What would you do?

reb259

I have a friend IRL who is also dealing with IF.  She will be 42 this year and has done 2 failed IVF cycles (one cycle was cx due to lack of response)

She was planning to do a DE cycle and had her FSH level checked it was a 9...she had it check a year ago and it was a 20.  Her RE said they should start a cycle with her OEs now.  She has agreed and is very excited.  Fwd to today, had brunch with some friends, one is an Ob/Gyn.  I was telling her about my friend and she said once you have an elevated FSH, even if the numbers go down it doesnt matter.  She did say that she could possibly still get pregnant but all her training says that she will not.

You guys know how hard a failed cycle is financially and even harder emotionally.  Do I tell my friend what my dr friend said?  I feel like if there is a chance it could work, who am I to say anything.  I also feel like my Ob/Gyn, although a great Dr isnt a RE and if the RE of my IF friend didnt have a concern, who am I to say anything...I am FAR from being a dr of anything.

Thoughts?

amethystgrrl

That's a toughie... is your friend all OOP?

NMscubagirl

I tend to think that her RE knowing her history and her health would know best how to advise her. The OB may know some things antecdotally, but that is not her specialty, and she is not her patient. I have heard the same things on this board and if I were in your situation, I might mention it in general not as an expert opinion so she could maybe ask her RE, but that would be the extent. Positivity is so hard to come by in IF that I wouldn't want to take that away if she has already made the decision. GL

reb259

yes she is OOP.

Scuba... I agree with you.  I thought that if it were me, I would not want to know and might even feel resentful.  I agree when you cycle you need all the positive thoughts.  I just pray it does work for her...we all deserve to make it to the other side.

Gregermis

I think I agree with SCUBA's assessment.  Fx for your friend!

reb259

One thing I forgot to add, her husband was an expat so her 2 ivf's were done out of the country.  She has not ever cycle with her current RE.

amethystgrrl

And a new RE might be just the trick. Good luck to your friend.

Mrkyrain

Once the FSH number has a high reading like that it indicates DOR.  Even when it goes down, it doesn't mean that ovarian reserve has changed.  You are still working with the same number of eggs.  Having said this, it doesn't mean that she can't get pregnant.  Mine was close to 19 when it was tested two years  ago so it could have been even higher when I got pregnant.  It is possible to get KU, just less likely than someone who doesn't have egg issues.  I assume that her RE has gone over the chances.  If it were me, I would not say anything to my friend.  I would just tell her that I am there for her, as I'm sure you are.  Best of luck to her.

reb259

Mrkyrain:

Once the FSH number has a high reading like that it indicates DOR.  Even when it goes down, it doesn't mean that ovarian reserve has changed.  You are still working with the same number of eggs.  Having said this, it doesn't mean that she can't get pregnant.  Mine was close to 19 when it was tested two years  ago so it could have been even higher when I got pregnant.  It is possible to get KU, just less likely than someone who doesn't have egg issues.  I assume that her RE has gone over the chances.  If it were me, I would not say anything to my friend.  I would just tell her that I am there for her, as I'm sure you are.  Best of luck to her.

  Thanks!!

blueberries8

I agree that I wouldn't say anything to her. Being a little cynical here, it doesn't behoove her current RE to encourage her to try with her OE if he/she thought it was a real long-shot since it would just lower his/her SART stats. Given that, I think it is likely she has received good advice given her particular situation and bringing up what your ob/gyn friend said will likely just lead to self-doubt. Good luck to her!

AmCheri

Mrkyrain:

Once the FSH number has a high reading like that it indicates DOR. nbsp;Even when it goes down, it doesn't mean that ovarian reserve has changed. nbsp;You are still working with the same number of eggs. nbsp;Having said this, it doesn't mean that she can't get pregnant. nbsp;Mine was close to 19 when it was tested two years nbsp;ago so it could have been even higher when I got pregnant. nbsp;It is possible to get KU, just less likely than someone who doesn't have egg issues. nbsp;I assume that her RE has gone over the chances. nbsp;

Ditto this. I would, however talk with her about things I've learned about DOR status. There are other very serious considerations to pursuing your OE once you have DOR. Certainly a big obstacle is a reduced number, but this issue is not the primary concern of TTC with DOR, based upon my personal research. The research I've read with respect to trisomies and m/c rates with DOR patients under the age 35 is staggering and played a huge role as a woman over 35 in our decision to stop cycling with my OE. DOR is a bigger deal than just a numbers game and with a high FSH and a canceled cycle under her belt, she's dealing with DOR.

AmCheri

I wanted to add that I'd say something to a friend if we had a close relationship. I'd also say something only if I had firsthand knowledge of the pertinent facts. And, most importantly, I would tell a friend who was in my shoes because I wish someone could have told me. It would have made my angst with respect to the OE v DE decision much less, and the answer clearer to us sooner.

It's frustrating to see many women with DOR make these major decisions without having all of the information to consider first. Even our RE didn't really tell us and he conducted a major study on the consequences of IVF with DOR. I guess he wanted us to find our own way? Maybe that's where your friend's doc is coming from. You have to be ready and willing to receive the info. Erg. It's a stinky and tough situation, reb.

ETA I have a big mouth, so you should take what I've said with a grain of salt. lol

Mrs.McIrish

Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

reb259

Mrs.McIrish:

Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

I tend to agree and that is basically what my dr friend said in addition to there is a chance it could work.  My IF friend does plan to do PGD.

Like I said before, she is not a newbie to all this and she has struggled a lot and I hope this does work for her. 

Thanks Ladies!! 

 

vanessagorc

Well, fsh is only as good as ur worst number...so the 9 means nothing.

I would think her RE should do amh, and get a better pic.  How she moves forward is her call, but the care she is getting sounds suspicious.  Maybe u could point that out, and a 2nd opinion could help her make a more informed decision.

Trippleb

I wouldn't say anything to her.  The fact that she was already prepared to move to DE tells me that she is prepared for the worse in using her own eggs.  If it were me, regardless of my response and outcome at a foreign clinic, I would want to give myself a chance here in the US.  Plus I've had really bad advice from OB/gyn in the past and quite frankly I don't think they have a clue how to get a patient pregnant.  Their expertise is only after the bun is already in the oven.

lynn0926

Mrs.McIrish:

Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

This is how I feel. But, I think you need to let her find out for herself. It may be one of those things that she needs to cycle one more time for closure. Just be there for her in the end if things don't go her way.