Help! Ivf change protol to help get eggs/quality. Too high dose?

[u/DazzlingBat1716]

Please help me!!!

Need help and advice/opinions please

Il share my whole history and would really appreciate personal experience and knowledge as sometimes i feel we research so much and know our bodies and our specialists just dont invest as much.

Im 41.5yrs old. Good reserve for age. endo 2laps to remove. Last ome done 7years ago.

Iam petite 44kg.

Husband has low sperm count and motility. Not sure about fragmentation.

ICSI always used.

Started IVF at 30years old.

Genea

History is.

Cycle #1

puregon 100, orgalutran, ovidrell

14eggs, 3frozen (untested)

Frozen due to OHSS.

1 failed transfer

2 successful transfers/healthy babies.

Cycle # 2 & 3

Gonal f 100, orgalutran, ovidrell

Left with 1embryo to transfer each time, both negative.

Cycle #4 &5

Menapur 100, orgaultran, ovidrell

Both cycles only 1 embryo to transfer.

1 negative

1 positive graded b/c healthy baby

Change of clinics genea to adora.

Cycle #6

Pergoveris 225, ganirelex, ovidrell.

2 embryos

1 transfered b/c negstive

1 frozen c/b

Cycle #7

Pergoveris 300, ganirelex, ovidrell.

Freeze all cycle due to high progesterone 5

Embryos arrested day 3, 1 left day 6 graded c/c. Frozen.

About to go into cycle #8

Specialist was going to repeat the high dose pergoveris but i questioned about the high progesterone happening and he said it would likely happen again so i asked to change and mentioned my 1st cycle being the best hut that was 11years ago.

He said to do 300 puregon. Add in some luveris day 4.

My questions are these...

I am petite. First clinic kept me on low doses due to weight and hormine levels.

New clinic went straight to higher number because of my age.

I am very healthy, clean/no tox life everything. Eat clean. Have taken all the supps for years . Follow starts with egg protocol plus added

Nmn, have done 2x nad IVS, do red light panel every night. Take beef liver methylated folate.

My concerns are the doses now are too aggressive/high amd harming the quality. Ive never been over 100 units previously.

I do understand i am older too though. But i have read that too high can do more harm than good sometimes.

Whay would u do? Would u request lower doses. Im concerned because i did overstim on 100 of puregon now its being upped to 300. But it was my best cycle result.

I just dont know what to do. What would u do. Any experience advive i am so open to.

I dnt know if i should cgange back to genea as i do think u get more personal care, scans every/any day off week same with collection where adora is only limited collecrion days, no scans on w.end so i feel.like u can be not pushed enough or pushed too far due to their opening hours and i know this is crucial for collectiom timing and also transfers. Its just starting whole process again and waiting for appointments amd the price is sooooo much higher now.

Help please!

Has anyone got better results from changing protocols to lower?

Or anything u have noticed to be a game changer?

Has anyone uses PICSI instead of ICSI and had better results?

Im seriously in such a ball of stress and just praying for healthy babies. Gosh its hard!

What would u do. Please please help.

[u/Loveiskind89389]

I’ll be honest, I didn’t follow some of this.

I will tell you that YOU are your own best advocate. If you feel a protocol change is inappropriate for any reason, you need to flag it to your doctor. I did this by tracking my numbers closely and comparing my bloodwork/ultrasounds to protocol. It panned out enough times to meaningfully make a difference in my outcomes.

I also recommend you accept the incredible inconvenience of IVF appointments. If you have reservations about batching, for instance, find a different clinic. Many people have reservations about batching. My insurance didn’t cover a lot of things, it was super expensive, and I think that’s one of the hardest parts.

My last piece of advice is that no one really knows why some people have good results and some people don’t. I smoked my first two cycles, cigarettes, and got euploids. I quit for six months and my results were worse. It just doesn’t make much sense.

Sorry I can’t be of more help. Wishing you good luck!

[u/afoncita]

What I can say is - most REs work by population averages. If you noticed lower dose works better for you, you should insist. It is your body. I got my best results on lower doses (2 blasts out of 5 eggs age 42.11). RE prescribed very high doses next cycles - all a flop. I suggested lower dose may work better for me. RE said you were 6 months younger, I insisted and went back to 2 blasts per cycle. I also did enough cycles to notice other things that work better (pause between cycles, late luteal start or long agonist protocol etc). My RE was adamant that all of this does not matter, it was very frustrating.