Low AMH Level

capps42613

@emmasemm like others have said, try not to get hung up on quality. My RE had us do a day 3 transfer bc he said they may grow better inside you vs waiting til day 5 outside. 

@JamieH2000 I graduated from RE @ 7 weeks, had a scheduled u/s @ 10 weeks, and first official OB appt at 12 weeks. Are they sending you to MFM doctor in addition to regular OB bc it was IVF? I don't think it's standard protocol bc of IVF but my OB sent me for extra monitoring bc of my hypothyroidism and IVF for extra measure. Wouldn't hurt to ask OB. 

bakerstreetboys

Hey ladies.  I have posted on the June and July IVF thread, and have been reading this thread obsessively.  I'm so impressed with everyone on here and how much you've been through.  I'm 40, AMH is 1.03, and I'm halfway through my first IVF cycle.  It isn't gong well and I'm trying hard to not get too upset before we've finished the round.  I'm on a long angonist protocol and started with estrogen priming patches.  I think they oversuppressed me because my u/s yesterday showed only three measurable follicles after eight days of stimming.  My baseline had 14 so although I wasn't expecting a ton, I was hoping for more than three.  I'm still on stims, and Cetrocide in the mornings, and I go back tomorrow for another u/s.  I'm super uncomfortable because the medications in the injections makes my endo flare up.  Blah. 

Anyway, thank you for sharing your stories; they are an inspiration!

JamieH2000

@capps42613- I am meeting with an OB for the first time next week, i just saw an NP the other week. I wouldn't expect to see an MFM, now that its only 1 baby and I am only 30. but we will see what they say!

@bakerstreetboys- Sorry you are in this situation, but glad this board has given you hope! It really is trial and error with protocols for DOR. Defintiely still hope if they can switch up your protocol next cycle!

Imajin99

@bakerstreetboys I know how frustrating it can be but try to stay positive as they could increase your meds and you may see some better results.  I had my first IVF cycle in June and wasn't seeing the results I had expected and spent a lot of time worrying and being anxious which is not good for the body.  Keep us posted on how things progress.

bakerstreetboys

@JamieH2000 Thank you   Good luck with your first OB appointment!

@lmajin99 Thanks.  They won't be increasing my meds for this cycle because I'm already on 400 of Gonal F and 150 of Luveris.  Hopefully they'll look at not suppressing me for the next round.  Such a game of hit or miss   I hope you have had better luck since your first cycle.

tosh24

@bakerstreetboys Hi!!! Remind me again, is this your OHIP funded cycle? I'm not sure if you're aware (I wasn't at the time) that if your cycle is cancelled before ER, you get one more attempt at a funded cycle. Definitely something to bring up with your clinic in case it's better to cancel and try a different protocol rather than go through an ER for less eggs than you/your RE think you can get and then have to pay OOP for a second cycle. Sorry you're not responding as well as you had hoped. I hope your ovaries kick it into high gear!

Kp214

@JamieH2000 yay for graduating!  

@bakerstreetboys I’m sorry you are having a hard time. I hope some more follicles join the party. It’s so hard to find the protocol that will work. Hang in there. 

@hopefuljj how are you?

@emmasemm what’s next?  Are you doing another cycle or taking it off or preparing for a FET?

bakerstreetboys

@tosh24 Hey!  No, this isn't our funded cycle.  We're on the waitlist, but given that it's 12-14 months long, we have decided to pay OOP for now.  Thankfully our work insurance covers 100% of the meds, which is about half the cost of the cycle.  It will still get expensive if we have to do it more than once though.  Thanks for mentioning the cancellation; we can get some money back if we cancel pre ER...I'll find out at tomorrow's u/s how things are looking.  I've stalked you a bit and and so happy to see that things are going well!

Edited because words are hard.

JamieH2000

@kp214- thanks! When is your next appt?

AFM- I graduated from the RE today! Baby looked good and HB was 180. I will be 9 weeks tomorrow. I will def miss the weekly ultrasounds, but hoping my OB will give me another one next week to check on the SCH, which is still there and still large. I thought I would feel more relaxed with each week, but not really! I can't wait for all my ladies on here to join me soon

Kp214

@JamieH2000 yay!! So glad things went well today. That’s a fantastic heartbeat.  I hope you do get another u/s. Those always provided reassurance to me.  My appointment is in the morning. I hope my lining looks good. I am supposed to receive PIO today from the pharmacy.

lemondrop1976

@JamieH2000 Thats exciting!

Imajin99

@JamieH2000 Awesome news!

hopefuljj

@JamieH200 omg lady, I’m just so thrilled for you!!! How wonderful!!!!!!  I hope the OB gives you a scan to check on the SCH.  Wow, this is crazy right???

@kp214 how was your lining check??

@bakerstreetboys welcome:) how did US go?  I know all to well the frustration of canceled cycles....your baseline was insanely impressive, so it is def worth finding out if you could have a better response with some adjustments.  I can’t imagine seeing that many follicles.  Let us know how it goes!

AFM - WTF appointment went well.

She wants to up my intralipid treatment to 2 times before transfer and then resume doing it after, if I get a BFP.  She wants to add a neupogen injection which I think is only once I start progesterone and not every day....she said ok to my plea’s for lovenox so bring on the awful bruising...and she wants to do an HCG wash prior to transfer as well as another aggressive scratch.  Not sure how I will schedule all these things prior to FET...  

So there it is.  She asked if we want to trust my ERA results and still transfer a day later, it makes me nervous but I just don’t have the strength to do another ERA cycle to confirm that day....so my response was to say yes, let’s trust it....if she could do one, great but driving hours out to that random clinic again for one, I just don’t think I can.   So the plan is to roll into another loooong FET protocol.  I started BC.   We shall see.  Feeling nervous and a bit defeated.  Hoping I’ll start feeling more positive again soon;)

bakerstreetboys

@JamieH200 Congratulations!  Very exciting   Hopefully you'll get regular u/s with your OB.

@hopefuljj That sounds like a lot to take in, but it's always good to have a plan!  I hope that all this prep will make your FET a success.

My u/s yesterday showed only three measurable follies.  The RE on call happened to be mine; she said that I might have more in another month with the same protocol, or even with a different protocol, but she felt that it was reasonable to go ahead with the ER.  So, I triggered last night and the retrieval is tomorrow morning.  I'm trying not to get my hopes up, but so much has to go right to even get to transfer.  Even if we make it through fertilization, they won't do a fresh transfer if my progesterone is too high.  Waiting for a FET would mean waiting another couple of months, and at 40, it's time I don't feel that I have.  Oh well, and we can do it hope and wait

JamieH2000

@kp214- can’t wait to hear a good update on your lining today! Transfer is so soon!!

@hopefuljj- wow sounds like a good plan. I think that is literally anything I have ever heard of anyone trying honestly!! One of those things has to be the magic ticket!! Any idea of a transfer date? Hopefully by end of August? As far as not repeating the ERA, I did do that and mine did confirm the initial reco if that gives you any peace of mind.

@bakerstreetboys- triggering is always exciting!! I hope you get all three mature and fertilized! It’s hard to wait for an FET but maybe you could do an ERA just to confirm your timing then? With only one or two frozen likely, I think it may be worth it just to make sure you have the right transfer time since 15 percent of ladies need it earlier or later than the standard. Just an idea since you have to do an frozen transfer now anyways.

Imajin99

@bakerstreetboys Hope all goes well at retrieval today and they all are mature and fertilize!

@hopefuljj Sounds like an intense plan, stay positive!

JamieH2000 How are you doing? What is ERA? I have seen it mentioned a few times and not sure what it stands for.

AFM

Yesterday was the last day of the Androgel, Provera and estrace and patiently waiting for period to arrive. Then will go in for the baseline ultrasound and start the cycle. 

Kp214

@adc0417 it’s transfer day!!!  Hope all is going well. 

Kp214

@hopefuljj glad you have a plan. It seems easier when we can work toward our goal rather than being in limbo. Hang in there. 

@Imajin99 waiting for AF eagerly is something many of us can relate to. It marks the start for us. I don’t think many people can relate. I hope she arrives soon. 

@bakerstreetboys yay for triggering!  I hope you have a great retrieval tomorrow and a great fertilization report. Praying that your progesterone isn’t too high. I assume you aren’t doing PGS testing. 

Afm, my lining is 8.1!  I barely got above 7 last time.  I’m tentatively scheduled for transfer on Thursday next week!  It’s all happening very fast to me. 

JamieH2000

@lmajin99- ERA stands for endometrial receptivity array. Essentially you do a mock transfer cycle and they do a biopsy on the day you would have transferred instead of doing a trasnfer. A lab then analyzes the biopsy to see if the lining is receptive. 85% of ladies are receptive 5 days after ovulation, but 15% need either more hours (like 12-36 usually) of progesterone or less (I needed 24 hours less). Its usually only recommended for repeated implantation failure cases, but when you only get very few embryos, some DOR ladies are doing it before they transfer just to make sure.

@kp214- 8.1 is great!!! I was at 8.2 this cycle Omg only 9 days! and you will be PUPO! I can't wait!

Imajin99

@kp214- Fantastic lining!

@JamieH2000- Thanks for the information, I have never had the RE mention anything about this but I of course have never had a transfer.  My RE never seems concerned with my lining, I think its always been good.  Will ask more questions for this cycle.  Feel like I am always asking questions but there are so many different variables.

Kp214

@Imajin99 I felt the same with about asking questions. I seemed to do it all the time during the monitoring appointments and then via email. You are not alone in that. I know I drove my nurse crazy, but she handled it fairly well. 

JamieH2000

@lmajin99- The ERA is definitely new technology and not all REs believe in it, but it was the game changer for me, with no doubt. However, the majority of women don't need it. Its just more of a gamble with us DOR ladies since we don't have enough embryos to have multiple failed transfers before we learn we need the test. I wish i had done it before doing DE since its possible my last transfer with my OE would have worked if we had done the right timing. Yet I didn't do the ERA until I also have a failed DE transfer. I just KNEW something else had to be wrong since we solved the embryo issue....

Imajin99

@JamieH2000- Thanks for the information, I will ask the ER about it and try to learn as much as I can online.  Always good to have additional information to ask them. 

Just waiting for this period to start and getting a bit frustrated as it is week late now and don't know if I should bother POS or just waiting.  Now we may not finish the process till mid August and we wanted to travel at the end of the month.  Sorry! Just my morning rant!

adc0417

So, we are now faced with another setback.  All of the embryos arrested on day 3 ( She was not a proven donor and so RE thinks that her eggs cannot handle freezing/thawing process.  I just don't see the light at the end of the tunnel.  Every time, I'm excited and think finally it's time, we are met with another setback.  I'm so sorry for always sharing bad news with y'all.  Now, we are in the process of looking for another donor, but no one that kinda even resembles me   We are also requesting them to fertilize the eggs and form into embryos before I even start another cycle.

@JamieH2000 Yay for graduating!!

@Kp214 lining looks real good, excited for your transfer in one week

@hopefuljj girl that's a complicated protocol, but as long as it works out...that is all that matters.  Praying for you!!!

lemondrop1976

@adc0417 Sorry to hear about the arrests, that is sad. Definitely getting confirmation before starting another cycle is a great idea. Hopefully you find another donor that resembles you, GL!

emmasemm

@adc0417 oh no!!! How much bad luck do we all have to go through??? 

@imajin99 AF is always late when you need it most! We should be not too far apart as I do baseline next Thursday.

@jamieh2000 you just described my main fear when it comes to transfer. As we don’t get enough OE embryos, you can’t afford to go step by step, but most doctors won’t do all the processes without having failures... As well as ERA I have a horrible feeling we will have to work a few times with different approaches to get my autoimmune issues under control. But nobody is going to put me on ALL the drugs and procedures for first FET... And with my age they are likely to chalk it up to genetic issues with embryos if we don’t do PGS testing, but we have a higher rate of mosaics as we get older, and still most clinics won’t transfer them... which could mean we have no OE embryos to transfer... ahhhh... 

@kp214 oh wow great lining! 

@bakerstreetboys hope the ER goes well today! 

@hopefuljj hopeless and defeated is ok right now. Doing all of these things is exhausting. Truly exhausting. 

AFM
I was worried the RE might even suggest not to do another retrieval. He is ok with it in the end, but they definitely won’t carry on with OE indefinitely for us. We’re tweaking the protocol and going back from ICSI to IVF to see if that helps embryo development without harming fert rates. He’s not so far on board with trying an MDL protocol as my baseline FSH is normally higher than would make that suitable. Except last cycle would have been. So we’ve agreed to see my day 2 baseline labs and then he might be open to persuasion. Baseline should be a week from now if my body cooperates. For now the estrogen priming is kicking my butt again!
I also figured out finally that the estrogen priming and when my E2 gets high just before ER this is triggering pustula psoriasis on top of the psoriatic arthritis. 
Oh and I get to go see a diabetic specialist as they think these priming and stim cycles are giving me some weird form of diabetes... If I eat a normal meal I literally fall asleep an hour later. And a really really deep sleep. So I’m on little and often at the moment and need to see how fast I can get in there. Because why not have one more problem... 

JamieH2000

@adco0417- i responded on the other thread, but again i am SO heartbroken for you!

@emmasemm- aww sorry if i freaked you out girl! I didn't mean to! I would suggest an ERA for you too, but I know your embryos are being frozen on day 3 so an ERA isn't applicable. I think you are doing EVERYTHING you can to make sure your transfer will work and the rest is just up to luck unfortunately. I am glad your clinic is willing to do another ER. You can never have too many i feel like. I am not sure why they should limit you? You are paying so you should get to do as many as you want? I am so sorry to hear about the diabetes too. I mean only you know when your body has had enough, but I honestly felt like my body told me when it was done bc it gave me a cyst that lasted for 2 months when i was trying to do one more cycle last year. 

Imajin99

@adco0417-Sorry to hear that. These processes have so many factors that can go one way or another.  Hope you find another donor that works out better for you.

@emmasemm- Glad you are able to start another cycle and we may be cycle buddies again! Hopefully this diabetes issue gets sorted out as with everything you have to do to get to your clinic and the cycle stresses you need as much energy as possible.

bakerstreetboys

@adc0417  Sorry to hear about the embryos.  I hope you can find a proven donor soon.
@lmajin99 hopefully you get in for your baseline soon!
@JamieH2000 My clinic only does ERAs after a failed cycle.  We're still hoping to do a fresh transfer at this point.
@emmasemm As if you needed another thing like diabetes to deal with!  Fx they figure that out quickly.  Happy to hear that you'll get to do another cycle.
@kp214 That's great about your lining and getting ready for a transfer!  No, we aren't doing PGS testing with this round.  I went into it hellbent on having it done, because I don't think that I can handle another loss.  But the RE was pretty adamant that we shouldn't do it; she knew we wouldn't get many eggs, and she thought the risk was too high with the freezing and thawing, and potential damage to the embryo.  They're also finding now that embryos that could have resulted in successful pregnancies are being discarded.  Too much risk with my numbers, but if this round doesn't work, we'll revisit it.  

ER went pretty well, though I'm sore now.  I had hoped they'd find extra "hidden" eggs, but no such luck.  Now begins the hardest part...waiting to see how many fertilize and make it 3-5 days.  So much waiting in IF.

lemondrop1976

@bakerstreetboys GL on your fertilization update!

Kp214

@adc0417 I’m so sorry. That’s really tough after everything.  I’ve had that happen with my eggs. It sucks.  

@emmasemm glad you get to do another cycle. I hate that the estrogen is affecting you like that and you’re dealing with diabetes. Why can’t this be easier?  Why would they limit how many retrievals you can do, if you don’t mind me asking?

@bakerstreetboys I, too, hoped they would retrieve more eggs. However, it is great that you’ve made it this far. One hurdle down. Now for a great fertilization report.  Will you do a day 3 or 5 transfer?  Does it depend on how they look in day 3?

@Imajin99  af never seems to come when you want her to. Ugh!  Waiting is so difficult.  I hope she arrives soon. 

capps42613

@adc0417 oh no! My heart just sunk. I'm so sorry. 

@bakerstreetboys Fx for great fert rates! 

hopefuljj

@adc0417 lady, I am just so gutted for you. I am so so sorry. I truly hope the perfect donor pops up:( don’t apologize for sharing bad news!  I know exactly how you feel, at some point, luck just has to turn around right?!! I mean honestly it better because this is just awful:( I’m just so heart broken for you.   How are you feeling??  I hope you are able to surround yourself with comforting things and get lots of love.

@emmasemm if you want to, you can always try and see with your doctors if they are willing to treat you like a repeated loss patient due to how difficult it is to get embryos.  I just did my first ever FET and before it I begged to be tested for NK Cells, I paid for a repeated loss panel (I had never had a loss yet) I did an ERA which they won’t do in NY so I found a clinic in NJ that would do it and my RE wrote me the script to go, I did a scratch, and I did the EFT.  I might not recommend that EFT again, I mean, I just have very mixed feelings about that test.  But my point is, my RE wanted to throw in an embryo 6 months ago or whatever it was when I finished banking and I was like, HOLD the phone!!! I need to do all the things!  I only have 2 PGS normal embryos after a year of banking!  So  after all the testing we ended up adding prednisone and intralipids drip treatments to my protocol and transferred 24 hours later per the ERA.  Now I wasn’t successful, and I only have one left, but i felt I needed to push for all the things.  In my case it just might not have mattered:(. And OMG lady, the psoriasis and diabetics?!! I feel your pain so deeply:( stims do such awful things to me eczema I can’t even explain how I feel dealing with that on top of everything else.  The weird form of diabeties is just like, seriously universe?!!!  Are you kidding me?!  I’m so sorry, like it isn’t all frustrating enough with out these added issues???  

@jamieH2000 yup! Transfer likely around Aug 24ish?  How are you?!!!!!!!

@kp214 awesome lining check!!!!! That sounds veeeery exciting! PUPO so soon!! It really is moving fast:)

@imajin99 I had to really really push to get the ERA.  And go out of state for it.  But I think it is worth asking about.

I actually regularily set up consults with my RE(well I guess more like WTF appointments) with just lists and lists of questions and things to talk about...I say ask all the things.  It’s amazing what comes out of it sometimes.

@bakerstreetboys congrats on ER. I am sorry they didn’t find any extras.  I hope for that too every time.  It seems women without DOR often get this nice surprise:-/ 

JamieH2000

@bakerstreetboys- hoping for a great fert report today for you!

@hopefuljj- wow only a month until the next transfer!! I think you may already be on a super healthy diet, but i have had a few friends go gluten and dairy free before transfer as a hail mary? For some reason I think you may already be tho... ill keep racking my brain for anything else you can try! Are you on an antibiotic and steroid before transfer? Its a bit of an older thinking protocol, but my RE agreed to throw it in this time. I took zithromax and medrol (4 times per day). But I know you said your RE was willing to add in predisone this time. I really think it just HAS to work!

Imajin99

Thanks ladies for all the support! Still waiting for AF

Kp214

@Imajin99 when do you plan to POAS? For me, AF almost always arrives within a day of that.  Where are you traveling to in August?

bakerstreetboys

Two our three eggs fertilized, which was more than I expected  If they both make it to Sunday, we'll be doing a day three transfer.  @kp214 My clinic automatically does day three transfers unless you have at least three fertilized eggs

Now to try and figure out how to sleep while hoping the phone doesn't ring! Thanks for all of your positive thoughts!

Kp214

@bakerstreetboys yay!!!  That’s awesome!  I look forward to your update on Sunday. You’ll be PUPO soon.

adc0417

Thank you ladies for your support.  We have picked another donor.  She is proven and this time around, we’ll be doing freeze all beforehand.

@bakerstreetboys 2 our of 3 is pretty good.  Can’t wait for your update on Sunday.

@hopefuljj thanks girl, I know you understand.  I feel better now that we’ve picked another donor.  Just hoping for no more glitches.  

@emmasemm it sure is a tough road for us all.  Glad that your RE is willing to do another cycle, but oh so sorry that all these hormones are causing high blood sugar in your system:((

Imajin99

@bakerstreetboys  Amazing news! Was happy to hear that 2 fertilized! Will keep fingers crossed all goes well with you on Sunday.

@adc0417 Yah for a new donor!