BONUS 186: Poor Responder Protocols

December 21, 2018

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

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Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Raya is gearing up for the transfer of a PGS-normal embryo, but she’s been through several transfers, miscarriages, uterine lining issues, and genetic abnormalities. She asks if she can trust that her body will get back to normal after all the problems.
  • Gabriella has PCOS and has never had regular cycles. She has questions about post-ovulation levels, progesterone supplements, pinpointing ovulation dates, and response to medications.
  • Karen has changed clinics and encountered chemical pregnancies and miscarriages, several transfers, but no success. She asks if FET protocols make a big difference in implantation rates.
  • Angela has PCOS, is obese, and has a family history of high blood pressure. She had a successful pregnancy two years ago via IVF and asks if that success would increase her chances of pregnancy in the future. She also asks if IVF pregnancies are more prone to high blood pressure.
  • Meg asks if a low AMH level will mean early menopause for her.
  • Sarah has ultra-high AMH levels and asks if IVF is a good option or some other course of treatment is recommended.

Dr. Rodgers and Heather continue the episode by discussing everything you need to know about poor responder protocols:

  • How would you define a poor responder? Are there certain parameters you use?
  • Can a poor responder diagnosis be made during any type of cycle other than IVF? Why or why not?
  • Are there any supplements that might help treat the hormonal aspects that cause a poor response to ovarian stimulation?
  • Let’s talk about the various aspects of an IVF cycle, and how they might be approached for a poor responder.
    • Prep/priming
    • Pituitary down regulation
    • Ovarian stimulation medications and dosages
    • Newer therapies (HGH, etc.)
    • Newer approaches (luteal phase starts, DuoStim, etc.)
    • Advanced laboratory techniques (assisted hatching, preimplantation genetic testing, etc.)
    • Fresh vs. frozen and day 3 vs. day 5 transfers
    • Progesterone support
  • Is there any recent research about how to approach treating poor responders?
  • Do poor responders also typically have poor egg quality? Why or why not? (If so, are they more likely to have miscarriages — or no implantation at all — compared to the general infertility community?)
  • What should poor responders be asking their doctors?
  • Do you have any success stories you can share?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to listeners who’ve been told they are poor responders?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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