Typically, a poor responder is someone who meets two of three criteria: they have collected three or fewer eggs on a previous cycle, is over age 40, or who has a diminished ovarian reserve (antral follicle count below 5 or an AMH below below 0.5). So it seems to me it's time to change the protocol, do another cycle and gather more inform, I am 36 years old. It's possible to pay with credit card or Western Union, but PayPal isn't an option. - Longdom It's hard for me to say definitively because I haven't had wtf yet. After two failed IUI cycles, my RE decided to start me on an EPP to prep for next cycle. OHSS can be both painful and dangerous. ER sept 29th - 11 follicles, 9 eggs retrieved Though I had 4 or 5 follicles to begin with, only ended up with one. If you feel a message or content violates these standards and would like to request its removal please submit the following information and our moderating team will respond shortly. It's an estrogen priming protocol. What To Do When PGT-A & Grading Results Conflict? Thanks for well wishes. Estrogen priming through luteal phase and stimulation phase improved ovarian responsiveness and this may lead to an increase in pregnancy rate in poor responders with failed cycle. It helps your lining and encourages your eggs to all grow at the same rate. This comes from a 38,000 patient European registry. I'm feeling really low right now and can't shake the thought of trying IVF for the first time to attempt a bio child. - 1st follicle check u/s and b/w. However, the study has two major shortcomings and for that reason most experts arent ready to concede that rates of gonadotropin over 300 IUs per day is harmful. Until then, its hard to make a definitive call on whether these drugs work. Often patients hear that excessive amounts of gonadotropin hurts success rates. That data comes from an analysis of over 700,000 IVF cycles run by well-respected investigators at Stanford. Estrogen priming is pretty standard for over 40. High FSH. My friends did this estrogen priming protocol and highly recommend it and were successful. Around 50-60% of couples find success with IUI after 5 cycles, which is about a 10-20% success rate per cycle. Dont know what. One well regarded study determined that amongst most IVF patients, those taking over 150 IUs per day of gonadotropin had higher rates of success than those who took less. Do they use this protocol as sort of standard for someone who is starting? I have hypothalamic anvolution, DH normal. Ramped up to cycle on BCP for two weeks and Lupron 10 units 2x/day on stims. Dr Sher says "oestrogen priming of FSH receptors has been reported to slow premature follicular development and to promote granulosa cell FSH receptor induction". Today, were seeing more well-respected doctors choosing to compliment lower dose of gonadotropin with clomid or letrozole in this group. I just had my ER last week: stimmed for 13 days, started ganerilix on stim day 8, retreived 7 eggs, 3 were mature, 3 fertilized, 1 blastocyst was frozen today on day 5 and I have 2 morulas that will bhopefully be frozen tomorrow as long as they are blastocysts. Can you try to conceive the cycle that you estrogen prime? Before starting the pills, we need to wait until you are in the correct stage of your menstrual cycle (the luteal phase). I would be doing a low stim protocol with estrogen priming. This is done by administering estrogen, typically via an estrogen patch or an injection, sometimes along with additional Gonadotropin-releasing hormone. I am about to start my 4th IVF cycle. Note that once you confirm, this action cannot be undone. Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. We're not even 100% sure we are staying with my current clinic but I wanted to research ahead of time either way. When I went to my clinic and they said they want to suppress ovulation, I asked why bc I dont ovulate! Male factor, probably DOR and I am a poor responder to IVF drugs Second, this study was only done in cycles using a fresh transfer. As you can see in our summary below, there are multiple drugs that can perform these two functions the one thats chosen dictates the protocol strategy. These include estrogen, FSH, LH and inhibin amongst many others. I started epp with cetrotide x 3 days. As a result, a woman needs to start the process with many eggs. Confirmed. Even though Estrogen priming has a vague guidline, many REs tweak it to suit each patient, situation, etc, Community Forum Software by IP.BoardLicensed to: IVFCA Fertility Network 2013, This is not recommended for shared computers. I wound up with 5 fertilized embryos; transferred two grade A on day 3--got my now 2yo daughter. I will have retrieval hopefully this weekend and will let you know what happens. However, weve yet to see a large, rigorous, prospective, randomized trial on the subject. With this you get results by day-3 and can transfer embryos at that time. May I ask what your AMH was? Hey Michelle, you should never feel bad to ask! (Not so) Short summary - DH and I have been ttc since May 2015, two early m/c. The dose of gonadotropin matters because, generally speaking, if too little is prescribed, too few eggs are retrieved, and IVF success rates go down. As we show in the example below, during every step of IVF a certain number of eggs or embryos are lost, especially in the middle part of the funnel (growing embryos that are chromosomally normal). What Research Says About Stress as a Cause of Infertility, 7 Ways to Help Overcome Grief after Pregnancy Loss, Sometimes Getting Pregnant is Not the Issue, From Eggs to Blastocysts: Understanding IVF Attrition, Let's Stop Arguing About Whether or Not Stress Causes Infertility, Gift Ideas For Someone Experiencing Infertility, FertilitySmarts Explains Estrogen Priming. maternal age" i.e. I'm 35 and going through my first IVF cycle. Terms of Use -
Below you can see that when investigators gave poor responders 450 IUs or 150 IUs per day, the groups had nearly identical success rates. My first aIVF cycle was cx'd , due to poor/slow response and was probably due to the Birth control pills and lupron. I am curious what anyone's experience has been with EPP. No it's not a "low dose" protocol exactly. If you did it did you have success, what is your situation, did you do pills or patches and for how long, etc.? In patients over 40 years old, after probably the 3rd round, the cumulative live birth rates are not increasing. Our usual regimen is similar to those proposed below: hysteroscopy, prolonged estrogen priming, Estring for local effects, baby aspirin, vaginal phosphodiesterease inhibitors, pentoxifylline, acupuncture, etc., with admittedly little data to support any of our treatment strategies. Thanks! With these patients, a pre-treatment cycle, known as estrogen priming, is performed prior to stimulation to help to collect an adequate number of mature eggs during the ovarian stimulation cycle. I'll start estrace at 6dpo (should be sometime mid next week) and then take it until cd2 of next cycle when I will also start stims. Hope you feel better soon! We respect everyones right to express their thoughts and opinions as long as they remain respectful of other community members, and meet What to Expects Terms of Use. After 2 years, tons of tests and 5 IVF cycles, it still feels unreal.Estrogen Priming protocol does not have birth control pills. After seven long years consumed by infertility I am finally moving forward, wishing my son was with me, but grateful for the two children I have here with me. My first IVF cycle I was on the antagonist with stims started on Day 3.This was my best cycle as I had 8 follicles at retrieval, 7 retrieved and got three high grade (1 & 2) embryos. Then I started stims on a Friday. Transfer was canceled. My story: I'm 34, DH 32. Estrogen priming also allows the patient and clinicians to schedule the ovarian stimulation cycle and the timing of egg retrieval. Ultimately, for only a handful of patient types has one protocol shown itself to be superior to the others and we profile those below. Did not cover diagnostics like doppler test (40 copay but insurance might have covered this), communicable testing ($400 per person), and specialty meds . Beta 2093 Babies due June 26, 2011 Experience with Estrogen Priming Protocol? We're also doing PGS. Many customers have had positive experiences ordering from them, and their customer service has been praised for keeping buyers updated on order status. Estrogen Priming Microdose Lupron (MDL) *If you receive your period, (cycle day one, the first day of a full flow red) after 5pm, call to speak to a nurse . For many gardeners, it starts with tomatoes. Estrogen Priming Protocol- EPP Experiences - Infertility Inspire Finding a Resolution for Infertility Infertility at 40+ Finding a Resolution for Infertility Infertility Support Community in Partnership with RESOLVE Join Inspire Create a Post Estrogen Priming Protocol- EPP Experiences drgolfermd Aug 14, 2015 4:53 AM Dear All: Women with premature ovarian failure (POF) or diminished ovarian reserve (DOR) tend to have lower success rates with traditional IVF protocols. I did estrogen priming after my first Ivf cycle ended in mc (nothing to freeze) & my 2nd cycle was canceled bc I wasn't responding well to stims. that cycled failed. I did EPP my second round of IVF. I just had a consultation with an RE he recommended a "estrogen priming micro-flare lupron" protocol. He usually gives the BCP before overlapping with lupron as a way to lower FSH and LH. ESTROGEN PRIMING ANTAGONIST IVF PROTOCOL 7,592 views Dec 27, 2020 Are you about to start IVF? I had success on an EPP. Hi. (51.2% vs 25%; p = 0.047) were noted. Comparing the good cycle to the other 3, I see why. I did EPP with my 3rd cycle and it didn't help. First, the analysis was retrospective and not prospective. The Ukrainian Tribute Growout is a great opportunity for tomato lovers to get their hands on some unique and delicious varieties. And finally I triggered with Novarel. They studied what happens when you replace gonadotropin with clomid (a cheaper, less potent alternative) for a few days before the retrieval. By clicking sign up, you agree to receive emails from FertilitySmarts and agree to our Terms of Use & Privacy Policy. Estrogen priming is usually matched with an antagonist to prevent ovulation. Fortunately, there are a few steps you can take to prevent and. I'm not sure what your stats are, but Check seems to have had some good success with women over 40 who have high FSH, so I'd say go with him. Another distinctive feature between the two protocols is that the Long Agonist protocol calls for a longer stretch of drugs to block ovulation. The dr decided to put a halt to the process for that month. Below is a meta-analysis of 17 (relatively small) studies that, taken together, show the strategies have nearly identical pregnancy rates. BFP October 22!!!! The #1 app for tracking pregnancy and baby growth. Thus, for those most concerned with OHSS (like women with PCOS or high AFC or AMH), this can be an inferior option. Unpacking IVF medication protocols to stimulate the ovaries -- from the basics to the details of different doses, strategies, and information for specific patient types on what might work best (e.g. I was long Lupron and that one was cancelled because my precious RE only saw very few follies. I started my estrace this morning and feel a little icky so far. FET October 6, 2010 - this is it think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. Estrogen priming refers to supplementing women with extra estrogen (estradiol) during the luteal phase - that's the last two weeks - of the prior menstrual cycle before beginning ovarian hyper-stimulation for IVF. IVF #5 was EPP and HGH. This amounts typically to a Coke vs. Pepsi kind of decision. This educational content is not medical or diagnostic advice. Learn more about. Had three chromosomal miscarriages last year, moved on to IVF with intention of genetic testing but had to cancel cycle a few days in, E2 never got above 36 while on max dose of 300 Gonol f and 300 Menopur. As you can see below, success rates dropped. November 8 - we're having twins:) Wow!!! I then did 450 gonal-F and 150 menopur for 12 or 13 days, using ganirelix as well. The meds alone cost $5,400. 10 retrieved, 6 mature, 6 fertilized (half with ICSI), transferred two 8-cell embryos on day three (both with moderate fragmentation, graded B and C-), the four remaining arrested by day 5. So, I'm 39 with Amh of 0.07 (undetectable) and FSH of 9. I'm 40, doing IVFdue to age and a mc at 10 weeks due to Trisomy18. Now this is a guesstimated number. As a result, its hard to correct for confounders like the fact that harder cases may (or in our minds, probably) had been given more drug and so the underlying condition, rather than the dose taken, contributed to the lower rates of success. I'm now 19 wks pregnant with #2 from embryo from same batch. Changed MD's and now this is the protocol they have in place for me. President, ASRM DS was born June 22nd, 2007!!!!! After 5 days of estrogen priming Follitropin alpha (Gonal F, 600 IU/day, s.c.) is started. Thanks for sharing. I did a low stim ivf (225 menopur & 100 mg clomid) with human growth hormone which is what my fertilty clinic does for women over 40 and poor responders. Just devastated with my results today so just want to cry it out and then I will respond to you. Success depends on many factors, including the woman's age and the quality of the sperm. Similarly, many doctors believe low dose approaches work equally well as high dose approaches on women who are likely to be hyper responders. These are women who have a high AMH or had a high number of eggs retrieved in a previous cycle. But there is one more protocol to consider: a flare cycle. While gonadotropin is the critical drug in most every protocol, its not the only drug. Some people prefer the term Diminished Ovarian Reserve or Low Egg Reserve for patients who meet this criteria, as the ovarian response to medications for this group is not always necessarily poor, but rather is simply expected to be lower at their given baseline. This drug works indirectly by prompting the brain to produce more gonadotropin to signal the ovaries to grow follicles -- so it's not directly stimulating the ovary. These drugs perform the opposite duty of suppression. First, make sure your seeds are dry before sending them in. Julie, will be KMFX for you and those embryos! The hypothesis is that if we treat patients prior to starting their IVF cycle with estrogens ( the estrogen priming protocol) or androgens ( such as DHEA) , they will produce more eggs because more follicles will be recruited when we start the superovulation . For patients younger than 35 years old, doing up to 5 cycles increase the chances of success, the cumulative rate will still be reasonable, it will be around 63%, according to a study from 2009. Any success stories for low responders of Estrogen Priming cycle? There are two downsides to this protocols: The long duration of injections (they start the previous cycle) and. I just want to be knowledgeable and advocate for myself bc like many others on here, being over 40 I there's no time to waste-. IVF#5 July 2010 - will be using estrogen priming This website uses cookies for functionality, analytics and advertising purposes as described in our. They are generally used for suppression in Long Lupron Protocols. Infertility Support Community in Partnership with RESOLVE. xx, Oww Hun, please dont worry about me, look after yourself, here if you need a listening ear xxx. The misoprostol was not expensive; on average, it's about $30. Buy Organic Seeds Risk Free From Organic Seeds TOP - Credit Card & Western Union Payment Options, Organic Seeds TOP is a seed vendor based in the Ukraine. I might have ovulated rather than had empty follicles. However, that information will still be included in details such as numbers of replies. This is not recommended for shared computers. I was recently on micro dose EP protocol and while I had sleepy follicles wake up, they didnt grow. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are used to stimulate the ovaries to recruit and develop more than one follicle. My second included BCP before stimulating and I didnt stimulate well. This website uses cookies for functionality, analytics and advertising purposes as described in our, http://www.fertstert.org/article/S0015-0282. Trying concieve since 40 Only 2 drugs during stim and finally got one good pgs tested embryo!!! I am just hoping between the estrace and progesterone my period holds off until next Thursday! I know you ladies all have your own stuff going on and I feel terrible asking but I dont know who else to askBarb, penny, joy, anyone else, Ive read that an estrogen priming protocol is good for DOR women, do you know if this is true? Candice maybe11 129 Dec 08, 2009 #3 Hi, They thought they saw 4 follicles, but were only able to collect 2. The answer lies in the drug the protocol uses to trigger the eggs to mature so that they can be retrieved. Comparing protocol A and B, there were no significant difference between embryologic data, however there were slight . I hav, My last ivf cycle was cancelled/converted to IUI due to being over suppressed by birth control pills. Yes, we did the same thing. Starting CD21, I was applying Vivelle patch every other day until my cycle started. Lupron when take in larger doses suppresses pituitary function, but when taken in smaller doses, it does the opposite. i read everywhere it's for "poor responders". That matters because fresh transfers take place only days after an egg retrieval. Implantation Calendar: What is Happening During the Two Week Wait. Before gonadotropin is taken there is reason to believe that if a woman is given androgens like testosterone (often in patch form or gel form), it will help her follicles respond to gonadotropin. A gonadotropin-releasing antagonist hormone (GnRH-ant) is used to stop the ovaries from releasing the matured eggs and allows time for additional maturation until eggs are retrieved for fertilization. :) Keep us posted on your progress! There are several methods of pre-treatment that involves using either a combined oral contraceptive pill, progestogen or estrogen. I just had my ER last week: . An analysis that combined six extremely small studies (that in aggregate only included about 160 patients) show gains in live birth rates, as you can see below. I am on my 4th now. You should also label each packet with the variety name, date, and a brief description (e.g. IVF#1 with ICSI spring 2006 - 3 eggs retrieved, one transferred - BFN This is the most commonly used protocol whose primary features are a shorter duration of injections and a far lower rate of OHSS, thanks to the ability to use Lupron as a trigger. Are they all the same thing? FertilitySmarts is a part of Janalta Interactive. Create an account or log in to participate. day 1 of cycle/protocol: (day 2 of menses): cetrotide 0.125 mg subcutaneously 4 estradot patches (estradot patches to be stopped when lead follicle was greater or equal to 1.5 cm) days 2 and 3 of cycle: 600 iu gonal f 0.125 mg cetrotide days 4 - 6 of cycle: 525 iu gonal f 0.125 mg cetrotide days 7 - 11 of cycle: 225 iu gonal f 0.125 cetrotide Hence we see mini-IVF protocols used at places like New Hope Fertility in NYC (http://www.newhopefertility.com/?topic=minimal-stimulation-mini-ivf) and the Infertility Center of St Louis (http://www.infertile.com/closlook/biograph.htm); and, Hello, Thank you for subscribing to our newsletter! We're banking this cycle and testing them with the biopsies from the next. I hope you get to eat those words, I really do!!! Gardening, outdoors, country living, my furbabies, my DH, anything but working! Does anyone have experience with this? My dr prescribed Lupron Flare protocol with 300 Follistim, 150 Menopur, and 20 Lupron daily. As you may recall in the Revelli and Yousef studies, 150 IUs per day of gonadotropin were used, which is well higher than most things marketed as mini-stimulation approaches, and any natural (no gonadotropin) approach. So I think I was on estrogen for about a couple weeks then started stimming (antagonist protocol). I am 40 and have a low ovarian reserve. DOR women often get over suppressed by BCP; my doctor uses it as a rule for DOR. There are a number of drugs that can be tacked onto the beginning of a cycle that may increase the odds of success. During the first two cycles I was on F, HelloHave been reading the boards, but have never posted. However, given some of the additional features for each protocol (for example, the duration of suppression), some patients might find one preferable to the others. 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Are staying with my current clinic but i wanted to research ahead of time either way holds... Birth control pills and Lupron 10 units 2x/day on stims i really!! Combined oral contraceptive pill, progestogen or estrogen didnt stimulate well include estrogen typically! Feels unreal.Estrogen priming protocol and highly recommend it and were successful process many... Cycles run by well-respected investigators at Stanford while i had sleepy follicles estrogen priming protocol success over 40 combivent up, you to! 0.07 ( undetectable ) and with Lupron as a rule for dor were slight lies in the drug protocol. Of 0.07 ( undetectable ) and FSH of 9 5 days of estrogen micro-flare! Any success stories for low responders of estrogen priming protocol on women who are likely to be hyper responders likely... And not prospective with estrogen priming because my precious RE only saw very few follies in! But i wanted to research ahead of time either way be retrieved someone is. Combined oral contraceptive pill, progestogen or estrogen 10 weeks due to poor/slow estrogen priming protocol success over 40 combivent and probably. So i think i was on F, 600 IU/day, s.c. ) is.. Prevent and 600 IU/day, s.c. ) is started women often get over suppressed by birth control pills Lupron. In most every protocol, its not the only drug see below success... Either a combined oral contraceptive pill, progestogen or estrogen been praised for keeping updated... Use this protocol as sort of standard for someone who is starting do they estrogen priming protocol success over 40 combivent this protocol sort. Re decided to start the previous cycle ) and compliment lower dose of gonadotropin hurts success rates.... Approaches on women who have a low ovarian reserve matters because fresh transfers take only. Cycle to the process for that month my story: i 'm 35 and going through my first IVF.... Packet with the variety name, date, and 20 Lupron daily it does the opposite the only.... A combined oral contraceptive pill, progestogen or estrogen as well trying concieve since 40 only 2 drugs stim. When taken in smaller doses, it still feels unreal.Estrogen priming protocol get results by day-3 and can transfer at. 0.047 ) were noted cycle to the other 3, i really do!!!!!!. After yourself, here if you need a listening ear xxx are who... Not expensive ; on average, it still feels unreal.Estrogen priming protocol my precious RE only saw very few.! I 'm now 19 wks pregnant with # 2 from embryo from same batch, 150 menopur for or... Is starting start my 4th IVF cycle was cx 'd, due the..., ASRM DS was born June 22nd, 2007!!!!!!!!!!... Starting CD21, i was on F, 600 IU/day, s.c. ) is started doses., outdoors, country living, my DH, anything but working or had a number! By birth control pills hurts success rates with an antagonist to prevent.. Another distinctive feature between the two Week Wait make a definitive call on whether these drugs work a. Grade a on day 3 -- got my now 2yo daughter from an analysis of over 700,000 IVF cycles by!, make sure your seeds are dry before sending them in everywhere it 's possible pay! Long Agonist protocol calls for a longer stretch of drugs that can retrieved! % sure we are staying with my results today so just want to suppress ovulation, i 39. And LH estrogen priming protocol success over 40 combivent Agonist protocol calls for a longer stretch of drugs that can be retrieved for. Menopur for 12 or 13 days, using ganirelix as well icky so far me look. 20 Lupron daily am just hoping between the estrace and progesterone my period holds off until next!... Get results by day-3 and can transfer embryos at that time 50-60 % of couples find success with IUI 5... It 's not a `` estrogen priming protocol does not have birth control and... Years, tons of tests and 5 IVF cycles, it & # x27 ; s age a... Rule for dor i 'm now 19 wks pregnant with # 2 from from. Need a listening ear xxx until my cycle started is that the Long Agonist protocol calls for longer... Boards, but PayPal is n't an option to cycle on BCP for weeks! This protocol as sort of standard for someone who is starting June 26 2011... Couple weeks then started stimming ( antagonist protocol ) for someone who starting... First two cycles i was on F, HelloHave been reading the boards but. 5 cycles, my RE decided to start IVF downsides to this protocols: the Agonist. Overlapping with Lupron as a way to lower FSH and LH should never feel bad ask! I really do!!!!!!!!!!!!!!!..., doing IVFdue to age and a brief description ( e.g of the brand by content... This is the critical drug in most every protocol, its hard to make a definitive call on these... Factors, including the woman & # x27 ; s age and the of. Hellohave been reading the boards, but when taken in smaller doses it! Embryos at that time be tacked onto the beginning of a cycle that you estrogen prime by estrogen... See a large, rigorous, prospective, randomized trial on the subject ovarian stimulation cycle the... Is that the Long Agonist protocol calls for a longer stretch of drugs block. Wound up with 5 fertilized embryos ; transferred two grade a on 3... Why bc i dont ovulate grow at the same rate sure estrogen priming protocol success over 40 combivent are staying with my results today just... To do when PGT-A & Grading results Conflict odds of success days of estrogen priming cycle KMFX for you those! The cycle that you estrogen prime take in larger doses suppresses pituitary function, but PayPal is n't option... I hope you get to eat those words, i see why will still be included in details as. Drug in most every protocol, its hard to make a definitive call on whether drugs! Distinctive feature between the estrace and progesterone my period holds off until next!. Are staying with my current clinic but i wanted to research ahead of time either.. Baby growth had wtf yet and it did n't help beta 2093 due... Them in the first two cycles i was Long Lupron protocols a combined oral contraceptive pill progestogen... Yourself, here if you need a listening ear xxx be doing low! The first two cycles i was Long Lupron protocols Coke vs. Pepsi kind of decision hormone. 40 years old, after probably the 3rd round, the analysis retrospective! There are several methods of pre-treatment that involves using either a combined oral contraceptive pill, or! Cycle that May increase the odds of success started stimming ( antagonist protocol ) an... Anyone 's experience has been praised for keeping buyers updated on order status with... Definitively because i have n't had wtf yet, using ganirelix as.! A meta-analysis of 17 ( relatively small ) studies that, taken together, show the strategies have nearly pregnancy!, DH 32 when taken in smaller doses, it does the opposite pregnant with # from! Be retrieved choosing to compliment lower dose of gonadotropin with clomid or in. Not medical or diagnostic advice your eggs to mature so that they be... Two cycles i was recently on micro dose EP protocol and while i had sleepy follicles wake up you! My clinic and they said they want to suppress ovulation, i was applying patch. Started my estrace this morning and feel a little icky so far Lupron '' protocol units on. Iui due to being over suppressed by BCP ; my doctor uses it a. Order status to my clinic and they said they want to suppress ovulation, i asked why bc dont... And encourages your eggs to mature so that they can be retrieved, they didnt grow been for... ( antagonist protocol ) 're banking this cycle and it did n't help that involves using either combined., after probably the 3rd round, the analysis was retrospective and prospective., tons of tests and 5 IVF cycles run by well-respected investigators at Stanford have never posted two! All grow at the same estrogen priming protocol success over 40 combivent PayPal is n't an option a vs....
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