To Lupron or Not to Lupron? Help!

Standard

It’s been a while since I last posted – mostly because life has been busy.  Hectic and busy.

 

I’ve now had my hysteroscopy – there was no polyp.  Some stray tissue, but no polyp.  I am unsure how one’s body gets “stray tissue”, but that is apparently gone now.  Which means I am ready to proceed – theoretically stims will begin next week.

This doctor wants to try a slightly different protocol.  She wants to do the injectibles, but with no lupron.  Not using lupron means we have the chance for premature ovulation.  Premature ovulation means we lose the $2,500 we will have invested in the cycle at that point. And we will have to start a new cycle.  Here’s the problem:  I don’t have another $2,500 after this.  I’m kind of against the wall financially after the $45,000  we have spent on this.  There are no more secret stashes – this is it.

On the other hand, isn’t it the definition of insanity to keep doing the same thing over and over and expect different results?  And didn’t I switch doctors because I wanted to see if they had a different approach?

Seriously, this is the most I have ever stressed about whether or not I want to take Lupron.

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11 responses »

    • She has me on 150 IU Follistim a day, probably for 9 days. If follicles are ready, trigger, then IUI. After mentioning my concern about premature ovulation, she said she would give me lupron if I want, but she wanted to try something different. So, I guess it’s ultimately my decision…. I’ve been on long lupron several times….probably 6 cycles on long lupron – including both IVF and several IUIs. I’m 34. I’m really torn.

  1. I would appreciate some links. I am not familiar with that. On long lupron, I generally have between 4-6 follicles. Twice I got pregnant – both time miscarried due to genetic abnormalities in the fetus.

  2. Lupron
    Lupron is not recommended with immune system issues because it increases NK cell activity.
    http://www.ncbi.nlm.nih.gov/pubmed/20367626
    http://www.ncbi.nlm.nih.gov/pubmed/8692508
    http://www.ncbi.nlm.nih.gov/pubmed/9170480
    It could be because Lupron decreases estrogen levels and estrogen suppresses NKa.
    Although this study doubts it:
    Results indicate that the standard GnRH-a treatment for endometriosis and uterine leiomyoma might increase NK cell activity. The etiology of the increase of NK activity with GnRH-a treatment is likely related to factors other than E2 concentration.
    http://www.ncbi.nlm.nih.gov/pubmed/10394096

  3. Birth control pills
    It is good to be on bcp’s prior to cycling as the estrogen and progesterone in the bcp’s reduce NKa and inflammation.
    Bcp’s also help avoid lead follicles so that at the beginning of the cycle all the follicles start at same sizes and there will be more even growth of them and hence more of the eggs will be mature at trigger.
    However, bcp’s do suppress quite a bit, so if there is DOR, and no overlap with Lupron (such as in an A/ACP protocol), then the bcp’s might oversuppress and stunt the response too much.
    http://haveababy.com/fertility-information/ivf-authority/birth-control-pill-ivf-outcome/

  4. Estrogen
    It is good to be on bcp’s prior to cycling as the estrogen and progesterone in the bcp’s reduce NKa and inflammation. For this reason it is useful to also supplement with high doses of estrogen after ER.

    A significant inverse relationship was observed between natural killer activity and serum estradiol levels, which resulted in moderate and severe disease (r = -0.4, p = 0.009) but not in stages I and II.
    http://www.ncbi.nlm.nih.gov/pubmed/7502688

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