When should I ask for stats? Fist ivf stimulus cycle with DOR low AFC and AMH

kyethra · August 2015

I am now, finally, currently on my first ivf stim cycle. I got the ball rolling in February and with time for workup, testing, insurance, delays, and cancelled cycle due to cysts I am glad to be doing something. I know my original amh was .24 and my AFC was around 6. I started on 225 follistim and 225 menopure and then on cd6 after 3.5 days of stims I had more blood work and ultrasound. Only 4 follicles on us and raised dose to 300 of both, will retest on cd 9 and see. No ganirelex start yet, but will eventually. The nurse I saw on cd2 didn't give me my afc when I asked how it was, just that it was ok, and I thought maybe I saw a total of 7, but my afc counting isn't exactly refined. I am thinking on friday I will press for some numbers. I am 32 (was 31 first afc and amh number) so hope age will give small advantage. My dh has low sperm count so we are doing icsi and we are also doing pgs for a couple of different reasons. So I tend to like to run stats in my head, e.g. if I have x visible follicles and 70 percent have eggs and 70 percent of those are fertilized and half of those have good pgs report.... I also will only do eset with frozen (eset because I had help syndrome with my 3.5 year old, frozen because higher success with pgs). Has anyone found it helpful to ask for certain stats on certain days? I tend to be hopeful but also like to try prepare myself for the worst.

krbjoy · August 2015

You sound just like me. I was able to watch the screen during my US and the tech called out the sizes and counts to the nurse for record, so I was able to keep track (with DH's help). I'm a planner too. I like to be prepared for anything. Hopeful, but prepared. I wish you luck on your cycle!

meganfauer · August 2015

I am a planner too and I like to know all stats at all times since I am in my 8th round I am nuts about comparing the rounds to my 1 successful round. But I am just like you Low AMH, Low antra follicle count and poor responder. But what is crazy my last two cycles had to be cancelled b/c even on high dosages of meds my body would just NOT respond at all. Its almost like my body fought back against and did the opposite. Right now I am responding so poorly IVF wouldn't event be an option. So I am waiting on my period and we are going to try a micro dose protocol, Letrolzole and Follistim (low dosage) and see if my body will do better. When I got pregnant with my son, we did an IUI and I had 7 mature follicles and I got pregnant with twins but that was in 2013 and I was 33, I am now 35 and my eggs are not cooperating and we have low sperm count, specially concentration.

Good luck!!

meganfauer · August 2015

@krbjoy I see you did a micro dose protocol, how did you respond?

krbjoy · August 2015

@meganfauer Well, since I have a low AMH they decided to do the microdose Lupron protocal to try to "flare-up" the follicles for better ovarian stimulation and more mature eggs. I think It worked well, maybe too well. I had a bunch of follicles that were responding and growing a bit too fast so they backed off my Follistim and Menapur so that the growth would slow enough to let the smaller ones catch up. I think I'm looking at maybe 9 mature follicles with a few pretty close. Weird thing is that the left ovary responded and the right really didn't. They said that was normal. Last US though, the right ovary decided to join the party and I had a 14mm and a 10mm show up over there lol. The only down side was having to take 4 injections a day...glad that part is over. Good luck on your next cycle. I'm here if you have any questions when you get to that point!

meganfauer · August 2015

@krbjoy what is your AMH? Wow 9 is amazing. I would give anything for that. my last two cycles I was on 300Iu's of follistim and didn't even get to add the menopur b/c i only had one follicle, then the next round I was on follistim and menopur an on CD 10 I had 4 follicles and they were 8's and smaller, it was just nuts how slow they were responding so she wants to do the same thing for me but using Letrozole CD3-6 and then add 100 iu's of follistim day 6 with my first ultrasound not till day 10 and see if this will help. This is all new to me b/c my other 7 procedures I have been on such big meds so we shall see how this does. Ugh the stress. Good luck with your egg retrieval tomorrow. Cannot wait to hear!

krbjoy · August 2015

@meganfauer My AMH is .882 I understand the stress, as I'm sure we all do. This is a good place to be for some understanding and positive feedback. I really think you are on the right track. I hope it all works out for you! I will definitely post an update when I get some news tomorrow...the waiting is the hardest part...

kyethra · August 2015

It is good to hear that there are still some protocol adjustments that will work even if this cycle doesn't. I got pregnant with my son at age 28 naturally after five failed iuis and over a year of trying, but back then we were just unexplained infertility and now we have both male and a huge female factor so I get nervous. I also secretly look at egg donor databases (dh says I am probably not going to need it... I want to prepare ).

rachlee2010 · August 2015

I am the same age as you @kyethra and also have DOR..I have an amh of about 0.1 and afc of around 4-5. we are doing our second round of IUI right now as soon as AF shows up but we are considering IVF

I am curious to hear how others respond to meds with DOR..we are trying to decide if the financial part of it is worth it with my numbers and the chance that I won't respond well to the meds or we only get a handful of eggs and then not tall of them usually mature and fertilze. Let me know how your cycle goes

meganfauer · August 2015

@rachlee2010 your AMH is very low BUT your age is on your side b/c your eggs are only 32. My Dr. says to not let my AMH get in my head too much and that even though my numbers are close to a 40+ year old women I am only 35 and my eggs are only 35. I did IVF twice when I was 31 and the clinic I went to did not test my AMH anyway I had 6 eggs my first IVF 2 were transferred on Day 5, second IVF I only got 4 eggs and 2 made it and transferred on day 3 and both BFN's. I have since been through 3 IUI's one successful and my successful one I had 7 measurable follicles, which was great for me. My recent two IUI's were cancelled b/c the first one i had only 1 egg and on high meds and the second one I had 3 small ones that were not growing so I canceled the procedure. I discussed with my Dr. if I should do IVF again and she said I don't even qualify b/c I am producing so few eggs.

The one thing I would say that if I was able to do IVF again I know I would be on a totally different protocol, one that focusing for poor responders. There are multiple options like we have been talking about the Micro Dose Lupron version or any of the micro dose options as well as natural IVF. These are options for ladies when they know even with HIGH meds they won't get that many eggs so why pump you with unnecessary meds and if out of pocket have you spend the money and just get your body to produce a few eggs like 1-4 etc. There are options and what is good is that you know you have DOR ahead of time, I found out way late in the game! good luck

meganfauer · August 2015

There is even a new protocol where they use HGH to help your eggs grow and it has been successful but expensive

meganfauer · August 2015

Also I know that this place https://www.centerforhumanreprod.com/infertilityedu/causes/diminished-ovarian-reserve/ and Colorado Center for Reproductive Medicine are World Class in dealing with DOR. If I was to do IVF again I would probably spend the extra bit and travel to one of these locations to have it done by the best.

rachlee2010 · August 2015

Thanks for all the info @meganfauer If we do I've I believe it would be a micro dose Lupron. Right now we are doing iui and if I get enough follies like 5ish I'll ask to switch to ivf retrieval

I've heard of ccrm in Colorado but it's so far from me. We will see how things go with our dr. She seems to know about dor and take it from there.

I have a 2.5 year old who we got pregnant with easily. I got pregnant again naturally in January but miscarried in February so I should be able to get pregnant (I think) and at 32 I know I must have some good eggs left.

meganfauer · August 2015

Best of luck!! and you for SURE have good eggs left. Keep us posted!!

kyethra · August 2015

No follicles over 10 mm, estrogen never got over 50. Cycle canceled. ugh. But there were at least several small ones. Dr. said to think about if we wanted to proceed odds are not good. DH and I decided to try again-- we have a mandatory wait of a couple of months-- and do a different protocol, I already mentioned micro flare to Dr. Then I told DH I want to go with donor eggs if we do not get a good response from that cycle. DH doesn't like the idea of third party reproduction-- I have never minded and think it is a wonderful option. So I told him to get over it because this is my plan. We both a want another child and we get to be the ones to raise it. I am also going to start taking DHEA-- I asked my dr and she said it was mostly indicated for quality issues, but it likely wouldn't hurt.

meganfauer · August 2015

@kyethra You sound just like me from my last TWO cancelled Cycles from no response and very slow response and low estrogen the second one. I am so sorry. I have started to take the list of CCRM supplements recommended for poor responders 2 days ago. I added 75mg of DHEA as well. We shall see. It says to to take it for 3 months prior to Egg Retrieval. Maybe you should give it a try? I am at the point right now, well what can it hurt

Best of luck to you and always know Im here to vent as we are in a very similar situation!

rachlee2010 · August 2015

@meganfauer I was looking at your signature with all your iui's and ivfs and noticed your son was born on 10/17/13...my son was born on 10/17/12!!!! GREAT DAY...I hope we both find luck getting number 2 one day

meganfauer · August 2015

@rachlee2010 the absolute greatest day!! fingers crossed for #2 us,

kyethra · August 2015

I am having a discouraging day after this. Ugh. I really just hope to get a decent number of eggs on a different protocol this fall so we get a decent number of embryos and then with pgs we have plenty of healthy girl embryos. Autism runs in my family -- my older brother has severe autism and my DS has autism with a speech delay. The risk is much higher in males and with my family history I really feel the need to do gender selection. That way if my daughter were to have autism I can at least tell her that I did everything in my power, and the universe must have been determined. Plus I really like the idea of a girl to go with my boy-- one of each. Even if I do end up doing donor eggs I might still do pgs. I feel better about knowing we are transferring healthy embryos. Because we had five failed IUIs in 2011 I know we are done with that-- and I know we need icsi. I know I can get pregnant an carry a baby-- and if weren't for that stupid HELP syndrome I probably would have gone full term. So now I am working on trying to take my supplements and lose some weight before we next do IVF (I am borderline obese, but that is down 10 pounds from when I got pregnant in 2011 and down 75 pounds from when I got married 9 years ago and was morbidly obese). And I am so researching donor eggs, just in case.

Want a personalized experience?

When should I ask for stats? Fist ivf stimulus cycle with DOR low AFC and AMH

Re: When should I ask for stats? Fist ivf stimulus cycle with DOR low AFC and AMH

Choose Another Board

Search Boards