My name is Polona, I’m 50 and I’ve done four IVF cycles, all in North Cyprus, two of them when I was 48 and two of them at 50, for the last one I changed clinics. I’m planning to do one more round with my own eggs and need some advise with the stimulation protocol, since all my doctors use only basic protocols. I listened to your webinar IVF stimmulation protocols and was really impressed, but also confussed. Most of the doctors say that you have to add more LH in older women, because they don’t have enough of it and their receptors for LH are damaged. And also most of them use Femara. I know that at my age is almost imposssible to get an euploid embryo,but want to try one more time with optimal protocol. After that, if I fail to get euploids, I want to transfer one of the donor embryos (I had tandem cycle last round).
I have PCOS, but I don’t have many symptoms – I’m skinny ( but have to watch my diet and do a lot of sports), I don’t have high androgens, I think I don’t have insulin resistance, but I don’t ovulate if I don’t take Femara (day 3 to 7) and even Femara sometimes doesn’t help.
My latest bloodwork and AFC (after fourth IVF):
25.8.2023, day 2 (after the last IVF
FSH= 4.4 mIU/L
LH= 4.2 mIU/L )
prolactin= 6.4 microg/L
estradiol= 111.6 pmol/L
AMH= 5.60 ng/mL
AFC at day 4: 13+13=26
My bloodwork and AFC (before starting the fourth IVF):
4.5.2023, day 3:
FSH= 7.0 mIU/L (it was 12.4 in 2021)
LH= 5.8 mIU/L (it was 15.35 in 2021)
prolactin= 14.5 microg/L
estradiol= 90.9 pmol/L ( it was 33.17 in 2021)
AMH= 4.05 ng/mL ( it was 3.99 in 2021)
AFC at day 4: 7+7 =14
22.5.2023, day 21:
progesteron= 30.61 nmol/L (it was 44.77 in 2021)
testosteron= 0.14 nmol/L
I’m taking a lot of supplements for last two years and doing red light theraphy from May 2023.
My stimulation protocols and results were:
Avgust 2021:
– Gonal f 300IU for 9 days (plus Femara for first 5 days),
– adding Cetrotide from day 7
– trigger with Gonapeptyl day 10
22 collected – 7 mature – 3 fertilized – 3 frozen at day 3
After the egg collection I had HSG done and they discovered I had an Y shaped uterus and they operated and I think it is now ok.
November 2021:
the same, only a day more of Gonal f and trigger one day later
15 collected – 9 mature – 7 fertilized – 6 frozen on day 3
They did PGT on all embrios together, but only 5 chromosome FISH (13, 18, 21, X, Y), two came out normal, one was monosomy 18, X0.
I transfered all three (one by one), but didn’t implant.
March 2023:
– Gonal f for 9 days (plus Femara day 1 to 5)
– adding Dabroston pills at day 7 ( instead of Cetrotide)
– trigger with Gonapeptyl at day 13 (I overslept the trigger and did it 8 hours late), they collected 11h after the trigger.
I ovulated before collecting, I think at day 7, I think because I wasn’t taking Certrotide injections, but they said, Dabrostone pills were OK.
7 collected (the big ones ovulated before collection) – 3 mature – 0 by day 3
After that failed cycle I changed the clinic, but wasn’t sure from the start if the stimulation protocol they prescribed would be ok for me (high doses of FSH). I did an estrogen priming, but my doctor didn’t read my mails and he didn’t know I did it. My follicles weren’t growing at all at the beginning (because of estrogen priming, but I didn t know at first that was the cause), I told the nurse about the estrogen priming, but I think she didn’t tell the doctor, so he just kept highering the dose of meds. At trigger day they said that there were a lot of big follicles, but then they collected only four (I still don’t know what happened to the rest, because I left right after the egg retrieval and I still didn’ t get an explanation by mail). Only two were fertilized and only one made it to day 5 to early blastocyte stage, but it was tested chaotic. They did a cytoplasmic transfer on both of them and also fertilized 7 donor eggs with the same donor sperm, but only 3 got to day 5. I still didn’t get an explanation, what was the problem, but anyway, I have three frozen donor embryos there and two frozen donor eggs. I took hGh for 8 weeks before and during the last stimulation. Last stimulation protocol and results:
July 2023, (AFC at day 3 was 10):
Day 1 to 5: Gonal f 375 IU and Femara
Day 6: Gonal f 300 IU, Meriofert 150 IU
Day 7 to 12: Gonal f 350 IU, Meriofert 150 IU
Day 13 and 14: Gonal f 350 IU, Meriofert 300 IU, Cetrotide
Day 15: trigger with Gonapeptyl, half of Ovitrelle and Cetrotide
Day 17: 4 collected – 2 fertillized- one early blastocyst at day 5, tested chaotic
If it is possible, I would be glad to have an online consultation about my case. I’m from Slovenia (Europe).
Thank you for your answer!