# Anyone been a poor responder and had the antagonist protocol?



## FolicAcidIngester (Mar 23, 2012)

I'm thinking of suggesting the antagonist protocol to my clinic.
I'm doing one last OE try in the UK before going to Serum.
Peny has recommended this protocol for me but I didn't want to tap her for too much detailed info about it given that I'm not doing it first with Serum but here
So I was wondering if any of you ladies had had the antagonist protocol because they were a poor responder (not because of OHSS)
If so, what dose of medications, especially stims, were you on?
Also how many eggs did you get? More than usual/less?
Anyone do the antagonist protocol and still have high doses of stims eg 450?
Thanks FAI x


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## Belle0001 (May 15, 2013)

I have done 3 rounds, two with antagonist and one long.  Both antagonists (rounds 1 & 3) only led to two eggs.  Which is why we triedthe long version, which got 6 eggs, but only 2 fertilized.  

Each round we had two embryos transferred on day 3.  iVF#1 m/c at 6 weeks, other two were BFn.  So still no baby....  
Was on max doses of stims for all 3 rounds.

Not sure if that helps.....now considering DE after hysteroscopy & laparoscopy ..... Tomorrow!!!!


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## Val74 (Jan 3, 2015)

I struggle with the agonist/antagonist labels but think from Belles response antagonist is where you don't down reg first

If so I've done a mix. Did agonist my first two cycles, both Menopur, 300iu and 375iu. Four eggs first time, two mature, one second time, cracked zona so perished before fertilisation.

Next two were antagonist (I think! No down reg) due to poor response and I was an ovary down by that point. Still did high dose stims (the first time mix of Menopur and Bravelle). Responded poorly though, only two follicles and one was dominant, so cancelled and converted to IUI. Second one I went abroad and did 450iu Merional. Still only two follicles and one egg. 

Don't know what to do next  so trawling the boards for inspiration!  I'm dismayed to hear you saying that you're going to be recommending a protocol to your clinic, the money we pay they really should be more forthcoming with their expertise and recommendations I think. One of my biggest frustrations.

Good luck whatever you decide  xx


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## FolicAcidIngester (Mar 23, 2012)

Thanks ladies, I'd given up hope of anyone responding.
Interesting experiences and I agree it's hard to believe given the expense that we have to become the experts and 
advise the clinics rather than the other way around...
I had a phone consultation with Serum as I mentioned, Peny suggested an antagonist protocol but both the clinic 
I'm using and the Lister (i had a telephone consultation with them also and it was well worth it) said no to the antagonist 
protocol.
The lister advised using the same version of the flare protocol again which resulted in my son. With my recent failed
IVF attempt i had used a different flare protocol. If anyone's  interested i can explain their rationale (it wasn't just that
it had worked  before)

FAI x


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## Val74 (Jan 3, 2015)

Yes I'd be really interested to hear about your flare protocol, even flares in general  as I have no clue about them. Am having a hard time trying to convince my husband to double anything at the minute following a failed high stims cycle (tandem so with donor also). My AMH is under 1, what's yours? I emailed Penny too and she talked about natural/mild cycle for me as well as clomid  with possibly freezing until lining is improved. My last clinic advocated high stims as said I respond so poorly anything less is a waste of drugs and money.  My husband thinks I'm some kind of vigilante searching for answers myself. Have you cycled with the Lister before?  How much was a phone consultation with them? xx


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## FolicAcidIngester (Mar 23, 2012)

Flare protocols (also called 'short agonist protocols' are one of the things that are recommended for 'low ovarian reserve/poor responders' such as ourselves. Check out this document by the Lister which I found helpful:
http://www.ivf.org.uk/media/54653/Low-Reserve-or-poor-response-what-can-we-do.pdf

My AMH is 3.54
Most fertility treatments involve some down regulation which I think is to prevent you body from triggering ovulation itself before egg collection...and all of your eggs (I only got 2 last time) tumbling down your fallopian tubes and into your womb when there is no one there to collect them. With the first verison of the flare protocol I had daily down regulation which I guess must wear off towards the end of the 24 hours in order to need to be taken daily. With the second I had a single injection of down regulation which continuously blocked ovulation. With the first version of the flare protocol I got 5 or 6 eggs it wasn't clear and with the second I got 2. Now there was 2 years in between but still the Dr at the Lister thought I should have gotten more and thought the reason was the total block of the down regulator.

The Lister consultations cost 205 but mine only lasted about 35 mins and they charged me 150...very well worth it

FAI x

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## Altai (Aug 18, 2013)

Folic- I had both short antogonist & short flare with Serum. Thou short flare was suggested by Lister & I wanted to try it. 
My first protocol with Penny was 450iu ( mix of  altermon ( fostimon) and merional plus 2 letrozoles. Got 7 eggs (my absolute max), 5 were mature. With short flare 300 iu altermon - i got 4 eggs all mature. 
I also did tamixofen combo with 125-150iu puregon got 7 eggs on one cycle all mature. 

I think you just have to try different protocols & drugs to see which one suits you.


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