Secondary IF

What would you do?

I'm 39-years old with a DOR of 0.389 and an FSH of 9. I had an AFC done yesterday and they saw 4 follicles. I've been told by two RE's that I'm not a good candidate for IVF and that I should move on to IVF with a donor egg. For many reasons, that's not an option for us. We would like to do several rounds of IUI as a last shot of getting pregnant.

I started with an RE in December. She has been very conservative in her treatment. She wouldn't let us start with an IUI despite my age and tests results. Since then she has told us that she really doesn't feel that she can help us much because we aren't interested in using a donor egg. She offered to do one cycle with an IUI, but she didn't really even want to do that for us. After that discussion my DH decided to go to a different RE to see if they felt the same way. We pretty much got the same response. The only difference is that this RE was very open to us trying IUI if that's what we'd like to do.

My dilemna is this: I have one ovary. I lost my right ovay due to a long of history of ovarian cyst that would get very big. They were painful and wouldn't go away on there own. After having several surgeries to remove cyst my doctor removed the ovary. So, I'm pretty protective of the ovary I have left and don't want to stress it out too much. I did one cycle with letrazole, follistim and ovidrel and ended up with a fairly large cyst that took two months to resolve on its own. The other two medicated cycles I just took Letrazol and Ovidrel and I was fine. I produced two follicles each month.

The new RE I went to said she wants to be very agressive with medications despite my gut feeling that I'll just end up with another cyst, or worse, if we follow her protocol. She said I'll be fine, but probably just really uncomfortable. I thought about it and decided to call my original RE. I was honest with her and told her what the new RE wanted to do and I told her how nervous it made me. My old RE was very nice and said that if I wanted to try some IUI cycles she would help us. She suggested we start with letrazole and Ovidrel and then we can add a low dose of follistim if I don't get a good response.

If it were you, would you take the more aggressive approach and hope for the best or would you play it safe and stay with the first RE and go with a more conservative plan? Deep down I feel more comfortable with being more conservative, but of course I worry if I'm making the right decision. In the end I just want the best (ha ha) chance of getting pregnant. I'm very aware that my chances are very low with either course of treatment.

Sorry this was so long! Thanks in advance!

Re: What would you do?

  • pdbirdpdbird member
    @RudyGirl76 - First of all, it's not a long post and don't apologize for that! I've seen a lot longer. Second, I hear you about not knowing what the right decision is. If it was me, I'd stick with the first RE based on getting the second opinion. I'm glad you did that. Because now you know all the options. If this is the only ovary you have, I'd be protective of it as well. It would be so awesome to be pregnant, but in the chance you don't get pregnant you wouldn't want to have to live with a bigger issue of having no ovaries or something else due to a side effect. At least that's my opinion. I wouldn't want to jeopardize my health long term if the outcome of pregnancy isn't in my favor. Hopefully that makes sense.

    I don't envy you for having to make this decision, but I'm here to listen and I know you will find the right answer to your dilemma. And I wouldn't second guess yoor decision. You know what's best for you at this time in your life. And like everyone and their mother says, "Everything happens for a reason" (Ugh, I hate that!) Best of luck! Hugs :)
    Me: 37 DH:41
    10/2009 - TTC#1 Stopped BCP! Let's DO this!
    1/2010 - BFP (Natural) --> 10/2010 - DS born! Yay!
    12/2010 - DH diagnosed with stage 3B testicular cancer. #cancersucks
    10/2011 - Complications with DH and lymph nodes in groin area removed. No longer able to ejaculate.
    1/2014 - TTC#2 - IUI#1. No luck. Findings: DH sperm did not survive freeze. RE recommends IVF with ICSI.
    3/2014 - IVF Cycle #1 Started BCP
    4/2014 - Lupron, Gonal-F, and Menopur
    5/7/2014 - ER day (25 eggs retrieved, 15 mature)
    5/10/2014 - 6 fertilized, 3 embryos frozen - one grade A and two Grade B. Plan was to grow out to blastocyst stage but rest of eggs arrested by day 3. Decided to freeze on day 3.
    2/9/2016 - FET #1 with Grade A (8 cell - 3 day embryo); 2/20 - Beta was <5. BFN.  :/ Waiting for period and start next FET.
    7/8/2016 - FET #2 with Grade B (8 cell - 3 day embryo), fingers crossed this one sticks. :)
    7/19 - Beta was 74. BFP!!!!; 7/21 - Beta was 182; 1st U/S on 8/2; 2nd U/S on 8/16 :)

    BabyFetus Ticker
  • I would try and take the conservative approach first
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