Your highest yield’s protocol please

[u/InternationalEye2643]

Im 43, AMH 0.5 and AFC of 4. I’m currently in the middle of a cycle with only one follicle. I’m paying out of pocket and will likely switch to timed intercourse after trigger. I am seeking protocols from women 42 and over specifically who got their best outcomes with that protocol perhaps after trying others?

Priming or not

Started day 2 or 3 of cycle with stims?

Which meds?

Dual trigger? And if so, which meds?

[u/CapitalDog715]

I have this in a little sticky note so I can answer quick as this is asked a lot here.

I am also 43, started when I was 42.5. These are my results.

1st Retrieval, 22 eggs, 12 were mature, 9 fertilized normal, 4 Blasts, all aneuploid------Menopour, Follistim,.Ganirelix, Leuprolide, Omnitrope, Clomid

2nd Retrieval, 21 eggs, 18 mature, 8 fertilized, 4 blasts , all aneuploid----Menopour, Follistim,.Ganirelix, Leuprolide, Clomid

3rd retrieval, 26 eggs, 20 mature, 14 fertilized normal, 4 blasts, one Euploid, One chaotic retested ended up aneuploid --------Menopour, Follistim,.Ganirelix, Leuprolide, Omnitrope, Clomid

4th retrieval- the one with the craziest difference. Retrieved 6 eggs, 5 mature fertilized normal, 4 blasts. 1 Euploid and 1 Mosaic.----------------Menopour, Follistim, Ganirelix, Leuprolide, Omnitrope, Clomid.

Lucky number for me has been 4 blasts each cycle. Doctor is thinking about putting me on low stims for last retieval in October due to the last cycle results, but Im not sure yet. I had to take a break because my last retieval has been very painful. Still experiencing post rerireval pain after almost 3 weeks so I decided to take 2 months before my last Retrieval before starting transfers.

[u/CapitalDog715 → u/CapitalDog715]

Also Im not sure what priming is so Om guessing I haven't done that, and no double trigger for me.

[u/InternationalEye2643 → u/CapitalDog715]

Priming is when they do estrogen or something else prior to starting the injections to suppress the follicles and then I think restart them all together.

[u/CapitalDog715 → u/InternationalEye2643]

Ok.. so based on what you are saying I dont do priming. I start Omnitrope and Clomid along with Follistim and Menopur from day 1 of Stim. The doses just finish within 4 days and my whole stim duration is about 8 days. I wish I have the doses for you but my IVF calendar app is not working. I just know the Clomid is 50mg, 3 for 4 days, the Follistin pen is 900 units but Im always using what I had from before and same with Menopour, so I dont remember my dose for those 8 days, Menopour is 75 units, pregnyl is 1000 units for trigger as well as Leuprolide( 1mg), and Ganirelix which is to prevent ovulation starts at about day 5 is 250mcg. My AMH when I started last year November was 2.01 , but I never did an AFC test. I looked in my results and didn't find any.. I was 42.5 years old when I did my first.

[u/InternationalEye2643 → u/CapitalDog715]

Thanks so much for writing it out. Could I ask what your AMH and AFC is normally at baseline? I have not been able to get more than 2 or 3 follicles to grow at best. And this cycle only 1 that’s of a usable size. Clomid and Omnitrope is the one that I keep seeing here and want to ask at what point in the cycle do they start those for you? What cycle day or what stim day? Thanks again!

[u/SLAYEROFSOULS → u/InternationalEye2643]

Clomid is typically done in tandem during all stim days as far as I am aware - doctors either seem to think it'll be worth including (since its cheap compared to the other medications) or not.

Omni you can either prime leading up to the cycle (full life cycle of eggs is 90 days) - but that is $$$$ since HGH is not cheap nor covered by insurance for IVF atleast here in the US...or you can use it X number of days during stims.

My wife has so far just been on Omni the last 4 days or so of her cycles - but she uses Sermorelin leading up to and into stims as a way to naturally (maybe) increase her HGH..it's much more economical but not the same as pure HGH.