. Does anyone have experience of meriofert and gonalf and / or high stims? Are there pros / cons to the different type of stims drug? I’m concerned about the impact different drugs and a higher dose might have on embryo quality. Last cycle I produced 2 good quality day 5 blastocysts (from 11 eggs collected - although I suppose the quality can’t have been as good as it seemed if the outcomes weren’t successful). Any thoughts / experiences you could share would be appreciated. Thank you! Im 38 with low AMH by the way although our issue is male factor (we need ICSI).

It's a myth that high dose stimulation reduces egg quality, that theory is pushed by Create's business model.

From my experience and that of friends, lower dose stimulation has always produced poorer quality eggs. I was bought in by the "high dose means lower quality" claim and insisted on my round 2 that stimulation was lowered, against my consultants advice. We had a much worse outcome.

I've changed clinics now as was unhappy with that one for other reasons but every consultant I've spoken to, has said high dose stimulation is needed to get the best result if you have low AMH.

Low stimulation dose is only beneficial if you have PCOS, very high AMH.

Thank you so much for this helpful reply, @ButterscotchBabe. I seem to read so many mumsnet posts about the benefits of low dose stims, perhaps I was starting to buy into that idea too! Thank you for explaining that high dose stims has actually led to better outcomes for you - that’s really reassuring. Wishing you all the best for your next stage of treatment.

@Otessa85 sorry to hear about your MC and BFN. My thoughts are that gentler form of IVF can possibly improve outcome, but I think a lot is based on personal decisions/research.

I have low AMH, am 37 and MFI was slightly lower morphology but otherwise fine. Had my first go at my NHS cycle earlier this year which was abandoned due to what they thought was a poor response as I only had 2 follicles growing even though in investigations I had 4-6 showing (was on 300 Gonal-F).

I then restarted the cycle of 450 Gonal-F for 9 days and still only had 2 follicles with one leading the way and the other lagging behind, but I was allowed to still proceed to egg collection. Got 4 eggs, 2 mature but neither fertilised (one failed and the other abnormally fertilised).

We then explored private options and decided to go with Create, which @ButterscotchBabe you have rightly flagged their business model is natural/mild approach produces better quality- if you don't agree with that approach then steer clear as they won't do high stims. Now I agree it is all up for debate and if you ask one Dr you'll get one response and another will say the complete opposite, so it is personal preference. Personally my experience has been different, and that has been with an even milder version of IVF, natural modified.

So we decided to do a 3 cycle package with Create and I've not long completed the 1st cycle of those 3. We got 5 eggs (that was just from the one side as my other side was hard to get to on this occasion so may have been more), 4 were mature, 3 fertilised through ICSI (the 4th degenerated because of ICSI which is always a possibility with ICSI) and we have a good quality day 3 and day 5 embryo in the freezer (Create like to freeze a day 3 on the first cycle just in case you did not have any other embryos to freeze through all the cycles). The 3rd embryo made it to blastocyst but was not good enough to freeze but still an improvement from the last high stimulation round. I was on 150 Gonal-F for 6 days - lower cost stimulation wise and less stress on the body, but somehow better results on this occasion.

It's a personal decision but I found this article an interesting read that talks about low AMH and collection of embryos over 3 cycles to get the best odds possible.

www.ncbi.nlm.nih.gov/pmc/articles/PMC6822952/

All the best on your journey!

Hi @Otessa85 , I'm very sorry to hear about your MMC and BFN.

I was on a recent thread about high dose stims, and thought you might be interested: www.mumsnet.com/talk/infertility/4902007-high-stims-due-to-low-amh-success-stories

Very best of luck with this new cycle!

Thank you @Sunflower360 for taking the time to write such a detailed and considered response. Reading about your experience on different levels of stims / with different types of IVF is really interesting and I will be sure to check out the article link you sent me. You're right that personal circumstances - research, clinical context - plus the advice of consultants are key. It's great that you've found that the natural IVF approach suits you and I wish you all the best with your next two egg collections and upcoming transfers.

Hi @beachbum85. This thread link is great - thank you for sharing it because it's very very relevant to my questions / worries! Wonderful that a round with high dose stims gave you your son and two frosties - what a result! Wishing you all the best and thank you so much again.

Hi @Otessa85 some similarities here! Our main problem is male factor but I have low AMH and am also on Meriofert and Gonal F this cycle. I had heard good things about Meriofert so was pleased to be prescribed it after fairly poor response to other stims (bemfola, menopur, gonal f - tried them all!) I’m not responding particularly well this time either but obviously hard to know how I would have done on anything else. What I would say is that 11 eggs in your last cycle seems like a great result for someone with low AMH so obviously you need a bit of luck, but I think you have plenty of reason to be optimistic. Good luck!

Hi @Sunshinebytheseaside - nice to hear of a similar situation! Great that you’ve heard positive things about Meriofert. Sorry you’re not responding too well at this current point in your cycle - I really hope things pick up for you or (if numbers are low which I know is typical for us lowAMHers) I hope the quality is there rather than the quantity. As they say, it only takes one! Wishing you all the very best and thank you again for your reassuring message.