XP: DOR/High FSH ladies

UMichGirl · January 2011

I'm about to start the work-up cycle for IVF. We've done 6 rounds of IUI's and they've all been BFN's. RE wants me to do antagonist protocol starting out at 300units Gonal F and 300units Menopur, adding in Ganirelex later. I've done 300units of Menopur for an IUI cycle but am nervous about being on double the dose of meds for IVF. Also, even at this dose, my RE is *hoping* we get 3 mature eggs at retrieval...he said he'd be thrilled with 6. That much medication, and only hoping for half a dozen doesn't give me the greatest hope with this. In addition, he said he would definitely recommend the 3dt because he isn't sure that any of our embryos would survive a 5dt. I realize you can't know for sure til you do the retrieval, but all in all we're going into this without the highest of expectations which sucks considering how much money we have to pay to do it.

So I'm looking for any advice, suggestions, reassurances, etc. Feeling pretty down and nervous about everything today since I officially got my BFN this morning for our last IUI attempt.

Also--what odds were you given of having a successful IVF take-home baby? Our RE gave us 5-15% odds. Crying

Thank you!

fallbride110406 · January 2011

I can't speak as to the med doses (I was on 225iu of Follistim and then either low dose HCG or Menopur) but I was given a 60-70% chance of success both times. 5-15% seems really low to me, even for DOR.

As for 3dt vs 5dt, they always strived for a 5dt. I know this is different based on the lab though since some labs are better at growing them out to 5-6 days than others.

I'm sorry that you're moving on to IVF, but I really didn't think the actual process was that bad personally. I think the waiting was worse than any of the procedures.

Good luck!

howleyshell · January 2011

First - I'm so sorry for your BFN. They suck. BAD.

I'm a DOR gal.

We did a MDL (micro dose lupron) IVF cycle being told about a 25% - 35% chance going in.

Then they retrieved 3 eggs (looked like maybe 6 or 7 growing and the right size). No one could look me in the face.

My RE wrote off that cycle and before I left from retrieval told me he'd be stunned if we made it to transfer. Lower odds than your doc is giving. He started discussing donor eggs. I started discussing other protocol options for another IVF.

The next day all 3 had fertilized.

3 days later we transfered back all 3. One was clearly not going to make it (3 cells at day 3 = dying). The other 2 were 8 celled just like they should be with minimal fragmentation.

BFP.

Blood draws with sky high betas and progesterone. Nurses start talking twins. I'm saying NO WAY.

1st u/s = TWINS both with heart beats.

I think the RE's jaw dropped lower than mine and DH.

Sadly one didn't make it but the other is now a BRILLIANT 4.5 yr old.

It really does only take one.

I'm praying like mad for your golden egg.

Hold on tight because IVF is one serious roller coaster!!

And if you'll check my siggy I've had 3 unmedicated pregnancies since that IVF baby was born. Sadly only 1 was viable but still.... after going SO long with no BFP at all I consider it a nice F-U to the whole DOR diagnosis that I have an unmedicated live child.

They don't fully understand DOR.

BTW..... Have you had your AMH run?

armywife76 · January 2011

fallbride110406:
5-15% seems really low to me, even for DOR.

This. Do you mind my asking what your FSH, AMH, AFC, age, etc. is? We were quoted 50-55% with IVF using a protocol for poor responders, microdose fupron flare. Had 9 antrals, I believe, and got 13 eggs and 8 embryos, so it really helped to boost #'s at ER. IVF #1 was successful after 3 failed medicated IUI's. My RE told me early on it would probably be a 3dt because if he waited, there would be nothing to put back. He was right. Ok with me because it worked! If you want, you can check my blog, July/Aug. 09 for protocol details. GL!!

howleyshell · January 2011

fallbride110406:
As for 3dt vs 5dt, they always strived for a 5dt. I know this is different based on the lab though since some labs are better at growing them out to 5-6 days than others.

Had to comment on this.

Our embryologist explained that the uterus is THE best incubator for an embie.

They only go to day 5 if they've got a ton of them and can't tell which are the best quality. By going to day 5 some fall off that might not have done as well going back at day 3 but it was too soon to tell.

A day 3 isn't a BAD thing.

We knew going in that we wouldn't get enough eggs to end up with a 5 day or anything to freeze.

Of course I would have preferred to have 2 dozen to work with over just 3 but doing a day 3 transfer is NOT a bad thing IMO.

fallbride110406 · January 2011

howleyshell:
fallbride110406:
As for 3dt vs 5dt, they always strived for a 5dt. I know this is different based on the lab though since some labs are better at growing them out to 5-6 days than others.
Had to comment on this.
Our embryologist explained that the uterus is THE best incubator for an embie.
They only go to day 5 if they've got a ton of them and can't tell which are the best quality. By going to day 5 some fall off that might not have done as well going back at day 3 but it was too soon to tell.
A day 3 isn't a BAD thing.
We knew going in that we wouldn't get enough eggs to end up with a 5 day or anything to freeze.
Of course I would have preferred to have 2 dozen to work with over just 3 but doing a day 3 transfer is NOT a bad thing IMO.

I didn't say a 3dt was bad, just that my RE liked 5dt's. Specifically because it gave them more time to watch them and weed out the absolute best ones. I had 9 fertilize, 6 at day 3 and 3 at day 5 the first time and 6 fertilize, 5 at day 3 and 3 at day 5 the second time. Not a ton, but enough that he felt comfortable doing a 5dt.

UMichGirl · January 2011

My highest FSH was 18. AMH is 0.84. I'm 30. I think he was quoting us the live birth success rate, not the pregnancy success rate. I know it just takes 1...I'm hoping I can produce 1 good one at least! Thanks for the responses.

armywife76 · January 2011

Even though your numbers are elevated, I still think the RE might have been a little conservative with your success rate prediction. Is he a high-FSH friendly RE? You might ask him about his thoughts on MDL flare or estrogen priming protocols. There have been many success stories on this board with those protocols. More than the numbers is how your body responds to stims and the quality of your embryos, which is something they won't know until you get started. Have you talked to your doc about dhea supplementation? A bit controversial, but I swear by it. GL!!

UMichGirl · January 2011

armywife76:
Even though your numbers are elevated, I still think the RE might have been a little conservative with your success rate prediction. Is he a high-FSH friendly RE? You might ask him about his thoughts on MDL flare or estrogen priming protocols. There have been many success stories on this board with those protocols. More than the numbers is how your body responds to stims and the quality of your embryos, which is something they won't know until you get started. Have you talked to your doc about dhea supplementation? A bit controversial, but I swear by it. GL!!

I think he was giving me the chances of a "take home baby"...not the pregnancy success rate (which he said would be higher). By high-FSH friendly, do you just mean will he let me cycle with a higher FSH? I know they told me their "cut off" is usually 15. Mine has only been over that once, and it was the time it was 18. Usually it's 11-13. I didn't ask about the micro-dose lupron or estrogen priming...I know I'll have a month of work-up testing done so I can ask the nurse about that then (to ask the doctor). I don't know much about those protocols either so I'll need to look into them too!

I haven't talked to him about DHEA supplementation...to be honest I don't know much about that either. Huh? Feeling a bit like a newb right now, lol!

Thanks for your help.

And fallbride--your babies are adorable! Last time I saw your siggy was I think when you had just had them and they were teeny tiny!!!

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