# No response to highest dose of Gonal F



## CGSM74

Hey,

Just joined and in desperate need of some advice.

I am 38 with low AMH levels. Started our first course of IVF in Jan. on 300mg of Gonal F. Only saw 6 follicles on day 3 ( but we weren't expecting loads) however, not a single one had grown on day 9. Advised to stop but we carried on till day 11.

Sadly no change so abandoned cycle. Devastated as been told that in all honesty all drugs work the same way and if I haven't responded to one then why would I respond to another ? Also I was on the highest dose so no where to go from that.

We have a follow up appt at the clinic on Monday.

Look forward to hearing any similar stories and any advice.

PS. Just ordered DHEA in the hope that it may help


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## Maisyz

Hi, sorry to hear what happened. My last cycle was a Gonal F one and was also a disaster (in my case I had a follicle which went mental and was massive by day 4 so had to cancel). Have you ever had a short protocol using Menopur before? In my previous cycles I had short protocol with Cycloprogynova priming followed by Suprecur and Menopur, all cycles produced embryos and we got to transfer etc so I prefer that. Next cycle we're doing a combo of Menopur and Gonal. If I was you I would ask why they don't use Menopur in case it works better for you. Have yo had your amh and lh tested, if not I'd say probably worth looking at.

good luck x


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## sallyliz

So sorry to hear about your cancelled cycle. 

I was in a similar situation this time around and thought we would have to cancel - I started on 300 Gonal F and had no follicles by day 6 of stimms, but by day 12 I had 4 follicles and luckily for me they are still growing although my consultant has increased my dose to 450 Gonal F which I think is the maximum, not 300. Due to go for EC on Monday which will be day 18. 

It's always hard for people with low AMH knowing how you'll respond. For my last cycle I used a combination of menopur, fostimon and clomid (plus cetrotide to stop me ovulating early) and had a much faster response with 5/6 follicles on day 6, but still ended up with only 2 eggs at EC on day 12. I'm hoping that a slower response will mean more eggs for me, but it shows that people can respond very differently with different combinations of drugs, so it would definitely be worth you trying a different protocol.

Best of luck xx


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## CGSM74

Thanks for that. Just our first cycle and we just went with what they advised us. Don't really know about all the drug combinations but I will be asking them on Monday - I have booked our follow up appointment.

It's all so confusing and hard to get a straight answer from people. But relieved to know that we still have options (the nurse started talking to us about egg donors and adoption on day 11 and I just can't even begin to process that just yet). Feel like we've failed miserably but not even being able to get off the starting line !

Plus they also implied that if my hormones AND the ones they gave me didn't work then they couldn't see how turning off my hormones first would help .... Which I think is the long cycle ? I just don't know !

AMH was tested but not LH. And they haven't done any blood tests to see how my hormones are reacting. Hubby is absolutely fine, it's just my biology apparently .... Which was very helpful to also hear on day 11 while we were falling apart !

Good luck with your cycles too !!
X


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## Sunnypal

Hia, 
Sorry to hear about your last cycle. It's so hard when you get yourself all geared up and excited, only for it all to fall apart. I've had a similar experience. I used to respond ok to Gonal -F, always slow but would get there eventually. Then after my DS was born it seemed my body no longer responded at all! I was on long protocol, on 450 iu Gonal F and after 15 days only got a few eggs, all poor quality. On my next cycle, same thing, 450iu Gonal F for 16 days resulting in a few poor eggs and no fertilisation. 


I then tried short protocol, and stimmed with 300 Menopur and 150 GonalF. Much better response, 8 eggs and a BFP for me! 


Please speak to the consultant about changing your drugs, or combining them. I've heard so many stories about poor response to one and good response to another. It's worth a try   


Good luck! Xxx


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## CGSM74

Thanks for giving me some hope !!!

I will most certainly be asking for different drugs and will ask about all the combinations above too. Fingers crossed they will treat me and it will work.

So great to hear good news  and good luck too !

Xxxx


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## Lil Elvis

Hi there,

I've just dug out all my old paperwork and checked my protocols because 300 didn't sound that high a dose. 1st was 375 GonalF for 7 days, dropping to 300 but adding 75 Menopur and second was 450 GonalF for 7 days, dropping to 375 and adding 75 Menopur. I had more than a dozen follicles each time but they were very slow at developing - each cycle it took me 17/18 days to get a single egg! As all my other levels, including AMH, were far better than my chronological age would suggest it would seem that I am a very bad responder - apparently one of the worst cases my clinic had seen. Your dosage certainly wasnt high and 11 days isn't that long either! I would definitely question what has happened and if you don't get a satisfactory answer I would change clinics. Also very unusual that your other hormone levels weren't checked before starting treatment - that is usually the starting point. The nurse was also over-stepping the line in mentioning either donation or adoption - that should only come from the consultant after reviewing all the particulars of your treatment and whether a different protocol and mix of drugs might be more effective.

I hope you can get some answers.

Caroline


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## CGSM74

Hi Caroline,

Thank you so much for doing that ! I really appreciate your help and advice. Feel so confused and muddled and useless about the whole thing. Also made to feel like I'm being so unreasonable and may as well just ask for the moon.

I will be going to my appointment on Monday much better informed and with a load of questions. I think if they aren't supportive and forthcoming with some solutions I will be changing clinics as I feel that they have been quite negative ... Considering we are only on our first cycle and haven't even begun to explore any alternatives ! 

Thank again and here's hoping for a miracle !


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## Wraakgodin

to FF, CGSM74!!! Have a good look round the site, post in whatever section you want and make yourself at home. There are so many sections here with a huge amount of information, so whatever you are going through there will be someone here to help you.

I am glad the other ladies have come along and given you some advice and hope. I am so sorry to hear that your cycle was cancelled, there is a "Poor Response to Treatment With Low AMH/High FSH" section ~   CLICK HERE  , the ladies there might be able to help you as well.

Here are a few general links that might be useful, either now or in the future.

Complementary and Holistic Approaches - CLICK HERE The sub board of "Supplements & Fertility Friendly Foods" has a lot on DHEA.

IVF General chat ~ CLICK HERE

Regional ~ CLICK HERE

What Every New Member Needs To Know (includes a list of common abbreviations) ~   CLICK HERE

Our live chat room has a new member chat at 8pm on Wednesday. Here is our Chat Zone section which will give you info on other chats: CLICK HERE

Please feel free to ask more questions here, or on any other part of the site, there will be wonderful helpful people there to give you lots of support, information and cyber hugs if you need it.

I hope your appointment goes well on Monday.            

Sue


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## CGSM74

Thank you !

Clinic have had to rebok us for a Wednesday appointment ! So two more days to wait and it's driving me nuts. Just want to get some answers and options so that we can begin to think about and move forward.

Hate them in between, limbo, not knowing anything time.


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## CGSM74

Well we are going again ... Next cycle which should start on Sunday ? So straight in there. They reckon sometimes it is worth it to see if the drugs from the first cycle sort of give the ovaries a boost. But if this doesn't work then they said it was no point carrying on. To be honest we have been told that isn't likely it will work anyway ...... But if we wanted to give it another go ... Then do it next cycle.

Only upping it to 375 of Gonal F as they said again that it wouldn't be any point as it is the max dosage ? They wouldn't give me Menopur as said it wouldn't make a difference ? Really don't believe them after some of what I have read on here.

Not sure how to feel ... Nervous, excited, petrified, hopeful ...... Just dealing with it by putting it to the back of my mind !! Yeah right !!!!! If only !!!


Had the scratch today too which was horrid but every little helps.
Xxxx


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## Lil Elvis

It's good news that you can go again but it must be doubly tough when you don't have full confidence in your doctors. It is hard going, but clinics can never foresee how we will respond - they just have to use their experience to offer the best advice they can. They will be trying as hard as they can to get a good outcome for you. Hold onto that thought and you will make it out the other side. 

Caroline


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## CGSM74

Thanks Caroline,

Am hoping but trying not to get my hopes up too much.

They also spoke to us about using donor eggs - which I see you have done. Clinic in Alacante. So something to consider if things don't work out. 

Have quite mixed feelings about that. Was a no to begin with but I maybe coming round to the idea slowly. Any advice on that would be very very welcome as I don't know anyone whom I can speak to about it.

Hope all is well with you !
Christina
Xxx


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## mccrea74

Maybe you should look at a low stim or even a natural cycle? Some girls with low AMH, including me, respond far better with lower doses of GonalF. Also down regging was very bad for me, just seemed to switch everything off.


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## CGSM74

Hi mccrea74,

I did ask about that but they said that with gentle stim they just don't get the eggs !!! Which again I just don't believe ! It's almost as if this is what we do with these meds .... And if it doesn't work it just isn't going to work.

They did say the same about down reg that it would switch everything off.

Oh we'll. we are going again with this clinic, but if it doesn't work I think we make look at another clinic who are more open and willing to consider different ways to treat me.

Just telling me that my ovaries are not going to produce any more eggs seems to be their out !

Xxxx


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