# IVF - Poor response Gonal F - any hope?



## monicatje (Apr 8, 2004)

Hi all,
I am aged 40 and on ICSI attempt no 2 and have just had my first scan after 7 days on Gonal F - 450 ius ( *maximum dose*). As in my first attempt ( dosage Gonal F - 300) I have only produced 2 folicles that have grown at all - currently 9-10mm and 1 other one that is very small. Last time they went ahead anyway with the 3 follicles I got then and from them produced 2 embryos ( Grade 1 and 2) which were put back, but unforatunately it was a BFN in the end.

This time I have to go back on Sunday to see if my only 2 eggs have grown anymore, otherwise the treatment will be cancelled.

I am so disappointed, frustrated and upset. My Day 3 FSH levels were 7.5 so I thought I would be OK this time. I wasn't expecting a lot but at least more than 2 small ones.

Is there anything else I can do next time? Is there a possibility that different stims will work better. My hospital ( in Holland where I live) only seem to use Gonal-F. Has anyone had this experience and still gone on to produce more follicles or is it just my age against me and with the same thing likely to happen next time?

Look forward to any advice here!
Monica


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## Ruth (Aug 6, 2004)

Sometimes it is recommended that a mix of FSH and LH is better for women with poor response, so a drug like Merional or Menopur may be better. Worth suggesting.

Sarah


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## Dee (Jan 27, 2003)

Hi Monica

Just thought I'd butt in here and hopefully give you some "hope" from a fellow poor responder.

I have IVF cycled 3 times with different stimms on each cycle ... menogon, menopur and then gonal f. On each cycle I responded poorly .... the most I have ever got is 3 follicles (2 on cycle 1, 3 on the other cycles) and each time I was "threatened with abandonment. My first cycle was actually converted to IUI as the clinic would not proceed to EC with only 2 follies.

Anyway, the positive hope that I can now send you is that even though I only had 3 follies on my last cycle ... I got 3 eggs ... 2 of which turned into first class embies. I am now just over 22 weeks pregnant!

So, my message to you is hang on in there, keep on hoping and keep believing that you can do this.

Good luck for Sunday

Love
Dee
xxx


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## MarthaF (May 19, 2004)

Dee you really are an inspiration to us all. I have seen lots of your postings but I hadn't realised from your bio that you had such a low response to the drugs. I had to abandon no 1 (DH has motiloty probs so they don't give us a shot at IUI!!!!) and with no 2 only had 2 eggs from 5 follies but both fertillised and kept on going. BFN at the end though unfortunately. Both times I have used Menopur (150 then 300). 

I have to say though, low responders do seem to get pretty good quality ones.....and that is what I am hoping for at the end of August. I will be on a short protocol with 600 (!) Menopur!!!

Good luck Monica & Liz 

All the best Dee!!

Love Martha xxx


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## MarthaF (May 19, 2004)

Correction!!!! Going mad!! I am going to have 450iu not 600 (although they have said that is the max they would take me to if I didn't do much next time). 6 AMPULES!!!

Just shown DH the site.....now he knows how interesting and supportive this site is!!!

Lots of love
Martha xxx


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## chick66 (Nov 18, 2003)

Hi there
On my first round if IVF, I responded very porrly to Gonal F on max doseage- infact I prosuced one immature follie and nothing else, my endometrium didn't even thicken! After te first few days it was obvious the Gonal F wasn't going to produced enough follies for IVF so like Dee, our was converted to IUI, but abandonned due to no follies, I was gutted at the time but funnily enough, I now look back and can laugh about it.

Second round of IUI, was put on menopur & clomid, again abandonned as producxe absolutelty nothing despite being on the highest possible doseage of both drugs.

Have since been told that there are other srugs which may work better though & if it weren't for the fact that my remainingovary is almost dead, I would be trying them like a shot.

I am sure it is ust a case of finding the right drug and doesage for you o stimulate with, hopefully with some inspriation from Dee, you'll make it very soon

Chick


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## monicatje (Apr 8, 2004)

Hi everyone,
Thank you so much for all your replies.

Dee - you have definitely given me some hope. I'm so gald for you that things worked out in the end. In fact, I agree about the quality thing becuase first time round despite only producing 3 eggs they got - 2 good embryos from these.

Liz - I have also tried both the short protocol ( first time) and now long protocol but unfortunately it hasn't seem to have made any difference.

However, it is interesting to know, Sarah, that some different drugs may make a difference, so I shall certainly discuss that with my hospital if this attempt doesn't go ahead.

Anyway, as everyone says it's the quality not the quantity that counts in the end so I will just keep hoping that my follies will have grown enough by tomorrow morning for them to continue.

Thanks for all your support everyone and I will let you know the outcome after tomorrow.
Love,
Monica


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## Rachel (Mar 10, 2004)

Hi Monica 

I have had 2 go's at IVF both with gonal f.

On my first cycle I was on 150iu for the first 8 days and a scan showed only 1 follicle. My dosage was increased to 300iu but unfortunately no more follcles grew and we had to convert to IUi at the last minute as my consultant won't do ec with less than 4 follicles. The result was negative.

On my second cycle I started on 300iu of gonal f and a scan at 7 days showed 1 largeish follicle and 1 smaller one. I was very disappointed but they told me to keep perservering. My next scan at day 9 showed that there were 4 follicles. The largeset one had grown aswell. I had to keep on plodding on for another 9 days (18 in total) and the four I had grew to a good size. Also, one more smaller one grew so ny ec day I had 5 reaonable follicles and 1 large cyst! We got 4 eggs and they all fertilised which was fantastic. Sadly the result was negative again.

I have been told that as I am a poor responder maybe I down regulate too well so next cycle I may not have to d/r at all. I'm not sure fully how this works yet but it sounds like a good theory to me!

Don't give up hope. As everyone has said, Dee is a marvellous inspiration to us all and proof that us porr responders can get a result too!

Keep your chin up 

Rachel xxx


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## monicatje (Apr 8, 2004)

Hi all,
Well - I had the scan yesterday and they have grown - I have 2 of about 14-15mm and 1 smaller one that they hope will still grow, although my lining has still not thickened enough but it looks like we're going on.. I have to continue with the Gonal F another 2 days and then back Tuesday morning for another scan.

If that is OK hopefully it will be EC on Thursday or Friday. 

Anyway, I am really glad that I'm probably still in with a chance and all this nightly stabbing has not been in vain!

Lots of love and luck to everyone,
Monica


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## Rachel (Mar 10, 2004)

Great news Monica ^thumbsup^

I know just how you feel. I was backwards and frowards for scans every 2 days too!! I began to think I should take my sleeping bag to the clinic and camp out!! 

Good luck 

Rachel xx


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## Dee (Jan 27, 2003)

Great news Monica!

Loads of love and luck to you for EC, great fertilisation and ET.

Dee
xxx


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## MarthaF (May 19, 2004)

Well done Monica

Good luck to everyone. I am really pleased I have found a group of people who seem to have similar probs to us because I was beginning to feel "different". I see so many others with really bad probs (no tubes, no sperm etc) and think most of the time that we are actually quite lucky but the fact that I am a low responder is nice to share. 
I have posted in a couple of other places as well.....low progesterone, luteal phase defect (mine is 10 days) and wonder if any of you have the same issues?

Thanks and best of luck to all of us.....

Love Martha
xxx


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## monicatje (Apr 8, 2004)

Hi Rachel, Dee and Martha

Well - this morning's news is that only the 2 follies have grown. The small one is still small and seems to have stopped growing. But they are OK to go ahead with the EC anyway- they gave em the choice. Of course, I am going to continue! I haven't come this far to give up now! So, EC is scheduled for Friday and so I have another 2 days of injections. I hope I can find a new place that doesn't hurt like hell to stick those needles in!

Thanks for all the support - it's been so great. Good to hear I am not the only "low-responder" around!

With love,
Monica


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