Monday, November 16, 2009

Announcing A Protocol Change

Lupron Mini-Flare

Anyone, anyone... Bueller?

Anticipating no negative results from today's bloodwork (thanks to a recent seminar advocating checking progesterone and estrogen even with the pill) it looks like I'll probably start twice daily 0.1 unit Lupron on Friday and then add a combined 450 units of Menopur and Bravelle on Sunday. That's 1.5ml of fluid with a total of 6 vials of medication added. Yikes!

On the up side - no welt-inducing Ganirellex will be needed. Yay!

Since I've never done Lupron or Bravelle before, is there anything I need to be aware of as far as possible side effects, etc? If you've done a Mini-Flare after a combination of Follistim/Ovidrel/Menopur have you noticed any difference in quantity/quality of the resulting eggs?

Yet another trial. Hopefully this time there is no error.


  1. I'm currently on 600iu combined meds (450 menopur/150 gonal-f) plus ganirelix. Let me know you, it's one burny, potent shot!! That Menopur has a nice sizzle ;). I felt like a mad scientist the first time I combined them all.

    I think I might be doing a flip-flop of you. Last cycle I did EPP with very little results. This time no EPP but much higher Menopur and much better results (relatively speaking). What I've come to realize is that there is no "right" protocol, especially for poor responders. Every woman's body is different and I think there's alot more at play than even the doctors realize. So twekaing each cycle is critical. I hope your RE has gotten the cocktail right for you this time!

  2. My IVF was a lupron flare protocol with Bravelle. It is a bit of a pain to get the full dosage into the needle (have to mix the powder with the saline and then bring up into the needle) and it does sting when going in. My nurse's advice, which seemed to work, was to actually inject it slowly, even though I always wanted to push it in as fast as possible. But doing it slowly helped decrease the sting.

    One time we just couldn't seem to get all the bravelle out of the vial and therefore I was concerned that I wasn't going to inject the full dosage. So we decided to throw the whole thing away and start over. Fast forward to a few days when I needed to get a few extra dosages of Bravelle and found out it is really expensive (even with my insurance coverage). Needless to say, don't waste any of it!

    Good luck and let me know if you have any more questions about the Bravelle. I feel like I became an expert!

  3. P.S. Lupron for me was very easy. Easy to measure, easy to inject and I didn't have any side effects.

  4. I hope this switcheroo does the trick!

    I never did the micro-flare, but I have been around the block a few times with lupron. I expected terrible side effects, but I had exactly... none. I'm pretty certain I'm a freak of nature, but it is possible to have no side effects.

  5. I've never done a 'flare' (honestly- don't know what it references) but I have used Bravelle for my last cycle (and tomorrow, I begin it again, yea for CD3). It stings. I don't know why, or if it helps if you go slow, my husband give me the injections (I'm to much of a wuss), and he barely can do them- so he 'gets it over with' as soon as possible... If you have the prescription for the Q-caps, that makes the mixing SOOOO much easier! You don't use the syringe/needle to mix it. The first few times I had a friend of mine that was an RN help me, and even she had problems with it (that was before we realized what the Q caps were for). You've got my normal e-mail so if you want more info, let me know! I'll try to remember to take a picture of what the Q cap looks like. Also- as for side affects- for me it was just about the same as Clomid (though my husband thinks worse... I think it was jut the fact of getting shot up every day for SO many days that wore on me, after we had done three other 5-day rounds of other drugs on that cycle). I'm not sure about better egg quality with Ovidrel, but my first cycle was with another drug (can't remember the name) that was left over from my last RE, and nothing happened, this past cycle I triggered with it, and got pregnant (but lost it- damn clotting disorder!) I guess we will know this cycle if it's a pattern. Sorry- this got long, e-mail me if you have questions :)