Reply to Not exactly DOR, but some other ovarian reserve issue.... thoughts?

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[quote=Anonymous]I’d love to get some thoughts on where to go from here.  My official diagnosis is unexplained. I just turned 33. My AFC is 15-17 and my lowest AMH is 1.8, but most recent is 2.17, FSH is 7.7. After two IVFs, it’s clear my response is not good so there is some kind of issue with my ovarian reserve that these tests are showing.  One thing that maybe could be playing a role is that I also have two well controlled autoimmune issues.

IVF #1 started with bcp.  I stimmed for 12 days, initial dose of 150 menopur and 75 Gonal was upped to 225 menopur and 75 Gonal after 3 days. I had 10 follicles at trigger, estrogen was around 1400.  Retrieved 7 eggs, 5 were mature, 3 fertilized with ICSI and made it to day 3.  One was transferred at day 3 and resulted in a miscarriage at 5w5d. None of the others could be frozen (one arrested and one made it to early blast on day 7, but didn’t have enough cells).

IVF#2 we did estrogen priming (estrace 2mg 1xday starting the day after ovulation, orilissa 4 days later due a short luteal phase).  Then we did 375 menopur for 8 days with cetrotide starting on day 5. Estrogen two day before trigger was 1117 (last time it was taken).  Also 2 days before trigger there were 6 follicles between 13-15mm and 10 between 10-11mm.  We again got 7 eggs, 5 mature, 4 fertilized with ICSI.  We froze a 8 cell grade one day 3 embryo (we don’t have any children and we’re hoping to do some banking)and are still waiting on the final results from 2 10 cell grade 1 embryos and 1 14 cell grade 1.  I’m not really holding out hope though.

My doctor seems to think my second protocol was a better one for me even though the results are similar. She suggested we go again with the estrogen priming and menopur (not sure if she plans to tweak it or not).  We plan to meet with her before doing another cycle and talk to a few other clinics.  Any one have any thoughts on why we are getting  so few eggs/no blasts and what we can do to improve our odds of getting blasts? At this rate we would have to do at least 3-4 more retrievals and I’m not eager to do that.  Is there anything different we can do?[/quote]

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