# Best stimming drugs for over 40's?



## kenbren99 (Mar 16, 2006)

Hi Ladies

I am only now allowed to join your club - turned 40 on the 29th July.  On the day of my birthday had 1st ivf et - unfortunately found out last Friday it was a BFN.

We will be trying again in around 6 months.  This time around started in June on 4 amps Menopur and had my tx cancelled as was not responding.  In July started stimming with 5 amps Menopur (the max my clinic allows) and got 8 eggs, of which 3 fertilised and were grade 2.  Not great, but not bad.

Which drugs would you recommend for our next cycle?  Also any other tips for increasing egg production/quality etc would be much appreciated.  And what should I be asking the Consultant at my post treatment appointment?  All advice greatfully received!

Many thanks.

Love and Luck.

Brenda x


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## Dobby (Oct 23, 2005)

Hi kenbren99 

I had 6 amps of menopur in my last 2 cycles and was told this was the maximum effective dose - I know some clinics use more than that (especially the London ones) but the Consultant I am with said it reaches a saturation point at 6, and using any more has no more effect at all.

I had read somewhere that menopur is the best drug for people over 40, as it contains two types of stimulating hormone rather than one, but I don't have any experience of anything other than menopur to comment really - I had menopur for both IUIs and both ICSIs.

As someone who only got 4 follicles and 4 eggs on both my cycles, I am deeply jealous of your 8!!  The clinic I am at say that they prefer to aim for 8 follicles as you can get more follicles but generally the egg quality isn't as good.  Although we had the same number of follicles on both cycles, the egg quality and fertilisation rates were much better the second time... but there was no change at all between the doses of drugs with each ICSI cycle - the only difference the second time was that I took low dose aspirin (75mg) each day, and had assisted hatching.  Even with my poor response, two of the three embies they put back implanted on my second ICSI, so perhaps it is just a case of you trying again to see if you get a better response this time?

Do you mind me asking why you are waiting 6 months to try again?  I am not being nosey, it is just that I have been told that every month past 40 makes a difference in fertility terms, so I am surprised you have been told to wait that long before trying again.

Very best wishes for your cycle....

Dobby


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## druzy (Jan 25, 2006)

I second what Dobby has said, in fact it was Dobby that suggested it to me!

I had 450 of Menopur on this last IVF and got 9 eggs, 8 fertilised, 8 embryos, 3 x grade 1 and 5 x grade 2.  The first cycle on 200 of Puregon I got 6 and 5 survived (chemical)  and on the second on 300 of Puregon I got 4 and 3 survived (BFN).....

I have also read that the combination of FSH and LH in menopur as opposed to just FSH in Puregon is better for the over 35s.  Quite a few other people seem to take Gonal F, not sure how that is for over 35s though?

I had 75 on Menopur on my two IUIs and got 3 good and potentially a 4th follie - so almost as good on the lowest dose of Menopur as the highest of Puregon.  

Not everyone reacts the same though, just to make life more complicated of course!

Best wishes

Druzy xx


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## kenbren99 (Mar 16, 2006)

Hi Druzy and Dobby

Thanks so much for taking the time to reply to me.

Will have to have around a six months wait because my contract runs out at work next June (hubby earns very little and I am by far the main wage earner in our house), so now have to job hunt and try to get in for a couple of months before getting pg.  Can't afford to find myself six months gone and out of work.  Also need to save again for treatment - how sad that the chance to become a parent comes down to money  .  Not sad to be looking for new job though, as hate my current job and my line Manager and her boss were both absolutely horrible to me last week on the second week of my 2ww - even though they are both women and knew about my tx and 2ww.  The stress caused by their abominable behaviour definitely did not help and I simply do not want to be there any longer.  In an ideal world, we would try again much sooner.

Also wanted to pick your brains (or anyone else out there) about what I should be asking my con about at my post negative cycle interview.  Should I ask about a short protocol or hatching etc?  What could be helpful next time around?  Any advice very gladly received.

Hope you are both well.

Love and luck.

Brenda x


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## Dobby (Oct 23, 2005)

Hi Kenbren99

I would definitely ask a more general question about would a change in protocol help with another cycle (e.g. the short), what about assisted hatching, and what would they recommend to increase your chances next time.

I had millions of questions to ask (I didn't exactly have a follow up appointment, just a long chat after the first ET with the Consultant sat on the end of my bed about what would we do differently next time, with him attempting to be overwhelmingly positive, and me attempting to be overwhelmingly practical!!)  but really these three cover just about everything!

Very best wishes to you

Dobby


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