# Long v short protocol PCOS and high AMH



## rosebud5 (Apr 19, 2005)

Hello
I didn't know where to post this so I hope I have put it in the right place.  I have done 2 full rounds of ivf before (one of which resulted in our little boy when we subsequently did an FET).  Each of my fresh rounds have involved the long protocol.  I have PCOS and a high AMH and would initially respond very slowly, ending up on a high dose of gonal F and then almost overstimulating both times.  It would be like ... nothing nothing nothing and then everything would take off at the end, we'd be on the brink of the cycle being cancelled due to overstimulation and we then went on to have 18 or so eggs collected both times.  Our embryos were good quality 8 cell ones too. Although we were / are very lucky to have our little boy we are about to undergo another round of ivf.  This time the consultant has recommended that we do the short protocol.  Its odd being back to front - FETs have a lower success rate than fresh but they have worked better for me.  I recently had another pregnancy from an FET but sadly miscarried at 11 weeks.


Sorry for the long winded intro, but my question is this ... has anyone else in a similar situation to me been recommended to do the short protocol.  The dr mentioned it as an option and said its what he'd recommend, explained it but left the choice to me.  I don't really know what I should do.  Although the long protocol has not been a smooth process for me and at the fresh stage has not resulted in a pregnancy, it did get us there in the end via the FET and so I am kind of nervous about changing anything.


I'd really welcome anyone thoughts people might have on this.


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## sugarpielaura (Feb 23, 2011)

Hiya

I have severe endo, slight PCOS and a high AMH and was told that the short protocol was the way to go for me.  It is also so much quicker than the long one.  I D/R with the bcp for three months and then got started with menopur and cetrotide for the fresh cycle.  I was also on metformin to prevent OHSS.  

xx


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## lulu72 (Jan 8, 2010)

hi

I've been on the short protocol for all 3 of my tx's (same as you, PCOS and high AMH). My understanding is that the risk of OHSS is much lower with SP as you need lower doses of stims drugs than on LP (since you haven't turned off your own natural hormone production).

I had very mild OHSS on my 2nd cycle, so on my third cycle I started on 225 of Menopur for the first three days to recruit follicles than reduced down to 150 Menopur for subsequent days. Worked a treat - EC was around 10 days after starting stims and as you can see from my signature resulted in me expecting twins (with no OHSS)

Good luck!

Lulu
xxx


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## rosebud5 (Apr 19, 2005)

Thank you both so much for replying.


Sugarpielaura - I wish you all the best.  I read your treatment journal in your signature block.  You really deserve a BFP and I hope you get one very soon.  Many of the emotions you mentioned described exactly how I felt during our seven year wait for our little boy.  Keep going.  It will be your turn soon.  You are certainly in good hands at GCRM. 


Lulu - congratulations to you.  One of each!  How wonderful!  I hope everything continues to go well in the coming weeks.


Thanks again


xx


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## IVF WTF Girl (Jun 25, 2011)

Hi Rosebud and SugarpieLaura,

At my initial consultation last week, after my scan the consultant said that it looks like I have polycystic ovaries (even though I have zero symptoms of this and the most regular periods ever) so we are looking at doing the antagonist, short protocol. I don't know whether this is good or bad? 

He said that I was going to be put on antagonist because they thought I would stimulate too much due to PCO and the number of follicles they could see on my scan. I know that the consultant knows more about what they are doing than I do (obviously), but since we saw the consultant last week, I've started to worry, worry, worry.

They want to put me on a protocol that won't produce many eggs and then because I am only 30 (and most of the clinic's clients are women over 40), they will only put one egg back as they aim to not have multiple pregnancies. 

I only have enough money for 1 go and if it doesn't work out when we gave it the best try then (sadly) so be it. But to not do everything they can

So I guess I'm in a similar situation to you Rosebud. Should I push for the more normal, long protocol or stop trying to interfere?! Am I worrying too much??!!! Aaargghhhh!

Have you made a decision?

   To us all xx


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## sugarpielaura (Feb 23, 2011)

Hi IVF WTF Girl

I had the short protocol and am also 31.  I produced 10 eggs, 8 fertilised and were all of a high enough quality to freeze on day 3 but we pushed them all to blast and got 4 blasts out of it.  If you produces loads of eggs, it can also affect the quality.  I didn't question my protocol as believed that the clinic were doing the best for me.

Hope that you can reach a decision which is right for you

xx


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## IVF WTF Girl (Jun 25, 2011)

Hi SugarPieLaura,
Thanks so much for your reply. I was having a very down day yesterday and I feel a bit better about it all today. You were totally right in that they know what is best for you and I should chill and try and think the same. I guess when you have such little control over this whole making babies thing, you obsess about every decision made on your behalf!


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## rosebud5 (Apr 19, 2005)

Hi Ladies,


I've been totally obsessing about this point and so, IVF WTF Girl, I know how you feel.  I was thinking that perhaps this time around we should do something different as I'd heard about this different protocol (the short protocol) - but when the doctor came out and suggested it without me even mentioning it I then instantly began wondering whether it was the right thing to do.  I've now resolved that it is the right thing for me to do and I'm putting my faith in the clinic.  When I used the long protocol for my two fresh rounds I got lots of embryos - but because I came so close to OHSS on both occasions I think my body was under a lot of strain and those fresh rounds didn't work ... so lots of embryos isn't necessarily a good thing.  


I wish you all the best!


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## lulu72 (Jan 8, 2010)

Hi all

It's a bit heavy going but I found this article useful (when conversely I had a clinic telling me they would move me to the long protocol against my will!!): http://m.humrep.oxfordjournals.org/content/25/3/683.short

Hth

Lulu
Xxx

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


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## rosebud5 (Apr 19, 2005)

That' really interesting Lulu.  Thanks!


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## IVF WTF Girl (Jun 25, 2011)

Thanks so much Lulu, that is really good to know.

I think the moral of this story is that I should just shut up in the knowledge that the people who do this for a living know best!! 

I am a total control freak though, it's not my fault!   

x


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## lulu72 (Jan 8, 2010)

Hiya, 

Glad it helped. I felt really stressed on my last cycle as my stims were changed from Gonal-F to Menopuir and I was really worried that after such good initial results on my 2nd cycle (10 out of 10 eggs fertilised), I wouldn't do as well ... I needlessly worried as you can see from my ticker!! What I'm trying to say is that we all worry and want to do the best we possibly can to maximise our chances of success - sometimes it's worth making the leap of faith! At the same time, I think we are all entitled to question our consultant's logic / thinking in making changes to our protocols!!

Wishing you all loads of luck in your cycles

Lulu
Xxx


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