IVF Protocol: High Responder Antagonist

Didn't think I'd ever see these guys again

Didn’t think I’d ever see these guys again

We had our second IVF consult last Friday and made a plan to move forward. We were able to get all our MANY questions answered and I’m feeling excited and optimistic heading into this cycle. Our protocol is High Responder Antagonist. From what I’ve read, the antagonist protocol is very common, and my doctor is choosing to use Lupron for the trigger because he feels I’m at extra risk of Ovarian Hyperstimulation Syndrome (OHSS) due to how well I’ve responded to small doses of meds during my IUI cycles.

One big thing we discussed is whether to do intracytoplasmic sperm injection (ICSI) or not. Our RE recommended it for us, but said as long as we get a decent amount of eggs (8+), he would be comfortable doing 2/3 ICSI instead of all of them. This will help us to know if our problem is with fertilization, and we also like the idea that some of our eggs/sperm have the possibility of meeting “naturally” and making an embryo. I completely understand why couples with low morphology choose ICSI, and I think it is a great option. Since this is our first IVF, we think doing partial ICSI is the right choice for us.

We also expressed our desire to do a single embryo transfer (eSET). Our RE agreed that this is the best option for us, based on age and diagnosis, as long as we have quality embryos. This will be a decision we make together after we see how everything is progressing.

So I’m on birth control for 2.5 weeks and then will start stimming. The fun has already started as I’m feeling nauseous and breaking out after five days on the pill. Lovely. I have a feeling that is just the beginning of the IVF fun. Below I’ve listed a breakdown of my meds and timing:

-Birth control (Alyacen 1/35): Sept 13-Oct. 1
-Pre-IVF ultrasound and bloodwork: Oct. 2
-Start stims (175iu Gonal F, 75iu Menopur): Oct. 5-? (10-12 days, typically)
-Add in Ganirelix when instructed
-Trigger (Lupron): ~Oct. 15-17
-Retrieval: ~Oct. 17-19
-Start estrace after the retrieval
-Transfer: ~Oct. 20-25
-Start progesterone after the transfer
-Beta test 14 days later

18 thoughts on “IVF Protocol: High Responder Antagonist

    • Thank you! Yay – I hope the questions help! My RE was very patient when I asked all the questions but could tell by the end he was thinking “really, more??” Haha! It’s such a huge deal though, better to ask all your questions. Good luck!

  1. I’m a few weeks ahead if you and really feeling things. I tell myself that side effects means things are working! I’m interested to see how things go with a Lupron trigger.

  2. looking good, very excited for you as you move forward! i’m floored by your med dosages compared to mine (gonal-F basically the same, but my menopur dose was 6 times your dose!), but it makes sense given your history. and anything you can do to avoid OHSS is definitely a good thing. i was pretty scared after my retrieval, since i produced more eggs than we expected.

    • Thank you! It is crazy how different doses can be. At first I was very happy to know that I responded so well to meds, but it has also caused us some trouble with teetering on the edge of OHSS and having to cancel IUIs. Been following your cycle and excited about your beta!

  3. We will have to keep in contact! I’m also going through IVF cycle #1… probably starting on September 27th with my baseline ultrasound & bloodwork. I’m especially anxious because we haven’t done IUIs or anything like that. Mine is a tubal issue (ruptured appendix when I was a 13-year-old girl created massive amounts of adhesions & I’m only finding out about it just now, 23 yrs after the fact)! So, IUI would never work for us.
    Like you, we are opting to primarily NOT use ICSI, but only if there seems to be an issue with the sperm sample on “game day.” And also like you, we’ve opted to transfer one embryo only. (Though sometimes I wonder if that’s silly of me, considering all the money we are spending out-of-pocket for this cycle). Doc says the difference between one and two transferred embryos only affects the chances for a live birth by 2%.
    I wish you all the best! As much as I’m nervous about taking the fertility drugs, the waiting is awful, too. Let’s just get this cycle GOING already! Right? 🙂

    • Hi, thanks for reaching out! It’s nice to hear someone making similar choices as we are. I’m so sorry that IVF is your only option due to your medical history, but excited that you’re starting the process. I love hearing that the difference in live birth rates between transferring 1 and 2 embryos is only 2% – very encouraging! Let me know how I can get in touch and follow your cycle. Sending you lots of positive vibes!!!

      • Just to keep you in the loop… Now I’m on OCPs, too! My cycle was supposed to begin yesterday, but the doc found a large ovarian cyst on the right side. Cycle postponed. 😦
        The OCPs should suppress ovarian action & shrink cyst and then we’ll revisit this in another 2 weeks. I’m sending positive thoughts to you for an on-time cycle start. This is something I was somehow unprepared for, emotionally speaking. It’s hard to be all ready to go and then get hit with a red light. You must be almost done with your round of OCPs; true? I go back to the doctor for a re-check on 10/13. Then, we’ll see if the cycle can begin or whether we need to wait another 2 weeks. (Not exactly the 2ww I was expecting)!!!

  4. Ugh, I’m so sorry to hear that you have to delay!! I am so looking forward to my baseline ultrasound and blood work this Thursday and totally get why it would be annoying/upsetting to have to delay. I guess I should be prepared for the same kind of thing. The silver lining is that they caught the cyst, so it won’t be able to mess up your cycle though. Sending you positive thoughts that your cyst resolves and you can start in two weeks! Hang in there!

  5. Pingback: IVF Update: All Quiet on the Southern Front | no one asks about my eggs

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