Opinions?

dreamalotmp · March 2011

I buried this question in my post below. Figured I'd post it on its own in case it was too hidden and in case anyone has any thoughts since we've all been through this and know so much separately.Of course, I'm going to pose this question to the clinic, but wanted your opinions and insight as well.

Here's what I'm so confused about in relation to my failed IUI... We have done 4 IUIs now. This one was our best shot. I had a 24mm follie and a handful of smaller ones, DH had 28mil count with 94% motile. We BD'd twice right after IUI (that night and the next) I did max follistim, menopur, had excellent lining... did acupuncture and FSH was 7.5, wheatgrass shots, supplements for good egg quality, prenatals, didn't drink caffeine or alcohol. had a polyp removed, didn't exercise so as not to tweak an ovary, listened to circle + bloom meditation sessions. What isn't working? I am seriously curious what you guys would think about that. I don't have any other problems.

Any thoughts?

Thanks SO much. I really appreciate your support even though I haven't been posting here long at all.

Edwina.McDunnough · March 2011

What was your dose and what were you follie sizes? with your FSH, I'd expect more than one follicle, but if your meds were too high, you'd get a lead follie that hogs up all your meds and the little ones will struggle to catch up. If that's the case, you may ask if EP is an option for you.

Do you have an immunilogical concerns? Had a lap? are you AMA?

It's all speculation without knowing what your dx is or what your background is, so any specific info would be helpful.

dreamalotmp · March 2011

My FSH has been high in the past (18 and 24), so that could prob affect quantity. My FSH # was lowered by acu... which I thought was a good way to head in to doing stims. I had one 24mm follie and 3-4 follies under 10mm on day 7 of stims (600IU of Follistim and 75 Menopur daily).

I have had a lap in the past, but all docs say that it wouldn't make any difference in my case.

No immunology concerns. I'm not sure what AMA is. I've never been told that I am that, so it probably isn't an issue.

I guess I just wish that there was a clear reason because it seemed like all things together should have worked this time. Maybe I'm fooling myself that my at-times-high FSH levels don't make a difference?

dreamalotmp · March 2011

Oh and I should mention that I agree about EP. My RE that I worked with before doesn't 'believe in it', so I'm switching clinics for that and other reasons. Hopefully the new clinic will try EP. Thanks for mentioning that.

baloneydisc · March 2011

I don't have any advice, but AMA is Advanced Maternal Age (over 35).

Delta04 · March 2011

I wish that I could provide you with some answers but I can tell you that you can find out info about your AMH number here: https://www.advancedfertility.com/amh-fertility-test.htm.

It tests your ovarian reserve level. Woman with a low AMH tend not to respond too well to stims. Egg quality could be an issue as well.

I you will be able to get some answers.

Edit: I am sorry, I realized it was AMA not AMH.

dreamalotmp · March 2011

Oh yes... I have AMA. I turned 40 in November.

I know that I am not going to respond great to stims, but why didn't that 24mm egg meet up with one of those 28mil swimmers? I wish I could have an answer to that mystery.

Edwina.McDunnough · March 2011

AMA is Advanced Maternal Age, over 35.

Have you had your AMH tested? A much better barometer for OR and response. Also, FSH without knowing your E2 at the time is less telling. You are only as good as your highest FSH. Also, what's your AFC?

All things aside, it sounds like you are DOR. Unfortunately, it can be hit of miss what protocol works best for you, and since I'm not an RE, I'm just throwing things out there. However, it does sound like you did get a runaway lead follie. With all the smaller ones, I'd think you could find a protocol that got you more mature follies.

dreamalotmp · March 2011

I asked my clinic twice to test my AMH... another thing they don't believe in doing. They don't think it is a good indicator of anything. Indifferent

My AFC was around 9-10. I didn't think that was horrible, although not great by any means.

DOR sucks azz. ;p Thanks for thinking through it with me, ladies. It helps to be able to brainstorm. Esp before my appointment at the new clinic in April.

Edwina.McDunnough · March 2011

dreamalotmp:
I asked my clinic twice to test my AMH... another thing they don't believe in doing. They don't think it is a good indicator of anything.
My AFC was around 9-10. I didn't think that was horrible, although not great by any means.
DOR sucks azz. ;p Thanks for thinking through it with me, ladies. It helps to be able to brainstorm. Esp before my appointment at the new clinic in April.

My AFC is around there too, either 10-11 or, ahem, around 4. I really do think that you could have a better cycle. Sometimes a poor response is really helpful to pinpoint what would work better, you know?

Good luck with your second opinion!

dreamalotmp · March 2011

Thanks so much, Edwina. Smile

kthappy76 · March 2011

I know it is very frustrating when you do everything right, but there a bunch of reasons why a seemingly perfect medicated IUI cycle may not work. Your egg can be too mature (who knew, right?). 24mm is pretty big. Not to discourage you in any way, but there could be egg quality issues, especially since you are AMA. Even if you do ovulate a perfect egg, and even if your tubes appear open, they could be getting "lost" on the way or not fertilizing at all.

How is the sperm morphology? There are lots of unknown factors that go into whether you get pg or not. Are you doing more IUI's or looking at IVF? FWIW, we got discouraged w/no success or answers after 3 IUI's and went to IVF since we figured it would give us a better chance and/or some answers as to why the IUIs weren't working. GL!

dreamalotmp · March 2011

DH's morphology was borderline on a SA months ago. That could have been an issue. I forgot about that since it was so borderline then and was fine with this sample.

We were trying for IVF + ICSI this time. Due to that big egg and the others not growing very fast, it was converted to IUI. I want to make it to ER and ET once with IVF. That's my goal. Hopefully this next time, we make it there.

KDR1979 · March 2011

All of my IUI cycles went "perfectly." On the last one, we found the sperm morphology issue. Some docs don't believe in morph causing IF, but I certainly do!!

Good luck!

hollymichael · March 2011

I agree with the other posters that it sounds like you have DOR. Your high-ish FSH & response to stims seem to indicate this. Also, at 40, there is a large percentage of eggs which have chromosomal issues and can't make a viable embryo. It sounds like your RE is not using the right protocol on you. Hopefully, your new RE will be a better fit. I have seen plenty of DOR women on here go on to a successful pregnancy. It sometimes takes more time, though, as you have to find a good egg.

Good luck!

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