Trying to Get Pregnant

Questions/Chart Stalk October 2022

Ask your cycle and chart-related questions here!

TTC History:
Me: 36 H: 40 Married 2015. Together since 2010.
TTC: Sept 2016-Oct 2017
BFP Oct 2017. DD born July 2018.
TTC: March 2020. BFP March 2020
Due date was Nov 2020
DS born Sept 2020. DS passed away Nov 2020 due to prematurity and birth trauma.
TTC: March 2021
IUI #1 Nov 2021, BFN
IUI #2 Dec 2021 BFP.  MC Jan 2022
IUI #3 Aug 2022 BFN
IUI #4 Sept 2022 BFN
AMH test came back at .081. Was going to move on to IVF with DE, but have decided not to. Will be leaving it up to the universe now.



Re: Questions/Chart Stalk October 2022

  • Ugh, so I did a slightly (read VERY) stupid thing and got one of these Proov kits to get a quick check on my hormones before I see the OBGYN in November. But now I know things I wish I didn’t know…

    My baseline FSH was 22! I’m confused. I still have a regular cycle and ovulate just fine, I was even able to get pregnant twice last year at 38 (TW both miscarriages). From what I read this level would put me in a diminished ovarian reserve category, and would also exclude us from IVF at most clinics. Is it possible that this is not as bad as it seems? I will obviously be asking the doc about this, but in the meantime, can anyone offer any insights on high FSH? 
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  • @maggiemadeit i would definitely want to get that rechecked through an official lab. fsh needs to be taken as a "day 3" (although day 2 works just as well). my fsh moves around a little bit, although the smart folks over in the IF thread told me that what "counts" is the highest lab result you receive. it reflects how hard your body has to work to kickstart the process of growing out follicles each month, but i am convinced that some months are harder for the body than others. so basically, don't panic. get that test redone, and see what your doctor has to say. and no one lab result on its own is the apocalypse, especially if you've demonstrated an ability to get at least partway down the path.
    History
    I am doing this on my own. Left ovary and fallopian tube removed due to cyst/necrosis just after birth. Right ovary and tube still purport to function.
    Began TTC in Aug '18 @ age 35
    5 or 6 (or 7?!) cycles using frozen donor sperm, ICI. All BFN
    Mar-Jun '19 IUIs, all BFN
    Began process of referral for RE in spring of '19, blood tests confirm low AMH (.54) but all else is good.
    May '19 HSG shows open tube, but ultrasound suggests fibroids
    MRI in June '19 confirms two large fibroids, one growing through wall of uterus
    In June '19 I move from California to Oregon, disrupting my insurance, referrals, etc. 5 months spent piecing it all back together.
    Nov. '19 attempted myomectomy (vaginal approach) failed. 2nd surgery using laparoscopic method in Jan '20 is successful.
    April '20 --> June '20, natural IUIs, all BFN.
    July? saline ultrasound and bubble test demonstrate open tube
    July '20 clomid cycle cancelled for thin lining
    Aug-Oct, 3 femara cycles, all BFN
    RE referral. While waiting to set up an appointment Nov-Jan,I continue with natural cycles and ICI, using a known donor, BFN...
    Jan '21 more bloodwork, AMH is worse (.30), FSH high albeit not catastrophic at 13.2. hysteroscopy all good. "looks cozy!" says the RE.
    Feb '21, injectables (menopur, novarel), iui, BFN (doc said the frozen donor sperm sample had the "best numbers she'd ever seen!")
    Mar '21, injectables, iui cancelled due to lack of follicles, converted to at home-insem. BFN
    May '21, first IVF round cancelled due to cyst.
    July '21 IVF: standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 7; 6 days of stims. 8 eggs retrieved, 7 mature, 5 fertilize, 4 made it to blast. 3 are 4AB, 1 is 4BB. PGT-A results all abnormal.
    Oct '21 somewhat improved AMH (.51) and significantly improved FSH (8.9). Maybe it's all the pills I swallow.
    Dec -21, standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 5; 11 days of stims. retrieval yields 5, 4M, 2 reach day-6 blast (4AB & 4BB). 1 low-level mosaic (chr. 3 deletion), 1 complex abnormal.
    Feb '22 FET (low-level mosaic): CP.
    May '22 egg retrieval, lupron flare protocol. HGH priming for 1 month before stims; md lupron 20/20u daily; menopur 225, follistim 225, 10k trigger after 8 days of stims; AFC 10; 13 retrieved; 10 mature; 8 fertilized. All frozen at 2PN for later thaw, grow, and biopsy.
    July '22 egg retrieval same protocol: 9 days of stims; AFC 8; 10 retrieved, 8 mature, 4 fertilized and frozen.
    Sept '22 ER same protocol: AFC 10; 12 retrieved, 11 mature, 11 fertilized.
    From the 3 retrievals, 7 survived to day 5-6 blastocyst, from which I have 2 normal embryos!
    Jan 20, Fully medicated FET, baby aspirin, dexamethasone, acupuncture, and as much woo as I can stand (which isn't very much). BFN.
    July 23, Natural FET + baby aspirin. BFN.
  • @optimistgardener Thanks for your insights! For sure, I’ll have the doc run it in a real lab. I am trying not to panic. I guess even if the number is accurate it’s not entirely unexpected, given that I’m almost 40 and having trouble making a baby. 

    Mostly I’m mad at myself for even going down this path. I spend 2 hours on PubMed yesterday instead of working. I clearly can’t handle this level of information 😂
  • @maggiemadeit speaking as someone who has spent a lot of time down the pubmed rabbithole, both for my own stuff and for family members with suckier diagnoses than my own infertility, i can say that information-seeking is a perfectly reasonable coping strategy and will at least help you to figure out what kinds of questions you want to ask your doctor. don't be too hard on yourself. :)
    History
    I am doing this on my own. Left ovary and fallopian tube removed due to cyst/necrosis just after birth. Right ovary and tube still purport to function.
    Began TTC in Aug '18 @ age 35
    5 or 6 (or 7?!) cycles using frozen donor sperm, ICI. All BFN
    Mar-Jun '19 IUIs, all BFN
    Began process of referral for RE in spring of '19, blood tests confirm low AMH (.54) but all else is good.
    May '19 HSG shows open tube, but ultrasound suggests fibroids
    MRI in June '19 confirms two large fibroids, one growing through wall of uterus
    In June '19 I move from California to Oregon, disrupting my insurance, referrals, etc. 5 months spent piecing it all back together.
    Nov. '19 attempted myomectomy (vaginal approach) failed. 2nd surgery using laparoscopic method in Jan '20 is successful.
    April '20 --> June '20, natural IUIs, all BFN.
    July? saline ultrasound and bubble test demonstrate open tube
    July '20 clomid cycle cancelled for thin lining
    Aug-Oct, 3 femara cycles, all BFN
    RE referral. While waiting to set up an appointment Nov-Jan,I continue with natural cycles and ICI, using a known donor, BFN...
    Jan '21 more bloodwork, AMH is worse (.30), FSH high albeit not catastrophic at 13.2. hysteroscopy all good. "looks cozy!" says the RE.
    Feb '21, injectables (menopur, novarel), iui, BFN (doc said the frozen donor sperm sample had the "best numbers she'd ever seen!")
    Mar '21, injectables, iui cancelled due to lack of follicles, converted to at home-insem. BFN
    May '21, first IVF round cancelled due to cyst.
    July '21 IVF: standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 7; 6 days of stims. 8 eggs retrieved, 7 mature, 5 fertilize, 4 made it to blast. 3 are 4AB, 1 is 4BB. PGT-A results all abnormal.
    Oct '21 somewhat improved AMH (.51) and significantly improved FSH (8.9). Maybe it's all the pills I swallow.
    Dec -21, standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 5; 11 days of stims. retrieval yields 5, 4M, 2 reach day-6 blast (4AB & 4BB). 1 low-level mosaic (chr. 3 deletion), 1 complex abnormal.
    Feb '22 FET (low-level mosaic): CP.
    May '22 egg retrieval, lupron flare protocol. HGH priming for 1 month before stims; md lupron 20/20u daily; menopur 225, follistim 225, 10k trigger after 8 days of stims; AFC 10; 13 retrieved; 10 mature; 8 fertilized. All frozen at 2PN for later thaw, grow, and biopsy.
    July '22 egg retrieval same protocol: 9 days of stims; AFC 8; 10 retrieved, 8 mature, 4 fertilized and frozen.
    Sept '22 ER same protocol: AFC 10; 12 retrieved, 11 mature, 11 fertilized.
    From the 3 retrievals, 7 survived to day 5-6 blastocyst, from which I have 2 normal embryos!
    Jan 20, Fully medicated FET, baby aspirin, dexamethasone, acupuncture, and as much woo as I can stand (which isn't very much). BFN.
    July 23, Natural FET + baby aspirin. BFN.
  • Not necessarily cycle or chart related, but...has anyone ever been told by one doctor that they might have PCOS and then definitely not by a second doctor? I've had 36-day cycles since coming off birth control last October and was pregnant in July of this year, (TW?) but unfortunately it was chemical, so I went for an ultrasound when the bleeding started. First doctor said my ovaries look polycystic and asked if I had ever been told that before - I had not. She reassured me that even though it was a chemical pregnancy, it was a good thing because that means "our parts work." Two weeks later they wanted me back in for a second ultrasound and I saw a different doctor. I came locked and loaded with a bunch of questions about PCOS and conceiving; she basically told me that no, I don't have PCOS, I just have multiple follicles. I'm just confused and curious if this has ever happened to anyone else?
  • hi @dmcgrew17, one of our graduates (@acleverusername) was misdiagnosed with pcos years before she started trying. once she started having regular contact with doctors for infertility, it became clear that the old diagnosis didn't seem to have a lot of basis. pcos is way outside my personal wheelhouse, but as i understand it, a visual interpretation of the ovaries (lots of little follicles or no?) should be combined with bloodwork (high  amh? evidence of regular ovulation and adequate luteal phase progesterone production?) and a personal history involving your cycle and other symptoms. if it's something you're worried about, you could ask for bloodwork, but if your cycles are regular, that's the main thing most pcos-havers struggle to try to manage in a fertility context.
    History
    I am doing this on my own. Left ovary and fallopian tube removed due to cyst/necrosis just after birth. Right ovary and tube still purport to function.
    Began TTC in Aug '18 @ age 35
    5 or 6 (or 7?!) cycles using frozen donor sperm, ICI. All BFN
    Mar-Jun '19 IUIs, all BFN
    Began process of referral for RE in spring of '19, blood tests confirm low AMH (.54) but all else is good.
    May '19 HSG shows open tube, but ultrasound suggests fibroids
    MRI in June '19 confirms two large fibroids, one growing through wall of uterus
    In June '19 I move from California to Oregon, disrupting my insurance, referrals, etc. 5 months spent piecing it all back together.
    Nov. '19 attempted myomectomy (vaginal approach) failed. 2nd surgery using laparoscopic method in Jan '20 is successful.
    April '20 --> June '20, natural IUIs, all BFN.
    July? saline ultrasound and bubble test demonstrate open tube
    July '20 clomid cycle cancelled for thin lining
    Aug-Oct, 3 femara cycles, all BFN
    RE referral. While waiting to set up an appointment Nov-Jan,I continue with natural cycles and ICI, using a known donor, BFN...
    Jan '21 more bloodwork, AMH is worse (.30), FSH high albeit not catastrophic at 13.2. hysteroscopy all good. "looks cozy!" says the RE.
    Feb '21, injectables (menopur, novarel), iui, BFN (doc said the frozen donor sperm sample had the "best numbers she'd ever seen!")
    Mar '21, injectables, iui cancelled due to lack of follicles, converted to at home-insem. BFN
    May '21, first IVF round cancelled due to cyst.
    July '21 IVF: standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 7; 6 days of stims. 8 eggs retrieved, 7 mature, 5 fertilize, 4 made it to blast. 3 are 4AB, 1 is 4BB. PGT-A results all abnormal.
    Oct '21 somewhat improved AMH (.51) and significantly improved FSH (8.9). Maybe it's all the pills I swallow.
    Dec -21, standard antagonist. 225menupur/225gonal-f/cetrotide/5000u trigger, AFC 5; 11 days of stims. retrieval yields 5, 4M, 2 reach day-6 blast (4AB & 4BB). 1 low-level mosaic (chr. 3 deletion), 1 complex abnormal.
    Feb '22 FET (low-level mosaic): CP.
    May '22 egg retrieval, lupron flare protocol. HGH priming for 1 month before stims; md lupron 20/20u daily; menopur 225, follistim 225, 10k trigger after 8 days of stims; AFC 10; 13 retrieved; 10 mature; 8 fertilized. All frozen at 2PN for later thaw, grow, and biopsy.
    July '22 egg retrieval same protocol: 9 days of stims; AFC 8; 10 retrieved, 8 mature, 4 fertilized and frozen.
    Sept '22 ER same protocol: AFC 10; 12 retrieved, 11 mature, 11 fertilized.
    From the 3 retrievals, 7 survived to day 5-6 blastocyst, from which I have 2 normal embryos!
    Jan 20, Fully medicated FET, baby aspirin, dexamethasone, acupuncture, and as much woo as I can stand (which isn't very much). BFN.
    July 23, Natural FET + baby aspirin. BFN.
  • Thanks @optimistgardener! The second doctor is my usual gyno, so I tend to lean more on her because I've seen her for years. She said that if we get to the 1 year mark (January) and haven't conceived yet, we'll do tests then. Hoping to not need the tests!
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