http://www.srm-ejournal.com/article.asp?AID=8348

A 35-year-old woman visits your clinic after several unsuccessful attempts at ovulation induction (OI) elsewhere (including 2 cycles of Clomid). You start her on Follistim, 50 IU/d, with microtitration. She produces one follicle; no pregnancy results. In her second cycle, you switch her to Bravelle, 75 IU/d; she produces 2 mature follicles and has a positive pregnancy, which results in a missed abortion due to a trisomy. In the third cycle, you give her Bravelle at 150 IU/d for the first 3 days, then reduce the dose to 75 IU/d. She produces 4 mature follicles; no pregnancy results. What is the next step for this patient?

Participating faculty:

• Wendy Shubin, MPAS, PA-C,(Moderator), HRC Fertility, Encino, California
• Jennifer Barocas, RN, FNP, Reproductive Specialists, Mineola, New York
• Patricia Jossim, RN, Florida Institute for Reproductive Medicine, Jacksonville, Florida
• Moya Laskowski, RN, The Advanced IVF Institute, Naperville, Illinois
• Margaret Post, RN, Valley IVF Center, Paramus, New Jersey
• Jackie Zagami, RN, Shady Grove Fertility Clinic, Annapolis, Maryland

This supplement is supported by a grant from Ferring Pharmaceuticals.