# menopur / puregon?



## sue93 (Jun 14, 2006)

hi there - another question...

Does anyone know the difference between menopur and puregon generally? My consultant used puregon last time round (4 follies, 2 eggs, 1 embryo, 1 BFP, sadly 1 m/c at about 7 weeks). I've got my follow-up appointment next week and would like to ask him about whether any other drugs might produce more follicles.

I've read on a couple of these threads that menopur does better for us oldies, but does anyone know if puregon has worked better in some cases? - and if not, why don't they ALWAYS use menopur?

questions questions...

don't know what I would do without this site...

Sue
xx

oops - just noticed other thread about stimming - should have probably put this on there!


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## three_stars (Jan 19, 2006)

Dear Sue,

My last treatment at 45 with my own eggs earlier this year they put me on Menopur AND Puregon.  And I did get follies... but we have MF so did nto work.

It was from Fertimed in Czech Rep.  Have a google search and you will get info on their scientific names... they are often equivalents with other drugs you may have heard of or used before.  I know when I used the Menopur there was an alternative ( Menogon) but it was much more expensive and my RE said that he often got better results with Menopur.

Hope that helps.  I am sending you a PM as well.
b123


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## druzy (Jan 25, 2006)

Hi Sue - me again, you're probably sick of my views but these are my favourite topics!!  You've probably read the thread just below this "best stimming drugs for the over 40s" or something.  For both me and Dobby (who is at the same clinic at me) Menopure worked better.  I don't think anybody knows why, including the experts, but it does have FSH and LH in it and not just FSH as with Puregon.  I think Puregon is genetically engineered whereas Menopur comes from the urine of menopausal women (or nuns as my dr says) nice - but, what the hell, worked for me!  I think it's hard to prove what works better because for example in my case it "could" just have been a better month for me, maybe my FSH was lower (not tested so don't know) and "maybe" I would have responded better that time on Puregon anyway.  Unless there's been a proper medical trial on what works better in women over 35 nobody knows for sure and as far as I know there hasn't been.  I don't think you can ever get away from the trial and error in this game but getting an idea of other people's experiences is helpful I guess.   Although we can all react differently ..... personally, it does my head in!

love Druzyxx


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## sue93 (Jun 14, 2006)

hi there - never sick of your views Druzy! Guess I will pick the consultants' brain too - am always a bit wary of how they will respond to a patient suggesting how they do their job, but hey i'm paying a lot for this so guess I am entitled to be a touch assertive!

And thanks b123 for the info too - and the PM - will let you know if I'm interested! thanks for the suggestion and good luck both of you

xx


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## Ellie.st (Mar 11, 2005)

Dear Sue
I had Puregon in my first cycle then asked if I could be changed to Menopur for my next cycle as I had read it might be better for older women in terms of egg quality because of the LH it has in addition to FSH.  My clinic said that they felt there was no difference between the various stimming drugs and so if I wanted Menopur I could have it!

I certainly felt that I did better on Menopur in terms of egg quality though NOT egg quantity (which is perhaps what you are more concerned about).  On the other hand, a few good quality eggs may be be better than more lower-quality ones.

With Puregon, I got nine eggs, five fertilised, and I got one Grade One emby and one slightly fragmented one.  With Menopur on my second cycle, I got eight eggs, five fertilised, and I got two Grade One eight-cell embys and two good 6/7 cells.  (Cycle Two was a Day Three transfer rather than the Day Two transfer I had on Cycle One).  On my third cycle I stuck with Menopur, only got four eggs (it was a nightmare cycle because of a cyst) but three fertilised, all were Grade Ones and I got my first-ever BFP in more than 9 years ttc.  As Druzy says, it may not have been down to the change in drugs, however, as there are so many other variables too.  I don't think that there have been any conclusive medical trials one way or the other.

Menopur is a bit trickier than Puregon as you have to mix powder with solvent rather than it coming ready to inject. However, it is pretty easy after the first time, and I preferred the syringes you use with Menopur to the Puregon pen which i found rather awkward to use. I have to say that it did seem to me that Menopur (from the menopausal nuns) seemed a bit less artificial than Puregon which is apparently genetically engineered (from hamster eggs, I think    ).  On the other hand, Puregon is meant to provide a purer form of FSH.

Not sure if any of this helps, but good luck with your follow-up consultation in any case.

Best wishes

Ellie


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## sue93 (Jun 14, 2006)

hi there - hamsters? nuns? what on earth are we all up to?!!

Ok, think I'll be keeping my consultant (un)happy for some time next week. So far it's: menopur/puregon? PGS? Blastocysts? Are they normally quite happy for you do have done your own research or will I face a stroppy consultant? he's generally been great - if reserved, which suits me fine - but am (ridiculously I know given the amount of money I've been handing over) rather nervous about my followup appt...

Sue xx


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## Ellie.st (Mar 11, 2005)

Dear Sue

I found the doctors at my clinic were generally quite pleased when you asked knowledgeable questions.  However, I would ask the questions regardless of the reaction you get - and keep going till you feel that they have been answered fully.  My advice would be to write down a list of questions and mark each one off once you feel it has been dealt with - and keep going until all of them have been marked off. (This is what I have done at my follow-ups and it worked, even though I am rather nervous of doctors and find it difficult to be assertive with them).  

It might also help to take some notes of the answers you get and/or what they agree to do for your next tx (do this either during the consultation or straight afterwards).  I found that otherwise I ended up wondering what exactly was said - and even though DH was there with me, he could never remember the details.

The main thing to remember is that it is your treatment and your chance of a baby, and that the doctors are there to try to help you. This includes discussing all options with you, so that you are able to come to an informed decision.  

Good luck

Ellie


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## sue93 (Jun 14, 2006)

thanks Ellie - good advice about the notes, wouldn't have thought of that but think I will just go blank otherwise. And I guess how he responds will probably dictate whether or not I stay with this clinic, come to think of it. So a good test, in a way.

You are right about the other half tho - Stewart doesn't seem to hold ANY of the information in his head (generally unless it's to do with engines or boats he doesnt'...)

thanks again all of you

Sue
xx

[br]: 18/08/06, 09:44hi all of you - well just had follow-up appointment and feel ok about staying with the same clinic I think.

Went along with notes (thanks Ellie!) and consultant was more than happy to discuss all the options which made me feel even surer about staying there. He's suggesting maximum dose of Puregon (which apparently is what I had last time), followed by adding in Menopur too in the second half of stimming.

He was generally fairly downbeat about my chances tho (but he always has been, oddly I rather respect it in him), not so much of conceiving as carrying to term.

But what the hell, I'm going ahead anyway month after next (DP has hol with brother organised for next month. I'm restraining myself from demanding he cancels it - and am trying the art of diplomacy as he's come round quite happily to trying again, after being totally opposed 3 weeks ago).

Any suggestions with how I could usefully use these 2 months?? Anything else I can do (am going back to acupuncturist next week)?

To be sure tho I will probably get myself an appointment at the Lister just to make sure it feels right. Does anyone know if they will see me without a GP referral, just to talk through the options?

thanks again for all the advice

Sue
xx


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## Ellie.st (Mar 11, 2005)

Dear Sue

Glad to hear your appointment went well.  Sounds like you have a good consultant there.  Worth hearing what the Lister have to say as well, though, probably.  (Sorry, don't know about the referral protocol). It is good that he is being realistic about the odds (conception and carrying to term) but, as you say, that doesn't mean that it is worth trying.  (I was told our chances were less than five per cent before we started our third cycle).

Re the coming two months, if you have/can get hold of a copy of Zita West's book "Fertility and Conception", I would suggest following her recommendations for the next couple of months re supplements and diet etc.  I also took a bee pollen supplement which is meant to help egg quality (and the acupuncture won't do any harm either).  I really don't know if any of it really makes a difference but it won't do any harm and you never know ...

Best wishes

Ellie


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## sue93 (Jun 14, 2006)

hi Ellie,

have just had that very book delivered this morning so will give it a go. Thanks for the bee pollen idea too. Am prepared to try everything (if only to give me something to do, instead of spending all day on FF... it's ruining my productivity at work - joys of self-employment...)

thanks again - congratulations on your bfp - that's briliant news. Enjoy it!

Sue
x


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