Menopur only protocol for stims?


#1

for our 3rd IVF attempt my RE is suggesting I try using only menopur for stims (no gonal F, no follitism). The nurse told me this protocol is more expensive and that it has not worked for anyone yet, which makes me angry as to why it’s be recommended for me if it has never worked.

Anyone out there tried menopur only protocol? or know of anyone who has? what were the results?


#2

Why is your dr doing this if its never worked? I would get a second opinion…


#3

I did a Menopur only stim cycle. I saw everyone else was getting a mix but the said I didn’t need it. It worked so I guess not.


#4

I forgot to add my results

I stimmed for 9 days. 5 days on 225 (3 bottles) and 4 days at 375 (5 bottles). I got 17 eggs, 15 fertilized, I put in 2 AA hatching blasts and froze 10 AA hatching. One of mine split and I had triplets but lost one at 7 weeks so now I am expecting twins!


#5

[quote=reston100]for our 3rd IVF attempt my RE is suggesting I try using only menopur for stims (no gonal F, no follitism). The nurse told me this protocol is more expensive and that it has not worked for anyone yet, which makes me angry as to why it’s be recommended for me if it has never worked.

Anyone out there tried menopur only protocol? or know of anyone who has? what were the results?[/quote]

They are all pretty much the same thing: FSH.

Menopur also has a very small amount of hCG in it to provide “LH activity”. The recombinant products (Follistim and Gonal F) don’t have any “LH activity”.

There is no reason why a Menopur-only cycle can’t work. Some might argue the merits of why it’s better or worse than some other protocol for certain patients. It seems your doctor thinks it’s best for you.


#6

I think menopur is just like repronex. They have both FSH and LH in them. I did a repronex only cycle for my only successful cycle. I was really irritated when my RE changed my protocol to follistim only and it resulted in a much crappier cycle all around. Also, if your RE is willing to use repronex instead of menopur, the repronex was much cheaper than follistim.


#7

[SIZE=3][FONT=Calibri]I have had two unsuccessful cycles with Long Lupron, so we switched to a new RE, Dr. Check (Cooper IVF, NJ). He is considered to be one of the best and is a personal family friend, so I feel confident that we are getting excellent care and decision making. For this cycle, Dr. Check stimmed me on 225 Menopur for 10 days and added Cetrotide on day 6 (I believe). I also did another 225 of Menopur the night of my trigger. Throughout my stimming, I had a large number of follicles due to my PCOS (about 30 ranging from 12-22), but we were not prepared to hear the RE tell us they retrieved 42 eggs today!!! I realize they will not all be mature and not all mature eggs will fertilize, but this is the best response we have ever had. Also, my E2 was 2200 at trigger and 3300 the next day, so well within the “safe” zone. Can’t wait to hear the fert report tomorrow! I believe Dr. Check chose this protocol based on the fact that he believed I was over-suppressed on Long Lupron, and because of my PCOS. Based on my response, I would say there is absolutely nothing wrong with Menopur only…good luck!![/FONT][/SIZE]


#8

[quote=Ghost]They are all pretty much the same thing: FSH.

Menopur also has a very small amount of hCG in it to provide “LH activity”. The recombinant products (Follistim and Gonal F) don’t have any “LH activity”.

There is no reason why a Menopur-only cycle can’t work. Some might argue the merits of why it’s better or worse than some other protocol for certain patients. It seems your doctor thinks it’s best for you.[/quote]

Not trying to be a pain, but this isn’t correct. Menopur is equal parts of FSH and LH with each amp being 75 units. Repronex is the same set of hormones, but in a less-purified form making it less tolerable in subcutaneous injections. (Follistim and Gonadal-F are both FSH only.) None of these contain HCG.

As for what works, it just depends on you and your response. My first cycle did great with Repronex (17 mature eggs). My second cycle totally bombed with the same drug. So, you just never know until you try!


#9

It’s funny. My first IVF failed where I used Menopur & Follistim mix. This second time around he did Follistim only. I have polycystic ovaries and am a high responder but perhaps not good quality since we had nothing to freeze first go around. Anyhow, I would be willing to guess that whatever strategy your RE came up with, he probably wasn’t smoking crack and he has his reasons.


#10

Thanks for the correction, but it was already correct. Menopur contains the equivalent of 75 IU of “LH activity”, which is not necessarily the same thing as LH. That mainly comes from the low levels of hCG, but there is also some residual LH, too.

hCG and LH activate the same receptors in the ovaries, so hCG is described as “LH activity”. The hCG is more potent, and longer-lasting too.

This is how the Ferring drug reps describe it when they come to the clinic. It’s also known pretty well within the industry.

It’s not mentioned in every description of Menopur, but it in mentioned in some. Here is one example:

Clinical Merit of Menopur in IVF

“…MENOPUR, a treatment containing both FSH (follicle stimulating hormone) and hCG-driven (human chorionic gonadotrophin) LH-activity…”

There’s more to be said, but that should suffice.


#11

I stand corrected. I guess I missed the “activity” portion of the Menopur and Repronex descriptions. As a physician, I must say that I find the Ferring boxes misleading…as my Repronex boxes clearly say that it’s FSH/LH 1:1. Technically…this isn’t correct! Amazing…

Thanks!


#12

[quote=lucyddr]I stand corrected. I guess I missed the “activity” portion of the Menopur and Repronex descriptions. As a physician, I must say that I find the Ferring boxes misleading…as my Repronex boxes clearly say that it’s FSH/LH 1:1. Technically…this isn’t correct! Amazing…

Thanks![/quote]

I’m not sure about Repronex, but I am sure about Menopur. I did not realize you were a physician.

Our patients on Menopur have detectable low levels of hCG, often just a few mIU/mL, but it’s there.


#13

This is fascinating info! I too am on a similar protocol. I am 34 yrs old and started 20 iu of lupron for about 14 days then stopped when AF began after having it induced by Provera. I began stimming for this, my first IVF, on day 2 of my cycle with 450 iu of Merional only and have continued since then. Is Merional the same as Menopur?
On day 5 of stimming, which was this past wednesday, I had my e2 at 1000 with several follicles (approx 8-10 per ovary) ranging in size between 0.6-1.3. Today I had sizes ranging from 0.9-2.4 with mostly 1.6s. Does this sound ok? I am waiting to hear if I am still set to trigger on Sun night with ER on Tuesday. Based on this info, am I progressing properly to expect trigger in 2 days?

Thank you!


#14

[quote=MamaMiawants2]This is fascinating info! I too am on a similar protocol. I am 34 yrs old and started 20 iu of lupron for about 14 days then stopped when AF began after having it induced by Provera. I began stimming for this, my first IVF, on day 2 of my cycle with 450 iu of Merional only and have continued since then. Is Merional the same as Menopur?
On day 5 of stimming, which was this past wednesday, I had my e2 at 1000 with several follicles (approx 8-10 per ovary) ranging in size between 0.6-1.3. Today I had sizes ranging from 0.9-2.4 with mostly 1.6s. Does this sound ok? I am waiting to hear if I am still set to trigger on Sun night with ER on Tuesday. Based on this info, am I progressing properly to expect trigger in 2 days?

Thank you![/quote]

Merional is another human-derived FSH product, roughly similar to Menopur. These are typically purified from the urine of post-menopausal nuns.

Sounds like your follicles are getting nice and large, to the point where many REs would consider a trigger. Best of luck.


#15

[quote=Ghost]I’m not sure about Repronex, but I am sure about Menopur. I did not realize you were a physician.

Our patients on Menopur have detectable low levels of hCG, often just a few mIU/mL, but it’s there.[/quote]

I based my first answer simply on the Repronex box! (It doesn’t say “activity” anywhere, at least in large enough letters to read!)

Repronex is the same in terms of the HCG contained…it’s just harder to find the “activity” word on the Prescriber Information sheet! The only difference that I can find after scouring the two inserts is that Menopur is designed for subcutaneous injections only whereas Repronex can be given IM or SC. Menopur has also been studied more and has some FDA approvals that Repronex does not.

Sorry for the confusion…


#16

[QUOTE=Ghost]Merional is another human-derived FSH product, roughly similar to Menopur. These are typically purified from the urine of post-menopausal nuns.

Sounds like your follicles are getting nice and large, to the point where many REs would consider a trigger. Best of luck.[/QUOTE]

Just wanted to say you were right! RE called today to say they are moving me up a day so Im triggering tonight and going in for an ER on Monday. They dont want to take a risk with premature ovulation since Im no longer on Lupron. Any advice on preventing OHSS? Also, they said their specialty is 3 day transfers…does this lower success rates?


#17

Are you at risk for OHSS? If so, you might ask your doctor about cabergoline.

Day 3 transfer is associated with lower implantation rates than day 5. Clinics generally compensate by transferring more embryos, on average, on day 3. The success rates vary a lot.


#18

I do not know if Im at risk or not. How can I tell that? At what point do I need the cabergoline? Im using Ovidrel as a trigger. The RE recommended transferring 3.


#19

My RE does mostly 3 day transfers. He transfers 2 for women under 37. His success rates are currently 60% ongoing for women in your age group…32-34. So, to me that doesn’t sound bad for a 3dt.
Good luck!!
:cheer: :cross: :cross: :cross:


#20

I did not mean to suggest you [I]need[/I] cabergoline. It is just one medically proven way to reduce OHSS risk. Only your doctor can decide if any prescription is right for you. If you are concerned about OHSS, you might ask these questions of your RE, and if he/she indicates there is some risk, then you might ask about cabergoline.