These damn antral follicles!

[Anonymous]

I am so frustrated. I'm on my 3rd cycle. I have been doing acu 2x/ week. I have been eating right - brown rice, veggies, hardly any red meat and only chicken 4 times a week, lots of antioxidant supplements, protein shake. I recently turned 42. I had one IVF cycle when I was 36 and have DC now. I started my stims last week. I had a f/u today. I started out with 9 follicles prior to stims, which RE said pretty good for a 42 year old. But then after stims began, I went down to 4 follicles! I'm on Bravelle and Menopur (max dosage). I did ganirelix injections just prior to my cycle beginning also. Why is it that everyone doing IVF seems to increase their AFC and my follicles seem to stop growing or disappear? Is it because of my age, stress, or lack of sleep....??

[Anonymous]

As a 43 year old who's been doing stim cycles for quite a while, my best guess is that it's your age. Up to 90% of your eggs could be "bad" and those might be getting weeded out now. Hopefully the ones you do get will be good ones. When do you go in again? And what is your e2? That can tell you a lot.

[Anonymous]

Do you just see a tech and not a doc when you did yesterday's u/s? Could be the tech missed a few and you haven't "lost" as many as you think. Agree about e2 - did your nurse say anything about your levels?

[Anonymous]

Anonymous wrote:As a 43 year old who's been doing stim cycles for quite a while, my best guess is that it's your age. Up to 90% of your eggs could be "bad" and those might be getting weeded out now. Hopefully the ones you do get will be good ones. When do you go in again? And what is your e2? That can tell you a lot.

OP here. What's an e2?

[Anonymous]

Sorry, estrogen level.

[Anonymous]

My estrogen levels for the last three cycles were normal according to the nurse. I can't remember exactly but I want to say both times it was generally around 30. For this third cycle it was 82. The RE attributes this higher estrogen level to the vivelle patches I was using before my menstrual cycle began. So they said a slightly elevated estrogen level is normal if one has been using vivelle patches.
So I'm wondering if my e2 levels were normal, why I'm losing eggs...

[Anonymous]

probably your age, but are you sure you really only had 4 follicles? sometimes they only mark down the biggest ones.

[Anonymous]

Nurse did say there were some that were smaller but they are no longer 'counting' those because these little ones are assumed to stopped growing with the rest of them.

It seems that most women have follicle counts that increase as they progress through with stims. The opposite always happens with me.

I saw a tech, not a doctor.

[Anonymous]

OP here. I went in for my f/u again today. My sonogram showed that I now have only two follicles that are the size they want. So basically I went from 9, to 4, and now to 2!

They might cancel my IVF cycle because SG wants at least 3 or 4 follicles to move forward with IVF.

I am so emotionally wrung out.

[Anonymous]

I'm so sorry. Try not to blame yourself. My understanding is that some protocols do this so some women, and that sometimes a change in protocol will make another cycle much better.

Did your RE warn you that you would have a high chance of cancellation?

[Anonymous]

When you say "cancel" I am assuming you mean changed to an IUI?

[Anonymous]

Either/or - I think it is up to the patient whether to cancel or convert to IUI.

[Anonymous]

Anonymous wrote:Either/or - I think it is up to the patient whether to cancel or convert to IUI.

Well, if that's the case, then definitely go for an IUI. I and a number of my friends were not even candidates for IVF due to "poor response" to injectibles (4 follicles or less mature) and all ended up getting pg with IUI's and injectibles. I was 40 at the time. A good egg is a good egg. More follicles means more potential that you'll have a good one. You never know what mature follicle is going to have that one good egg. GL!

[Anonymous]

OP here.

Emotionally wrung out doesn't even seem to describe my state of mind now. I'm days away from egg retrieval and I went from 9 follicles down to TWO follicles. There are apparently others, but they are too small in size and not likely to catch up to the two good size ones I have.

We can't do IUI because of my husband's sperm issue. We did three or four of these years ago and realized that it was futile, we needed IVF.

Our RE called us today to ask if we still wanted to proceed further because the chances of success is so low with our two follicles.

Then he asked us if we wanted to keep trying and asked us to ask ourselves whether it was worth it to keep pursuing this. I was devastated. I thought, so this is it? I can't even try again if this doesn't work?

I am looking to transfer to Dominion Fertility. Apparently they do natural cycles and they say that the egg that naturally ovulates for women, even women with advanced age, is much higher quality than the eggs produced in a stimulated cycle. Anyone 40 or over transfer from SG to Dominion and have success?

I am so confused as to what to do.

[Anonymous]

You could ask for a consult at Dominion but I don't think they do natural cycle for women over 35 years of age. I went to Dominion and had two failed IVF's- used ICSI both times due to male factor. Unfortunately I wasn't successful (40 years old too). but many are. I believe that the meds SG uses are different than Dominion. I was on Lupron and Follistim and my friend who used SG had two different meds and different doses all together. Another consult can't hurt. Dr Gordon is the nice, gentle one, Dr DiMattina is very straightforward. If you are completely a wreck I'd ask for Dr. G. I had Dr. D as the main but during the cylces you see both of them. I was happy with them but sad that I wasn't successful.