Poor responder

I know I just wrote an entry about an hour ago, but it was more of a filler entry and not that exciting. While watching the finale of Dr. Who (woot) I started googling things and some how ended up reading about estrogen protocols. That led me to reading about poor responders and as I was reading things I was like HEY! THAT IS ME!! Check this out. I found a chat transcript from a doctor who defined a poor responder as this:

1. Generally less than four follicles – Check
2 – E2 less than 1,000 – Check
3. A history of cancelled cycles – Check again

I think he was describing a ivf cycle as I don’t think I would want an e2 of 1,000 or so many follicles for just an iui, but still! I have never had more than one follicle to try with by trigger time. Here is another definition that talks about how you can work with someone who is a poor responder. I started googling poor responder and found a post of a girl that sounded exactly like me. Check this out. She had to have her period induced, barely bled, injected for a really long time, and her follicle wouldn’t grow past a certain point so she got cancelled. Sound familiar?

I have to do more reading and some of the reading is above my head, but it’s exciting. From what I have read so far it seems like most of the stuff is for people doing ivf so that doesn’t really help and I don’t know much about the meds and the different protocols for ivf. However, it seems like you need to be more aggressive and a lot of the time RE’s use estrace or something similar. My RE has been pretty against giving it to me which kinda annoys me. I also don’t know my fsh levels or if I fit into the definition with my hormone levels or antral follicles. My RE is always so careful to give me just enough medicine and not more than that so I won’t go overboard with the follicles and get too many. He is so conservative. I do know that I am always slow to respond and need more than just the normal protocol that they give people. I’m going to do more research and see if I can bring in evidence to him and see what he says. More reading to go. Anyone know anything about it or anything?

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20 Comments

  1. That would be me, too! I’m starting an estrogen priming protocol right now. (It’s an IVF cycle.) I’ll be using an estrogen patch. Also, no Lup.ron. No BCPs. Nothing to contribute to over-suppression. Last time my cycle was canceled my E2 was only around 117. I am really really hoping this protocol works for me. Happy to share more if you need more info – feel free to email me! 🙂

    • I hope that this protocol does work. I may email you about it 🙂

  2. Yah, I am a slow responder- my Lupron IVF was cancelled. The estrogen (antagonist) protocol worked MUCH better, stim-wise. Hope your RE is open to considering becoming more proaactive with you, if that is what you’re leaning towards!

  3. I hope your RE does something more than what he’s been doing, bc clearly, what he’s been doing is NOT working. Grrrr. He needs to have a more-open mind, I guess. Otherwise, you need to find another RE who’s going to be more aggressive with you (and it’s never fun to find another doc). 😦

    On a different note, I read in your last post about your re-design. I’m very excited to see what she comes up with for you. It’s so funny/ironic that you’re getting a re-design bc I was literally just talking with my hubby yesterday about getting more involved in WordPress design and I was telling him that the only blogger I knew of that I could possibly volunteer to practice on is you. But, of course, we’re talking a few weeks (or more) away before I would learn it anyhow. And besides, I would have to tack on a few weeks of therapy for counseling to get over my strong dislike for WordPress, in general. ;p So, this way is better. And, maybe I should take this as a sign that WordPress and I should never become friends. In all seriousness, I am really excited to see your makeover. I’ve seen her work in the past, and I’m very impressed. She was on my short list to do my design before I decided to just learn it myself. I know it’ll look awesome! 🙂

  4. I also just finished an IVF cycle with the estrogen priming protocol. It definitely helped my lining, but I’m not sure that it did much for anything else.

    I’ve definitely read a lot of information where EPP is very helpful to poor responders. Have you thought of getting a second opinion with another RE? It might be worthwhile to see an RE who is less conservative.

    • I have thought about getting a second opinion, but I’m in a small state and not sure who else there is close by. I also have such a good deal in that my re is soooo close to where I work.

  5. FCblacksheep

    Wow, I think the research you’re doing is great. You do seem to fit the definition. Hopefully once everything is presented to him, he’ll take action or at least change the strategy up a bit to try something different. Good luck and happy researching!

  6. Sarah

    You need to be your own advocate and don’t be scared to push or ask for a second opinion.
    You know your body best and if you follow your gut it will send you in the right direction!!

    Good Luck
    ICLW #97

  7. I’m on day 5 of my first injectable cycle and I am so worried I won’t have any follies (we can only work with the left as my right side is useless) or I will get to many and they will cancel my cycle. IF is so stressful! I hope you can come up with a new plan with the RE that will get you a BFP soon!!!

    Happy ICLW!

  8. Hi hun! So, so sorry your cycle got cancelled, but I’m hoping that maybe the information you’ve found out from researching will help them to make the next cycle work for you! Good luck sweetie!

  9. I think poor responder only applies to IVF attempts. You are on a super low dose of Follistim to make sure you don’t over respond. I hope your RE can find the medication combo that does the trick…enough follies, but not too many!

    • You may be right, but I have been a poor responder with the clomid and the femara as well. So it seems to apply to most of it with me.

  10. I don’t have any information for you, unfortunately, but it sounds like you are well on your way to figuring some things out….maybe a 2nd opinion from another RE? I wish you the best of luck! Happy ICLW (#78)!

  11. This research seems to be giving you hope and question your doctor’s lack of initiative and aggressivity to tackle the problem. That’s good ! Keep it up, good luck !
    Happy ICLW

  12. Hope you have found some great info! I am the exact opposite as you. Well, I didn’t have anything from Clomid and I overstimmed on injectables in May (17 follies) and got cancelled. Then had cysts and had to sit out a cycle. Now I am starting again on a lower dosage and hope that I respond “normally”.

    I wish you the best of luck!
    ICLW#40

  13. Sounds like you might be onto something….definitely push with your doctor if you’re concerned. I had to do that with my RE and when they listened and did what I suggested that was the cycle that finally worked: GOOD LUCK!!!

    Thanks for commenting on my blog.

    ICLW

  14. wow, such great research! hope everything works out for you!

    *iclw 🙂

  15. Stopping by from ICLW. I think you need to be your own advocate and get a second opinion. Your doctor should use your FSH, age, AFC and possibly AMH to determine your course of treatment. Especially of you are going to do IVF. DH and I saw a local doctor and didn’t like them at all. She seemed intimidated that we were so educated on IF. We got a second opinion with SIRM in Las Vegas and decided to cycle with them even though it was 2500 miles away from home. Well worth it. When it comes to something like this you don’t want to waste time and money on someone who might not be a good fit for you.

    Check out SIRM’s website. http://www.forums.haveababy.com. They have doctor forums where you can post questions and get information. They also offer free phone consults, so you may want to consider that just to get some more info to take to your RE.

    Best wishes.

  16. It just seems like your RE should get the light bulb that the rest of us are seeing! What he’s trying isn’t working! Please do feel free to look around and see if there’s another RE who can give you a second opinion. You’re guy has a lot of groundwork to build on, but it just seems like it’s time to try something new.

  17. Wow! Amazing research. You are a perfect example of how a patient can be their own best advocate.

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