SGF for Borderline DOR?

[Anonymous]

I know the general consensus here is to avoid SGF if you’ve got DOR or are AMA, but is that always the case—even if you’ve got a great (albeit new) doctor?

Debating switching between GW and SGF to follow my former RE who recently moved to SGF (Humm). She’s recommended the same protocol as GW— including luteal estrogen priming— but I’m worried she won’t have as much freedom to try new things/protocols if this round doesn’t work. And I’m worried they’ll give up on me if this round doesn’t work. I’m almost 34 but have a lower egg reserve.

Anyone have any insight?

[Anonymous]

Why not try it? She says she will do the v protocol you want this cycle. If she gives up next cycle, try some places else.
I went to sgf with borderline dor. It actually worked after a few failures

[Anonymous]

Thank you- and congratulations!!

[Anonymous]

Why would she not have freedom to pursue different protocols? It's not like they have to follow a certain order of protocols.

I had DOR, did several rounds at SGF, tried out different protocols. The one time I had a transfer (all other rounds were canceled before retrieval or I had zero eggs that fertilized) I was pregnant but miscarried. I eventually went with donor eggs. If my case wasn't so severe, I think I would have found success at SGF with my own eggs.

[Anonymous]

Sorry for bringing up an old thread, but wanted to add my experience here since we almost didn't go to SGF based on what we were seeing on DCUM.

I was diagnosed with DOR about a year and a half ago. Not great numbers...FSH was above 14, AMH I believe was right around 1, and AFC of 8. Age 37 at the time, 38 now. We were about to begin treatment elsewhere, but went way out on a whim - my husband knew that a friend of his mom's was a retired fertility clinic nurse, and although it was super embarrassing we called her up to get her thoughts. She strongly encouraged us to start at SGF, based mostly off her belief that the most important thing for determining IVF success is the quality of the lab, and her belief that SGF has a reputation for the best lab in the DC area.

We went through three cycles at SGF. The first two were cancelled and converted to IUI due to low egg yield. I was on a high dosage of stims and only developing around 3 follicles by the end of monitoring - they basically said I could go to retrieval, it was our decision, but they didn't think it would be worth it with only 3 follicles. After each cancelled cycle, we discussed how the protocols could be modified. Overall, my doctor (Dr. Nair) was not super supportive of doing drastic modifications like mini-stim or natural IVF so that is not something we tried. I took her position to be that there just wasn't strong enough evidence that these other methods were more effective, and I trusted she knew more than me and really did want me to be successful and would recommend what she thought would work best. On our third cycle, I believe we added Lupron to the treatment regiment. I got a slightly higher yield...I think they saw 5 or 6 follicles at the end of monitoring, but only retrieved 4. Of those, only one fertilized, but that turned out to be the one and I am due next week.

So just wanted to say, yes, there are people who have DOR and have good experiences with SGF. It doesn't mean the opinions of people who had negative experiences aren't also valid, but those with negative opinions will also tend to be louder - it doesn't make them representative of everyone, or even the majority. So just make sure you're checking out clinics' numbers on the CDC website and not just trusting anecdotal evidence on DCUM.

[Anonymous]

Anonymous wrote:Sorry for bringing up an old thread, but wanted to add my experience here since we almost didn't go to SGF based on what we were seeing on DCUM.

I was diagnosed with DOR about a year and a half ago. Not great numbers...FSH was above 14, AMH I believe was right around 1, and AFC of 8. Age 37 at the time, 38 now. We were about to begin treatment elsewhere, but went way out on a whim - my husband knew that a friend of his mom's was a retired fertility clinic nurse, and although it was super embarrassing we called her up to get her thoughts. She strongly encouraged us to start at SGF, based mostly off her belief that the most important thing for determining IVF success is the quality of the lab, and her belief that SGF has a reputation for the best lab in the DC area.

We went through three cycles at SGF. The first two were cancelled and converted to IUI due to low egg yield. I was on a high dosage of stims and only developing around 3 follicles by the end of monitoring - they basically said I could go to retrieval, it was our decision, but they didn't think it would be worth it with only 3 follicles. After each cancelled cycle, we discussed how the protocols could be modified. Overall, my doctor (Dr. Nair) was not super supportive of doing drastic modifications like mini-stim or natural IVF so that is not something we tried. I took her position to be that there just wasn't strong enough evidence that these other methods were more effective, and I trusted she knew more than me and really did want me to be successful and would recommend what she thought would work best. On our third cycle, I believe we added Lupron to the treatment regiment. I got a slightly higher yield...I think they saw 5 or 6 follicles at the end of monitoring, but only retrieved 4. Of those, only one fertilized, but that turned out to be the one and I am due next week.

So just wanted to say, yes, there are people who have DOR and have good experiences with SGF. It doesn't mean the opinions of people who had negative experiences aren't also valid, but those with negative opinions will also tend to be louder - it doesn't make them representative of everyone, or even the majority. So just make sure you're checking out clinics' numbers on the CDC website and not just trusting anecdotal evidence on DCUM.

congrats on your success. Please do re-read your post though. you had to do 3 cycles and the doc was not supportive of trying things out of the box. with a 1 AMH and under 40 you are in decent shape. You are on the cusp of DOR and it almost didn't work for you after 3 cycles.
For those of us with abysmal numbers throwing high dose stims does not work.

-signed .4 AMH at 34 and told to go straight to donor eggs by SGF. Mom of 2 DD's with OE at 37 and 42 from mini stim in NYC after 5 failed local cycles where I was just blasted over and over with high dose meds (and lupron).

[Anonymous]

I totally recognize that different things work for different folks, and not trying to say doing things any one way is the right decision for everyone. But:

(1) 3 cycles seems not uncommon at all, considering IVF is basically a numbers game. And we were (very luckily) successful on our first completed cycle of IVF. The cycles that were cancelled were cancelled due to low follicle counts - it's not like we would have had higher counts with less drugs (I understand the debate there is just that with other protocols you may, arguably, get higher quality eggs, not more). We were trying different protocols to see if there was anything we could do to boost the follicle counts...just nothing seemed to work very well.
(2) Doc was not supportive of trying things outside of the box because, in her opinion, it would not give us any better chance. For what it's worth, the other clinic we almost went to (Columbia Fertility) also did not recommend outside the box options when we asked about it, it's just that it sounded like their attitude about it was, "It's your money and your body, so if you really want to try something different we'll let you". That was my impression of it, anyways.

So just want to tell folks that they shouldn't be scared away from at least doing an initial consult with SGF. If they immediately start pushing you into things you're not comfortable with, sure, go elsewhere if that's what you want to do. This just wasn't our experience, and I want people to know that there are DOR patients who have positive experiences with SGF.

[Anonymous]

I think with DOR in general it really is a numbers game and luck of the draw. its not uncommon for DOR patients to have 3-5 retrievals before they finally find success. some get lucky on first try; others never do after 8+ rounds. what's important is finding a reliable clinic whose lab has a good reputation, knowing your limit (mentally, physically and financially) and your game plan. ie if it doesnt work at SGF after 3 tries do you go elsewhere, are you willing to try different protocols, etc.

For me, I was unfortunately a DOR patient at SGF who didn't find success after 3 rounds so i decided to jump to other clinics. Still chasing, but I do think I very well could've found success at SGF if I kept going, but I just as much may not have. I'm now doing our hail mary at CCRM Lone Tree and if it fails there, then at least I tried everything.

[Anonymous]

For DOR + AMA and wanting to use own eggs I would only go to CCRM Lone Tree or Cornell.
For donor egg, Zlin in CZ because you get the same results for way less money.

[Anonymous]

Anonymous wrote:I think with DOR in general it really is a numbers game and luck of the draw. its not uncommon for DOR patients to have 3-5 retrievals before they finally find success. some get lucky on first try; others never do after 8+ rounds. what's important is finding a reliable clinic whose lab has a good reputation, knowing your limit (mentally, physically and financially) and your game plan. ie if it doesnt work at SGF after 3 tries do you go elsewhere, are you willing to try different protocols, etc.

For me, I was unfortunately a DOR patient at SGF who didn't find success after 3 rounds so i decided to jump to other clinics. Still chasing, but I do think I very well could've found success at SGF if I kept going, but I just as much may not have. I'm now doing our hail mary at CCRM Lone Tree and if it fails there, then at least I tried everything.

Wising you the best on your next round! You have been through a lot. I hope this next cycle will be the one.

[Anonymous]

OP here! I ended up going back to my very first clinic, Columbia fertility (got pregnant from an IUI in 2020) and had way, way, way better results than I did at GW. Saw Dr. Sacks, who was willing to be much more aggressive than GW (let me do injections for an IUI, let me transfer 2 untested embryos during a fresh transfer).

And I honestly think the CFA lab is better than GW’s. I had a feeling something wasn’t right when I went from 10 eggs to 1 “ok” blastocyst that didn’t take (none to freeze). At CFA I ended up with 4 good quality blasts out of 9 eggs. Could be totally random, but the cycle at CFA was just better overall.

[Anonymous]

OP again. Should have mentioned that the staff and nurses at CFA were an absolute nightmare though!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think with DOR in general it really is a numbers game and luck of the draw. its not uncommon for DOR patients to have 3-5 retrievals before they finally find success. some get lucky on first try; others never do after 8+ rounds. what's important is finding a reliable clinic whose lab has a good reputation, knowing your limit (mentally, physically and financially) and your game plan. ie if it doesnt work at SGF after 3 tries do you go elsewhere, are you willing to try different protocols, etc.

For me, I was unfortunately a DOR patient at SGF who didn't find success after 3 rounds so i decided to jump to other clinics. Still chasing, but I do think I very well could've found success at SGF if I kept going, but I just as much may not have. I'm now doing our hail mary at CCRM Lone Tree and if it fails there, then at least I tried everything.

Wising you the best on your next round! You have been through a lot. I hope this next cycle will be the one.

Thank you <3