Thread: ivf protocol

In all fairness, your doctor has examined you and knows your history better as well as there being a general difference of opinion regarding the issues of aggressive stimulation and over- suppressing patients.

That being said, I had a 42 year old in my office with normal day 3 fsh/e2 an AFC of 6 who I preferred to stimulate starting day 1 of the cycle to avoid suppressing her follicles during the recruitment phase of stimulation. I added estradiol to sensitize the follicles and used higher doses of gonadotropins again to try to recruit the maximum number of eggs. I suppressed with ganirelix after achieving 14 mm follicles and completing recruitment. I also pretreated her with DHEA for several months.

There is no right or wrong way to approach this stimulation but my preference is to more aggressively attempt to get the maximum number of eggs from a patient with diminishing ovarian reserve.

Thanks very much!