A comment today on this post reminded me that there's a bright side to being at the last resort after all. I mean, the last resort is Ganirelix. Which means? No Lupron.
Admittedly, I don't know a lot of women who've done an antagonist protocol, and even fewer women who have done a Lupron protocol followed by an antagonist protocol (most women I know who've done ganirelix have simply started out there), so truthfully, I don't really know how the side effects are going to compare. Maybe they'll still suck. But I'm guessing that I'm not going to be describing headaches that slice through my head like a piece of broken glass. I mean, that was pretty graphic and gruesome, wasn't it? Ick!
It's bound to be better than that, right?
Admittedly, starting the Ganirelix protocol requires me getting my period at some point. And my dear, sweet period is still MIA, which, I must say, is definitely not amusing.
Honestly, there simply *must* be something interesting to say about waiting, but there just... isn't.
Hey, so, have any of you out there used Ganirelix? More importantly, have any of you who have used Ganirelix also used Lupron in the past? How do they compare (specifically with regards to side effects)? I'm thinking of posting this question to the LFCA in my copious spare time, but, um, you all know about me and my copious spare time. I've got so little copious spare time that I haven't even managed to put one of those handy dandy little buttons in my sidebar that says "post my news in the LFCA" which would make it super easy to just go and do it now, wouldn't it? And in the space of time it took me to type this little paragraph about how I don't have time to go post this in the LFCA, I could have popped it into Mel's google spreadsheet. Or picked up the phone and called Mel and told her I'm too lazy to post it in the LFCA and could she please do it for me? But no. I'm not as industrious as Mel. I, as they say, am lazy.
Tuesday, July 21, 2009
The Bright Side
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19 comments:
I'll do it for you, oh lazy one.
I have used both. Lupron over-supressed me the first time. Then, I tried the MicroLupron (or Lupron Flare) protocol and got somewhat better results, but nothing great. The last 2 times I used Ganirelix (Antagon) and had much better results. I think my ovaries are sensitive to suppression (since they suck and all), so I think they preferred the Ganirelix method better. The specifics of how these 2 drugs work is VERY different, so I hope this does the trick for you!
Here in Australia many FS go straight to antagonist cycles. Personal experience - GREAT! Such an easy cycle, and so quick - 8 days of stims, 4 of Ganirelix and we were there. Ganirelix hurt a bit as a shot but no nasty side-effects here. I have been told of the good effects on egg quality and in my case it seems to hold true - 12 eggs collected, 8 mature, 8 fertilised, 5 to good blast quality (1 tx, 4 frozen) and 2 of the others got to morula or blast (not freezable) Also my E2 levels stayed lower than they would on other kind of cycles and EPU and recovery was good. YMMV but a huge fan here...
I too did a Ganirelix cycle after doing Lupron and even though the shots hurt a bit more, for the most part the side effects were not to bad.
I have used Ganirelix and the side effects weren't bad. It gave me headaches, but you don't start it until later in the cycle. I haven't used Lupron, so I can't compare for you.
I have used both as well, with less side effects from the Ganirelix. Same # of eggs produced, but better quality. In fact, the quality was so much better that now I get to go on Lupron again for a FET. Yippee.
Best to you.
I started on the Lupron protocol, but it induced cysts in me the size of small melons, so they canceled it and
I did an Antagonist cycle. Lupron for me meant HELL. I was bloated, crabby, swollen, and had terrible headaches. With the antagonist, I never noticed any additional annoyances besides ovarian pain and some bloating... which is to be expected with the stims.
I know SO many people who've had better embryo quality on antagonist. No platitudes, but I am juuuuuust sayin'. Thinking of you.
My first cycle wasn't with Ganirelix but it was with Cetrotide which I think is somewhat similar. I know I didn't have to take Lupron the first time out. I don't remember headaches too much. I think I did have some minor just sort of there ones but they were more related to me not drinking enough water.
As a low-responder, I've only done Antagonist cycles: 8-11 days of Follistim/Menopur combo with Ganirelix on the last 2-3 days, so no Lupron comparison. As for side effects, Follistim gives me a wicked headache, and Ganirelix makes me want to claw off the skin on my belly for about a half hour after the shot. But nothing after that.
Good luck!
LFCA
Hello... I had 2 cycles with Ganirelix. Both cancelled either before retrieval or Transfer.. switched to Microdose lupron (no Ganirilex).. did not start out any better, but after 6 days in things took off (well as much as they can for a poor responder!) I had 10 retrieved, 9 mature, 8 Fert and transferred 3.. So for me, lupron was better, but really every one is different... Lupron was more annoying to shoot up with, but the needle is smaller (I think) than ganirelix... the ganirelix stung for me after going in... I could not tell the difference in side effects though.....
I used both (Ganerelix for my fresh cycle, Lupron for my FET). I had terrible side effects from Lupron. It made me sad and angry all of the time.
I had absolutely no side effects from the Ganerelix. Plus, I only took it for 3-4 days, rather than the weeks I was on Lupron.
I had a much better experience with ganirelix (and Centrocide), as I feel I was over supressed with Lupron. I started in on day 5 of stims and took it for 4 nights, including the night of trigger.
No side effects except for a little stinging at the injection site.
Lupron = 6 eggs
ganirelix (3 cycles) = 8/10 fert, 8/10 fert, and 11/11 fert.
The only problem for me wast that the suckers are about $100 a shot!
Good luck!
Yeah, I was going to express surprise at your FS because those protocols are really popular here, often as the first choice. Other doctors prefer to stick to the tried and true protocols but don't hesitate to go for this one for the "unusual" responders (ie low and high) - used a lot with PCOS.
It never ceases to amaze me how much of this stuff is just fashion/unscientific preference. Synarel vs lupron. Crinone vs pessaries vs PIO (eg the US docs all seem to want PIO - nobody uses it at all in Australia and success rates are about the same...). My FS admitted the biggest factor was the quality of the lab taking care of the embryos, not the drug protocol or anything else. Actually, I think it was a colleague of his I saw once. But patients don't like hearing that because they can't change what's happening in the lab (although they could change clinics) so they don't tend to say it out loud.
Bea
My first cycle was with Lupron which completely oversuppressed me and I was cancelled. Cycles 2-4 ended up being Ganirelix cycles and all three of those went to retrieval and transfer. I didn't notice any side effects with the lupron, but I can say that I didn't have any issues at all with the Ganirelix either.
I really hope that the last resort does it for you. I know how hard it is to struggle with cycles that result in a less than desirable ending.
Agreeing with everyone else. I used ganirelix for my cycle with my own crappy eggs. No side effects to speak of. Used lupron for my first donor FET. Sheer HELL! Lupron is the devil. For my 2nd (and successful) FET I took the chance of no suppression and just used oral estrace, adding progesterone a few days before transfer.
I used both. Lupron's the worst. It was a long time ago, but I think my emotional side effects were less with the Ganirelix.
Good luck.
I did 2 fresh with Lupron and my
3rd fresh with Ganirelix. Although my ER #'s were almost identical all 3 times, my fertilization rates and egg quality were significantly better on Lupron. The Ganirelix cycle was very disappointing for me - embies crapping out all over the place. I barely had anything to transfer on Day 3 and we never would have made it to day 5. Good luck!
You've had loads of comments now, so I don't really need to add my very good experience with the short protocol after being oversuppressed on a lupron-equivalent long protocol (UK docs seem to use buserelin instead). Academic studies show equivalent results between the two for most groups, other than PCOS where you need to control poss overresponse. No diff in egg quality or pregnancy rates or take-home baby rates, which makes me wonder why anyone is still doing the long protocol as it's so much of a pain for the patient compared to the short one. With the short one it's done and dusted in a month, it's easier on your body as you don't go into menopause (so no migraines etc.) Think the docs are just stuck-in-the-mud.
I used lupron first, then ganrilex. both worked for me, from a suppression standpoint. i much preferred the ganrilex. no headaches, hot flashes, etc. the shot burns a touch when you do it, but that's it. b/c you start it so much later, it made the whole IVF process feel much shorter and easier than the long lupron protocol. i hope you also like the ganrilex!
Mo
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