We went to IVF when I was 35 because at 33 we tried two IUIs and both were unsuccessful. My insurance allowed me to do an IUI without being married. A month later I got pregnant on my own and it resulted in an ectopic. We decided to get married. A year later, we met with Dr. Abbasi to start the IVF process and three days later I found ouot that we were pregnant....on our own, 3 weeks after being married....literally a honeymoon baby. Baby was born in 2015 (36 yr old). Breastfed for a year (37 year old). Spent 6 more months trying to lose weight. Did IVF blood work--all looked good, better for my age group. January before turning 38 we started trying. Unsuccessful since. Only 1 embryo has made it to blast and it tested abnormal. We have done 2 three-day transfers.

DH's sperm is normal DNA frag and above normal everything. For example, the sperm analysis for our retrieval yesterday was 23 million sperm, 13 after the wash, 98% motility. BUT, the doctor say that she believes something is happening with the sperm on a cellular level. In the last cycle we had 18 eggs, 13 fertilized. All make it to day 3 and then start to degenerate. She believes the sperm are not doing their job at the end of the process and are causing the fragmentation. We tested my husband two months ago for MTHFR and he (and I) have it. So he has been on MethylCare and folate. We will see this cycle if that helped any.

I started at Columbia Fertility and then switched to Shady Grove this year.

I'm really interested in trying a cycle with very low menopur and see it that has any effect on the quality even if we get less eggs.

Getting more just means that your body is responsive to the FSH. It's pretty typical to get higher numbers of eggs from back to back cycles. Numbers have very little to do with quality. There's not a ton of good info on what really goes on with respect to quality, other than older means lower quality. Some things tend to have a positive effect (Ubiquinol), some a negative effect, but overall, there is nothing clear anyone can do to ensure they get a good egg and embryo.

If you've done IVF 12 retrievals without success, and you're not making drastic changes, I think you're probably wasting money. I hope I'm wrong and you're successful this time. I agree with PPs that say low/no Menopur tends to be better for quality. Why did you start IVF in the first place? Usually each cycle is a 2 month process, so it sounds like you started at 37? Did you go right to IVF (I did b/c of severe MF)? Just wondering if you've tried other things or there are other issues. Also, many REs will do a phone consult, so you can get some good insight from leading REs far away without having to go there. Some charge for the hour call, but it's not a ton.

Looking at the SGF lab results, I see that my LH was anywhere from 4 to 34 in a cycle. I'm going to ask my Dr. about it asap. If nothing, I might just try that next cycle.

Just did the retrieval yesterday......24 eggs. Highest I have ever had. I just on't understand how each cycle gets better and better in egg #s but the quality stays shit. Can all of my eggs really be bad but I have a ton left? This is why I never think I should stop trying.

Anonymous wrote:Protocol is usually blood work on day 3,start 150 follistim, 225 Menopur. Around day 8, increased menopur to 300, Follistim stays at 150. Ganirelix in the morning. Lupron and HCG as a trigger. This is my third cycle w SGF. I was w Columbia Fertility before. Usually the same drugs but hormone growth or BCPs or estrogen combos before, etc.

Good point that I’ve always been on menopur. Always. Anyone have more luck with low doses of menopur??

I'm the PP who asked about your protocol, and also the PP who only ever got 6 blasts in 10 cycles (2 normals). As I noted, my 2 normals were with lower dose stims overall. They were also with only 75 Menopur. Most REs will argue that some LH is helpful, but there are articles showing there's an ideal window. I don't remember the numbers, but I think over 10 is bad, and less than 1 (as can happen when you start Ganirelix) you should supplement. Some REs will wait until after Cetrotide/Ganirelix to add it, and even then only 1 vial per day. Some will wait until the last few days to add it in. You might try negotiating this with your RE. It's probably not the magic bullet you seek, but maybe together with the MTHFR treatment, working on diet/supplements/natural toiletries, you can get that one good egg to meet a good sperm. When it's multifactorial, it's hard to get all of these things to align.

Speaking of good sperm, have you had sperm DNA fragmentation done? When I was at Shady Grove they suggested it and offered PICSI instead of just ICSI. Don't discount the role of the sperm! You can have good sperm parameters on a regular semen analysis and visually they look good during ICSI, but have poor DNA. As a precaution, you could put your husband on high dose vitamin C, vitamin D, L-Carnitine, and/or COQ10 (ubiquinol) and/or have SG do PICSI.

Protocol is usually blood work on day 3,start 150 follistim, 225 Menopur. Around day 8, increased menopur to 300, Follistim stays at 150. Ganirelix in the morning. Lupron and HCG as a trigger. This is my third cycle w SGF. I was w Columbia Fertility before. Usually the same drugs but hormone growth or BCPs or estrogen combos before, etc.

Good point that I’ve always been on menopur. Always. Anyone have more luck with low doses of menopur??

Anonymous wrote:OP- I'm on 300 menopur ( the first few days at 225) and 150 follistim. Centrotide/Ganirelix starting on day 5.

OP, has this been your protocol for all of your retrievals? If so, I would consider asking to go much lower on the Menopur. I've heard that higher levels of LH in older women can be detrimental to egg quality, as your receptors become more sensitive to it with age, I think. When I was suppressed with BCP or estrogen priming my initial baseline LH was decent but then for some reason in a few cycles it increased (not a premature surge, but just a spike over 10) over the next few days of the stim cycle before going down again later. I'm convinced this played a role in my egg quality. Does your clinic monitor your LH throughout the cycle? If you're at Shady Grove, then that answer is no.

What clinic are you at? Have you been at the same place for all of your cycles? If the answer is yes and they haven't tweaked your protocol, as another PP mentioned you may consider switching to somewhere that is willing to change things up.

Anonymous wrote:What is the toiletry change thing? What am I supposed to do? I'll do it

EWG.org has lots of info and product guides.

OP- I'm on 300 menopur ( the first few days at 225) and 150 follistim. Centrotide/Ganirelix starting on day 5.

Blood work. Mine through my OBGYN and my husband at his physical.

How do you know/find out if you are MTHFR positive?

Anonymous wrote:So we are both MTHFR. Last month, my DH started MethylCare vitamins. My baseline LH was 2.14. Started Cetrotide on day 5 which is the earliest I've ever started it...usually day 8 for 4-5 days. Hmmm.

What is the toiletry change thing? What am I supposed to do? I'll do it

It's basically avoiding all products that have parabens, sulfates, etc. I guess it's explained in the book It Starts with the Egg, along with supplements to add/avoid. I would also add that lower stims is also what gave me my two normals. (I'm the PP above in post #2.) I had previously been on 450 Gonal F plus 150 Menopur (at one time even 225 Menopur). I got the same number of eggs on much lower doses like 150/225 Gonal F and 75 Menopur. I did have some cycles on that lower dose that didn't produce any blasts, let alone a normal, but the 2 normals I did get were from low-dose cycles.

Hope you're changing your protocol and/or RE - it makes a difference. Egg numbers aren't everything. There are some stats that show little improvement after 6 cycles and essentially none after 9. Those are slightly older stats, but if you consider that technology has only improved, you'd expect those numbers to go down, not up.

I went 4 rounds with plenty of eggs, but low #s of blasts (2 different protocols, but higher doses of stims), plus 1 where I did a day 3 transfer before deciding that whatever was going on was not worth continuing. I didn't test b/c of the low blast #s and insurance didn't let me do embryo banking. I then did 2 NCIVFs and a mini-IVF. I had the best results with a mini-IVF (similar to Cornell's recommendations), 3 blasts out of 7 fertilized eggs, but it ended with a chemical. It was my last round. I was over 40 when I started, so continuing at 43 seemed stupid on a number of levels, better results or not. Hopefully, you have better luck! I did DE and the first transfer of a normal took.

Unless you are a high consumer of the personal care/cleaning products, I doubt it makes a huge difference, but there are plenty of products that have known toxins, including endocrine/hormone disruptors, in them, so it's just good to avoid them generally (and probably even more important when you have a baby). I avoided those products before I did IVF anyway. I think being generally healthy (i.e., reasonable weight, exercise and diet) is helpful, but I doubt the supplements are any sort of magic bullet, although I did take them and think that the ubiquinol was good. I tried acupuncture, too, but didn't do it for my DE transfer that worked.

So we are both MTHFR. Last month, my DH started MethylCare vitamins. My baseline LH was 2.14. Started Cetrotide on day 5 which is the earliest I've ever started it...usually day 8 for 4-5 days. Hmmm.

What is the toiletry change thing? What am I supposed to do? I'll do it

Anonymous wrote:Looking for some realistic, face the news reports about how long it took for you to find that one egg that finally worked.....

We can not get anything (but 1, abnormal) to blast. This is cycle 12. My numbers look better than ever this round....39, AMH 1.6, FSH 7, TSH 1.7, AFC 15, Currently day 7 and there are 27 eggs, 12 measuring over 12mm.

I did 10 rounds, still no success. Had 2 normals and one didn't take. Taking our time trying to figure everything out before we waste the last one. I also had lots of trouble making blasts (only 6 blasts out of 10 retrievals with response rates similar to yours of ~15-20 eggs each time and good fertilization rates). We did try 2 transfers of Day 3, but I feel like the protocol was not ideal so they didn't stand a chance (e.g., lots of Menopur).

Some things I wish I had known to try sooner: 1) My husband and I are both MTHFR positive, which apparently can affect blast rate; 2) I have a high baseline LH, which can be very bad for egg quality. Wish we had started Cetrotide right away with stims; 3) Lay off the DHEA if levels are in normal range, as too much can be bad for egg quality; 4) Wish I had paid more attention to the small things from It Starts with the Egg, like changing all of my toiletry and cleaning products (likely would have made very little difference, but I would like to not have the regret).

Looking for some realistic, face the news reports about how long it took for you to find that one egg that finally worked.....

We can not get anything (but 1, abnormal) to blast. This is cycle 12. My numbers look better than ever this round....39, AMH 1.6, FSH 7, TSH 1.7, AFC 15, Currently day 7 and there are 27 eggs, 12 measuring over 12mm.