Dr. Edward Ramirez is the medical director of Monterey Bay IVF, a women's fertility & gynecology center located in Monterey, California. He hopes to provide those who read his infertility blog with insights into the latest advances in women's health & infertility issues. He respectfully shares his knowledge as a specialist with women and men from all over the world. Visit his center at www.montereybayivf.com
Jamaican Woman Doing 1st IVF Confused About Meds: Possible PCOS Misdiagnosis
I am about to do my first ivf with a clinic and I got a lsit of medications that I will have to use/purchase. I am a litte uncertain about one of them - menopur. The list has over 40 vials of 75iu. I am certain that this is a mistake.
I will of course be asking the clinic but I wanted to be certain. I have had two iui - failed previously. one on clomid with three follicles gretaer than 10mm and one with menopur 150 with about 4 or 5 follicles. This is why I am uncertain about the quantity of menopur on the list.This medication represents the most expensive item on the list and I wouldn't want to order this many at once.
Again, I will be clarifying but I needed additional research/opinion. I have pcos and was diagnosed with endo, had a laporoscopy, ovarian drilling, suppression after lap etc etc
Thank you. KL from Jamaica
Hello KL from Jamaica,
I cannot tell you if this is the right dose or not because it depends on the protocol your doctor has you on. But I can make the following comments:
1. PCOS patients tend to be very sensitive to medication and therefore require less medication to stimulate. For that reason alone, I would be skeptical, as you are, of the amount of medication ordered.
2. Menopur is NOT a good medication for PCO patients (if that is a correct diagnosis) because PCO patients already tend to have an increase LH level and the additional LH in Menopur is not needed and will lead to the risk of ovarian hyperstimulation syndrome (OHSS). I will usually either use only Follistim or will use a very low dose of Menopur less than or equal to 75IU. However, given that you only had 4-5 follicles with Menopur 150IU before, I wonder if maybe the PCO diagnosis is not correct?
You definitely need to ask your doctor regarding these concerns.
Dr. Edward J. Ramirez, M.D., FACOG Executive Medical Director The Fertility and Gynecology Center Monterey Bay IVF Program www.montereybayivf.com Monterey, California, U.S.A.