It’s hard to wrap my brain around the logistics of how people do IVF in Denver or in NYC while being based in DC. I have to be home for certain things in the evening and go into the office a certain number of times a week, etc. how do people make it work?! Especially for secondary infertility.

Your low AMH makes sense considering your low follicle count. AMH, FSH and AFC (follicle count) are all the main predictors of potential success with IVF. Your AFC can fluctuate from month to month but won’t swing that broadly, and bear in mind there is attrition at every step so you will likely need multiple cycles statistically and success isn’t guaranteed. You could be on the good end of statistics and get lucky first try, you never know. Most “normal” people don’t realize your fertility drops significantly after 38 on average.

Agree DC area sucks for DOR. dr Davis at Cornell is always recommended but my two cycles with him were a bust (I’m also DOR but was 38 with higher AMH than you) but everyone responds differently.

We opted to go to CCRM in Lone Tree which is often considered the mothership. They’re expensive but you get what you pay for. That said, they have specific requirements and I think their AMH cut off is .4 to be accepted so I’d hurry if you want yo consider. Our RE was Dr surrey he’s great.

Also, up to 50% of issues in any single case, could potentially be male-factor.

Have you had him tested recently?

Sorry to hear your AMH was also very low.
What did you end up deciding to do, if you don’t mind me asking? (I’m kind of in a similar boat)

Thanks, everyone. I will schedule some additional consults. Just got my AMH - as I suspected, it's really low - around 0.41. I wonder if this means I'm completely SOL.

I love Dr. Owen at CCRM. She was really open to trying various protocols, including ones less commonly used at CCRM. She's also really straightforward and honest, but in a supportive way. At the very least, doing a consult with her and Dr. Davis at Cornell will give you a great picture of two very different clinics with different approaches.

Is there anyone good locally or is everyone in NYC?

Love Dr. Reichman at Cornell.

Dr. Davis at Cornell

Davis at Cornell. Luk or Nejat at Gen Next in NYC

We're not considering donor eggs at the moment because I'm in the lower range (41) and already have a bio child. Don't know AMH yet, I won't be surprised if it's low. Very helpful to hear that CCRM or Cornell may be a better choice. Any suggestions for specific doctors?

Cornell in NY for own egg. There is not a good clinic in DC for DOR. At a certain age own egg isn’t realistic. 40+ is a big range …at 45, for example, I wouldn’t try own egg.

If you do donor egg, I suggest going to Czech Republic (Zlin) as the outcomes are the same (good!) with young donor eggs there as they are here, but the cost is much less.

Your odds are not good. Be prepared on what you want to do when your first IVF fails. Find a doctor that is willing to try various protocols.

A few additional questions that'll help folks weigh in: 40+ isn't necessarily helpful, because for many women, there can be *huge* difference between 40 and 42, for example. Second, follicle count isn't only one factor to consider. AMH is also important. Do you know that number? And yes, follicle count can vary month to month, but it's not likely to go from 2 one month to 15 the next. You can have DOR and still be a candidate for IVF. Will you be successful? It's really about luck, which is hard to hear and so so hard to experience. My experience with SGF is they'll go right to donor eggs if they don't think you'll be successful with ivf and your own eggs, while CCRM will definitely give you space to try, sharing your likelihood of success. I'm pretty sure that's also the case at Columbia, too.

Hope that helps! Good luck!

So. I am 40+ and went in for my first round of testing with the RE on day 2/3 of my period. They could only find 2 follicles during baseline testing. I was shocked. Is this DOR? Does this make me a poor candidate for IVF (I am getting this feeling from my doctor who won’t say yes or no yet). Is it uncommon? Does the number of follicles vary from month to month!