Estrogen priming or NCIVF for my situation

[Anonymous]

I am 34, only have one tube due to an ectopic pregnancy, is diagnosed with DOR, day 3 FSH in the last few months was between 9.8 to 12.6. AFC 4 to 10. AMH was 2.02 last year. Husband is OK except low morphology.

I had two failed IVF cycles with micro lupron (flare) protocol, both started with 150 Follistim. First time have 13+ follicles, but only got 4 eggs.
3 fertilized without ISCI, got 1 good looking blasto on day 5 and transferred. Second time had 6 follicles, got 3 eggs, 2 fertilized without ISCI, two embryos (8+cell and 4 cell) transferred on day3.

My problem is that I can't produce a good number of eggs, even though my FSH, AFC and AMH indicate that my DOR is not yet "severe".

I am right in the middle of changing clinic and want to try either estrogen priming or natural cycle IVF. I don't know much about estrogen priming but heard that it might help women with DOR to get more and better quality eggs. I am also thinking, since I could not produce many eggs via stimulation, why not trying with the only one selected by my body. But the low success rate concerns me a lot.

I know many folks here know a lot about IVF and maybe someones have similar experience. I really want to know your opinions.

[Anonymous]

Lupron is bad for some DOR cases. Have you considered estrogen priming without lupron or any suppression?

[Anonymous]

Anonymous wrote:Lupron is bad for some DOR cases. Have you considered estrogen priming without lupron or any suppression?

OP here. Yes, I already consulted a new RE who suggest estrogen priming without lupron. The plan is taking estrogen pills for about 2 weeks
before AF, then stimulating with a high dosage of gonal-F, adding antagonist to prevent ovulating.

[Anonymous]

I would do some additional research. I would consider epp with low stim. Natural cycle success rates aren't that low, cumulatively, but you have to be willing to do 2-3 cycles, which is reasonable because it's so much less expensive and you can do consecutive months.

[Anonymous]

I think I would try EPP before NCIVF. Agreed, no lupron or anything. Just patches or pills. Try Clomid at the start of your cycle and then introduce your FSH injections (try low dose first, 150 sounds ok to me). This is the protocol I've been on and I've seen vast improvement over previous high-dose cycles. I also use a vial of menopur in addition to my Follistim. I think the Clomid (and estrogen priming) is what really helped. Also increase your protein intake and decrease carbs. Good luck!

[Anonymous]

I second the EPP with low dose first before going down the NCIVF route. I am actually in the middle of EPP low dose right now (banking).
Finished 2 weeks of EPP, started on the injection last night.
I generally produce 5~6 eggs at retrieval (also DOR) and my numbers were worse than yours. Given your age and numbers, I think you could target like 8~9 matured eggs.
GL.

[Anonymous]

I had similar numbers at 34 (different issues). EPP with low stim and no lupron helped me get 13 eggs. YMMV. I would not try natural cycle with DOR, because part of what IVF does is establishing the right timing for implantation. With DOR couldn't there be other hormonal imbalances that affect the lining? I'm not a dr so don't quote me on that but perhaps something to ask about.