When I first started trying, of course I knew nothing about stimulation meds or how different drugs are used at different times. I went on a research frenzy, reading studies, slide shares, forum posts and Q&As from various doctors. It was all very helpful.
During the process we tried many different protocols and both high (very high) and low dose stims. I managed to squeeze out 3 eggs max regardless of how hard we pushed. Ultimately my success for my oldest son and for the twin daughters I lost was with a femara antagonist cycle.
My cycle looked very much like the picture above. I was almost always doing back to back cycles and needed both progesterone and estrogen to have a good luteal phase so also was almost always estrogen primed. I did do both natural start and primed and my response was the same. But after the estrogen my 3 follilces seemed to be more closely matched in size. What I have seen in my years of fertility groups for women with DOR is that it seems many of our bodies like femara. We do well with a little flood of our own FSH and LH then supplement that with just a little injectable of those and response as well, and often better, than we just shoot a high dose from the start. It seems counterintuitive, but it truly seems like too much drug shuts down a poorly or not optimally functioning ovary and it is better to coax out a few follicles rather than push for a bunch.
I love too that the femara antagonist protocol is a short and relatively simple protocol. Very straightforward. And since you are depending on a cheap oral med to stimulate your own FSH, with only some Injectables, it can be a lot more bang for your buck. It amazed me that I made the same number of eggs on like $1000 worth of meds that I did on $9000. That’s a lot less money per egg! And again, many people actually get more eggs with less meds.
For more great info on protocols, check out https://www.ivfmd.net/services/aggressive-ivf-protocols.
I truly appreciated this site so much when first learning and point people there all the time. They explain the different options in easy to understand wording. They are located around the Dallas area and I am in NY so I never consulted there, but based on their webpage they seem to know what they are doing when it comes to dealing with the special ovaries that belong to us DOR women. Other options like Microdose Lupron with birth control or estrogen priming, which many do well with also, are detailed nicely too. If you live near Dallas, would be a clinic worth consulting. (Super nice when I asked to use their materials on my blog too. )