IVF slow response to stims /low E2

Hels

Hi Ladies! I'm not sure if any of you remember me, it's been a while since I've posted (will be interesting if my siggy is still there). 

Background on us: 

Me: FSH 5ish, AMH: 3.0, clean HSG, everything great; AFC: 20ish

DH: low morphology

Two previous pregnancies one our own (DD - May 2011 baby, and loss in Oct 2012 unrelated to fertility). 

We are both carriers of CF which is we are pursuing IVF w. PGD.  I'm doing long lupron protocol. Yesterday, on Stim Day 5, my E2 came back super low (only 57).  My RE upped my stim dosage and added micro HCG.  I've previously done a lupron stim challenge and responded great. But for some reason, my ovaries just won't "wake up".  I go back in on Friday for an u/s and another E2 check. 

Anyone have similar experiences and not get cancelled? Or should I push for cancellation? 

jessica_gail2

No advice but just wanted to tell you good luck. I hope it ends up working out perfectly!

kmc84

My first IVF I responded slow to stims. They upped my stim doses and my ovaries and E2 went nuts. On our second and third IVF cycles we kept to the 'slow grow method' and it worked well. I stimmed for 15 and 16 days on those cycles.

Ruthie04

I can't remember my exact e2 levels, but I feel like I was at a similar place around then. They upped my Follistim/ Menopur dosages and I stimmed for awhile. With my second cycle, a similar reaction occurred, but my initial Lupron dose was lower and I started out on higher stim dosages, so it wasn't as hard to "wake up" my ovaries. Your numbers are MUCH better than mine, so I think you still have every reason to be hopeful. Best of luck!

amandaleigh1

I have only stimmed once in my life. I had similar good stats as you-- high AMH and good >20 AFC. I stimmed on menopur and bravelle (starting dose was 75 and 150 IU ea-- 225 IU total) for 5 days after BCP and Lupron suppression, and I was very slow to get things going. However, after 5 days of stims, I had an E2 at 160. So a little higher than yours. Then I upped my stim meds to 375 IU total.

I stimmed a total of 11 days. I was pretty disappointed at ER because I only got 9 mature eggs out despite my much higher AFC at baseline. I had then 6 fertilize by ICSI. But surprise of all surprises, I have my son from a single embryo transfer, and I had 3 more embryos good enough to freeze at blast. So, sometimes it may still be okay to get fewer eggs out, as long as they are good quality. Since you are doing PGD though, I would probably want more than I got. If I were OOP, I would have a serious discussion with your RE whether cancellation is a good thing.

I think if I has been less suppressed before starting stims, I would have made a lot more eggs. But who knows if that would have been a good or bad thing.

Hels

Thanks, Ladies! My stim day 8 appointment is tomorrow and I guess we'll make the call after that. 

I'm in a multicycle plan that becomes void if I get cancelled once.  After you get cancelled, you start paying for each IVF and FET ala carte.  If I stay in the plan, I get two IVFs and all resulting FETs included.  It's kind of a number game, where it almost makes sense to do an ER to not have to cancel the package.  

I'll keep ya'll posted. 

kbeach82

I hope you get good news today! I have DOR and had to stim for 13+ days for both my Long Lupron and Microdose Lupron Flare cycles. We ended up only getting a few eggs at each ER, but they were always good to excellent quality. We have a singleton and twins from cycles where my E2 never went above 1,000 (only around 850ish for my Long Lupron). Good luck!

Hels

So I'm back from my u/s.  

Today is Day 8 (so after 7 full days of stims - no stims today yet). I had a bunch of follicles growing on each ovary (10+ on each side). All were about the same size. They were mostly 10's, 11's, and a 12.  Is that too slow of a growth? 

Waiting for the E2 results to come back.  

kmc84

That sounds just like what my ovaries did. I would keep chugging along! Fx for you!

amandaleigh1

I sounds good that you have a good number of follies growing at the same rate. I think you should be just fine.

Hels

E2 shot up like crazy (1300 yesterday on Day 8 of stims).   Going back tomorrow for an additional date with the dildo cam. 

kmc - sounds just like your cycle! 

kmc84

Hels said:

E2 shot up like crazy (1300 yesterday on Day 8 of stims).   Going back tomorrow for an additional date with the dildo cam. 

kmc - sounds just like your cycle! 

Hang in there! Tred as easy as you can with the stims. My first cycle I wound up with ohss pre retrieval:-( FX for you!!

Hels

Coming back to say it all turned out just fine.   I ended up way overstimmed and E2 was over 7000 at trigger. 

But, I got 18 eggs, 10 of which made it to blast and frozen. 

kmc84

I'm sorry you overstimmed. 10 frosties is fantastic!!! Way to go! When will you transfer?