What are your options with diminished ovarian reserve?

[Anonymous]

Anonymous wrote:That article is from 1998!

In any event, to answer OP's question, your options depend on just how diminished your ovarian reserve is. If your FSH is around the 12-14 level, you can do regular IVF at any of the respected clinics around here. If it is in the high teens, you could try a regular IVF approach to see if your ovaries will respond to the drugs. If it is in the 20s or higher, mini-stim or natural cycle IVF might be options for you.

OP here - thanks for pointing out that the article was outdated. I had read this before and it has depressed me. I'm glad to find that the field has moved beyond that line of thought. It didn't make sense to me that all these women with High FSH were doing IVF.

The rest of your answer is exactly what I was looking for. IVF is possible and that would increase my chances of having a normal embryo in a shorter amount of time. I just need to see exactly how diminished my reserve is to determine my options.

Thanks all for your responses

[Anonymous]

PP there is hope I'm 41 and got pregnant with IVF, after 6 failed IUI's.

[Anonymous]

I realize that 1998 is a bit old, but it doesn't necessarily mean that the information is bad. I'm the PP, and prior to natural cycle IVF, I tried two stimulated IVF cycles. My ovaries did not respond. I produced very few eggs, and they developed into very poor quality embryos. The REs told me that my eggs were bad. I read the article, and believed it, and decided to try natural cycle IVF. On my first try, I had a beautiful blastocyst (the first time that one of my "bad eggs" made it to that stage). On my second try, another beautiful blastocyst, and I am pregnant after a 5dt. So, it's fine if you want to say that the article is outdated... but the article's basic point is that the medications can hurt your eggs if they are already fragile. For me, that certainly appeared to be true. And let me tell you -- Natural cycle was a BREEZE as compared to stimulated IVF. It was easier; I had better results; and it was cheaper. But, if you want to believe that any information that comes from 1998 is per se "wrong", then go ahead.

[Anonymous]

I have not heard anything about the stims hurting your eggs -- if anything I think it's the culture medium/lab that helps or hurts if the egg quality is iffy. If your eggs are genetically bad though - no amount of stims or lack thereof is going to change the DNA.

[Anonymous]

So what is the difference between natural cycle IVF and getting pregnant on your own if there are no other issues than DOR? I thought the advantage of stimulation (IUI or IVF) if you can get was to give you more chances at a good embryo in one cycle.

[Anonymous]

The odds are higher so you get of faster before all your eggs are gone.
I have read that taking DHEA helps reduce miscarriages due to chromosomal issues in women 35 and up

[Anonymous]

"So, it's fine if you want to say that the article is outdated... but the article's basic point is that the medications can hurt your eggs if they are already fragile. For me, that certainly appeared to be true."

I'm the one who pointed out that the article was outdated, and I actually think that most of it is still correct today. However, I don't think that the idea that stims hurt old eggs is believed by many REs these days. Same is true with the idea that older eggs don't do well in the culture medium - which in fact have changed tremendously since the article was written, allowing for many more women to make blasts (assuming the lab is using a better quality culture).

[Anonymous]

20:37- Theoretically, there should be no difference between natural cycle IVF and getting pregnant on your own. The egg is the same with either. However, it's impossible for doctors to know why a particular couple isn't able to conceive. Older women don't produce as much cervical mucus, which serves to transport the sperm, so if the timing of BD isn't "perfect", there won't be a fertile environment for the sperm. In older women, the egg often also has a harder shell, so it is harder for sperm to penetrate it. These factors can be addressed through IVF -- the c.m./timing is no longer an issue, and if the RE uses ICSI, that is no longer an issue. Also, if there is any male factor (low sperm count or morphology), you can also remove that problem by doing ICSI.

You are correct that natural cycle IVF won't "fix" an egg if it is chromosomally abnormal. However, if the egg is chromosomally normal, then natural cycle IVF should still improve your chances.