DOR and next steps for baby #2

[Anonymous]

Just got my updated bloodwork back: undetectable AMH (no change from 2 years ago, hah), FSH of 18, AFC of 2. I conceived "naturally" 2 years ago with similar stats and have a healthy DD who's now 14 months. By "naturally" I mean I was undergoing a mock cycle for a donor egg and got pregnant while taking Lupron (I wrote about that on this board back then).

DH and I would love to have a second kid. We can try naturally again but odds seem so low. We could try IVF but odds of success there are basically the same as trying naturally. Or we could head down the DE path (while trying naturally in the meantime), which I was prepared to do 2 years ago when all we wanted was a healthy baby as fast as possible (we'd already suffered several losses and I was prepared to give up my genetic connection without even trying IVF). DE sounds more daunting this time around because now we have our DD and I can sooner wrap my head around being one and done. I'm also somewhat concerned about the OE/DE sibling relationship, but trust we can work through that. I'm just sort of stuck. Our daughter is perfect we consider ourselves so absolutely incredibly lucky to have her. DH really wants more kids but will respect whichever option I'm most comfortable with. I'd like to push off any decision for a couple of years (I'm in my mid 30s) by DH is older and would prefer not to wait more than a year or so before trying ART if that's what we're going to do. I guess I'd just like to hear how other people have wrapped their heads around some of these considerations.

Thanks.

[Anonymous]

I also have DOR and have secondary infertility. Pregnant with our son on the first try, easy pregnancy and delivery, started TTC #2 when he turned 1. He is now 4.5 and I have never been pregnant a second time. I had surgery (laparoscopy, hysteroscopy), did IVF and IUIs, no success. My AFC is 10, my AMH is .60 and my FSH is 5. Despite the fact that these aren't horrible numbers I've had 42 cycles TTC and zero BFPs.

We explored donor egg, donor egg plus surrogate and adoption. Ultimately after doing a lot of research into all these options we decided to make peace with having an only. We are still TTC on our own every month, but have moved on emotionally (donated all the baby things, turned our spare bedroom into something else, basically zero hope/expectation that I will ever get pregnant again).

[Anonymous]

I have DOR with amh of <.01 when I was 37. Had my first conceived naturally at age 35 (but after years of trying).

For my second, I tried naturally for a year unsuccessfully, and then went to dominion and did natural cycle IVF. Dr d told me that my odds were less than 5% and he suggested donor egg or adoption. I asked him to just give NC a try and he agreed since my oldest was just about 2 and had been conceived naturally (I'd also done unsuccessful IUIs with dominion). It worked on the first try. You just never know. If you ovultae, you can get pregnant. I think in my case, it was the assisted hatching and ICSI that helped. Maybe my eggs were too tough to penetrate. I don't know. Good luck. Don't give up.

[Anonymous]

Anonymous wrote:I have DOR with amh of <.01 when I was 37. Had my first conceived naturally at age 35 (but after years of trying).

For my second, I tried naturally for a year unsuccessfully, and then went to dominion and did natural cycle IVF. Dr d told me that my odds were less than 5% and he suggested donor egg or adoption. I asked him to just give NC a try and he agreed since my oldest was just about 2 and had been conceived naturally (I'd also done unsuccessful IUIs with dominion). It worked on the first try. You just never know. If you ovultae, you can get pregnant. I think in my case, it was the assisted hatching and ICSI that helped. Maybe my eggs were too tough to penetrate. I don't know. Good luck. Don't give up.

Does your second child have any health issues? ICSI makes me anxious because one of my REs says that he does not recommend it unless there is severe male factor due to a higher risk of birth defects.

[Anonymous]

My ICSI baby is totally healthy - i have never heard that before!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have DOR with amh of <.01 when I was 37. Had my first conceived naturally at age 35 (but after years of trying).

For my second, I tried naturally for a year unsuccessfully, and then went to dominion and did natural cycle IVF. Dr d told me that my odds were less than 5% and he suggested donor egg or adoption. I asked him to just give NC a try and he agreed since my oldest was just about 2 and had been conceived naturally (I'd also done unsuccessful IUIs with dominion). It worked on the first try. You just never know. If you ovultae, you can get pregnant. I think in my case, it was the assisted hatching and ICSI that helped. Maybe my eggs were too tough to penetrate. I don't know. Good luck. Don't give up.

Does your second child have any health issues? ICSI makes me anxious because one of my REs says that he does not recommend it unless there is severe male factor due to a higher risk of birth defects.

I didn't want to do Isci, and dr d said he would try without it, but he strongly suggested using it. I did a ton of research about it and was scared, but did it anyway. My second is now a 45 lb., totally healthy 4 year old who is smart and has no issues.

[Anonymous]

Anonymous wrote:My ICSI baby is totally healthy - i have never heard that before!!

This is pp, there is a higher chance of birth defects when isci is used.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My ICSI baby is totally healthy - i have never heard that before!!

This is pp, there is a higher chance of birth defects when isci is used.

This is not a true statement. If your issue is MFI then there is a slight - slightly - higher risk. The theory being that the majority of sperm have hidden issues. We did ICSI and don’t have MFI mainly due to DOR and we wanted the highest fert % possible. Two for two healthy babies and my RE laughed when I brought this up.

[Anonymous]

OP here, thanks for the responses, especially the first 2 who shared their experiences. I'll probably ask about NCIVF at my next appt.

[Anonymous]

NP - we have two babies from ICSI. Both healthy.

[Anonymous]

I conceived my first through IVF and immediately started thinking about number 2. Also we did ICSI and my daughter indeed had a birth defect, though the RE said it was random.
I was really worried about my AMH (0.31 when I did IVF) but somehow miraculously got pregnant naturally 7 months postpartum.

[Anonymous]

Just wanted to say many clinics are now doing ICSI or partial irregardless of diagnosis because it increases fertilization rates. If you have diminished ovarian reserve, are in your mid-30s and want to wait a few years, ICSI may become a tremendous option for you.

[Anonymous]

OP, I have exactly the same stats as you except my first DC is now 5. Have done a number of medicated IUIs but have responded so poorly to the meds that my RE (who specializes in DOR) thinks IVF would just be a total waste.

DH and I are now considering DE, and if we don't move forward we are going to stop treatment and just be done. I agree that I would have done it in a heartbeat the first time around, but since we already have one child it seems more complicated.

Wishing you luck.

[Anonymous]

Anonymous wrote:OP, I have exactly the same stats as you except my first DC is now 5. Have done a number of medicated IUIs but have responded so poorly to the meds that my RE (who specializes in DOR) thinks IVF would just be a total waste.

DH and I are now considering DE, and if we don't move forward we are going to stop treatment and just be done. I agree that I would have done it in a heartbeat the first time around, but since we already have one child it seems more complicated.

Wishing you luck.

Thanks. Best of luck to you, too, with whatever you decide.