Posted by: njanja1

Dear doctor,

I’d like to know if Decapeptyl is the right choice for a low responder and would you use it in ovarian stimulation of a low responder? I’d appreciate your answer very much. I am planning 5th stimulated IVF, and responded badly in all 4 previous ones. My AMH is 0.8 and my LH is 6.90 IU/L. The stimulation plan is the following: 300 IU of Puregon in the morning, one Decapeptyl in the evening together with 150 IU of Merional. I have read somewhere that Decapeptyl is bad for low responders and I’d like to hear your opinion before I ask for stimulation change.

Thank you very much.

 Answer by: Romana Dmitrović, MD, Ph.D.

Dear njanja1,

Your question requires a complex answer. Low responder protocols are still a challenge and there is no universally accepted protocol. Rather than that, each of us looks for the best solution and we experiment using our knowledge and expertise in attempting to help such patients. The antagonist-based protocol is considered likely to have better results than the agonist-based protocol that is planned for you, but it is also possible you have already undergone one of those in your previous 4 attempts with low response and your doctor may have opted to change it. Also, I believe that your AMH values are expressed in mg/L which motivated your doctor to use this high dose of gonadotropin (the equivalent of 6 ampules per day) in order to achieve best possible results out of this stimulation. Anyways, if your doctor knows you well, he/she surely knows the reasons for suggesting such protocol and such dosage. It would be best to talk to your doctor to learn more about this.

Best regards,

Romana Dmitrović, MD