Polycystic Ovary Syndrome (PCOS)

lupron experiences and question(long)

Question:

<<We were given the choice by our RE to do an IUI without the HCG shot (in case we had actually spontaneously ovulated)… Why couldn’t you do the hCG shot, anyway??  I don’t understand. << I have not felt anything like ovulation pain or anything like that since stopping stims. Since you didn’t have the hCG shot, then it’s possible that you didn’t ovulate.  However, I recently did an IUI where I *know* I ovulated (and I had about 7 mature follicles), but I didn’t feel a thing.   [I know I ovulated because I came down with ohss, which can't happen unless you ovulate] << This is very disappointing to me because I ended up sitting a month out before this one….. FWIW, I have to sit out a month between *every* stimulation cycle, because I get cysts.  It is frustrating, and time is passing by and we can’t even "try". << I am wondering things like how and when it is taken, for how long, what it does, possible side effects? When, how much and for how long you would take the Lupron is something you have to ask your doctor.  Lupron is largely used for IVF, not IUI.  Yes, some people do use it for IUI, but I don’t think there’s a "standard" procedure for it. Possible side effects of Lupron include nausea, hot flashes, vaginal dryness, headache, fatigue, etc. I have used it 4 times, and experienced headache (all 4 times) and vaginal dryness (once).  I never had any other side effects. <<can anyone with experience tell me if you think my follicles shrank due to upping the dose….. No, I *really* don’t think a dosage increase would have shrunk them. You said your follicles continued to grow.  I am confused.  How much did they shrink by??  A dropping E2 level doesn’t necesarily mean your follicles are shrinking. <<…. or because I should take an fsh only drug or what. Well, I think that’s a possibility (if you’re talking about dropping E2).  I know that the only time I had dropping E2’s was when I used Pergonal (but I also became pg that cycle, too).  [I have PCOS].  But, I never had shrinking follicles.  Not ever. << Everything I have found says PCO patients should stim low and slow. Yes, but that’s because most folks with PCOS are hyper-responsive.  Clearly, you are *not* hyper-responsive, so this "rule of thumb" wouldn’t apply to you. I am an example of a hyper-responder.  *One* amp a day has given me 18 follicles. It is difficult for me to keep my E2 below 2,000.   I am very prone to hyperstimulation.  This is where the "low and slow" thing comes in.  It is to control hyperstimulation (and has nothing to do with poor response). Best of luck with your next RE visit, and let us know how it goes.  -Kay

Response:

I am currently on cd19 of a pergonal cycle.  I was taking 4 amps a day up until cd11 and then 5 amps on cd12.  My estrodial on cd9 was 96 and on cd10 lowered to 69.  My follicles continued to grow up until the last day after taking 5 ampules.  We were given the choice by our RE to do an IUI without the HCG shot (in case we had actually spontaneously ovulated) or stop the stims and try on our own at home.  My largest follicles were 1.6 at this point.  We opted not to do the IUI as we did not feel this was the case. Basically I really feel pretty bad about this cycle.  I have not felt anything like ovulation pain or anything like that since stopping stims.  I am remaining hopeful but just dont think this is the one.  My RE did not sound too positive either.  Anything can happen I guess.  My course of treatment has changed a bit for the next medicated cycle and I have a few questions.  The plan is to wait for my period and if one does not start on its own I will get a beta test and if that is negative a progesterone shot to make it start.  I am then to go in on cd3 of my next cycle to check my fsh and estrodial levels.  We are to sit this month out.  This is very disappointing to me because I ended up sitting a month out before this one due to irregular bleeding too.  Depending on what my fsh and estrodial levels are the plan is to take lupron along with the pergonal.  I am trying to find info on lupron on the internet but have not found a whole lot that I feel pertains to my particular situation.  So I am wondering about any experiences any of you may have had with lupron.  I am wondering things like how and when it is taken, for how long, what it does, possible side effects? Everything I have found regarding it which is minimal has not sounded too pleasant.  my other question is can anyone with experience tell me if you think my follicles shrank due to upping the dose or because I should take an fsh only drug or what.  Everything I have found says PCO patients should stim low and slow.  I have in the past taken 2 amps a day and had a very poor response, 3 amps good follicles low estrogen but not as low as this cycle, and this cycle 4 and 5 amps.  I just have to wonder if less wouldnt be better.  I will discuss this with him when I go in later but wanted some experineced opinions from fellow IF’s  first.  Any help or advice you can give is appreciated.   Sorry this is so long.  I am grateful if you made it this far. Thanks, Joni PCOS TTC 3 yrs m/c once at 7.5 weeks Lots of clomid 3 pergonal cycles 5 IUI’s

Response:

Filed under: PCOS Treatment

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