19 follicles is great. At your age, it's a numbers game since quality isn't going to be what it was a few years ago, so it's good to have more eggs to start with.

I agree with ALL of the testing. DNA fragmentation, RPL workup, endometrial biopsy. Time is of the essence since egg quality is going to be dropping quickly and another 12 week MMC could set you back half a year once you track HCG down to 0 and start a new cycle. And if you do IVF and can't get normals and REALLY want that second child, consider donor eggs. We started when my DC was 2 and it seemed like we had tons of time. Now after many rounds of treatment and a few losses, DC is 6 and it just feels too late to jump to donor eggs for such a big age gap (and starting over when we're getting into the "big kid" stage of parenting). That's just us, but I know we would have gone for it and probably would have had our kid by now if we had been emotionally ready for donor when DC was younger.

I second the advice that you and your partner start taking coQ10 and other dietary supplements/ making healthy lifestyle changes now because it takes 2-3 months to see a benefit. I wish I had known before I rushed into an egg retrieval. It all worked out eventually for me, but I would have done things differently if I had known.

OP here, thanks for all your help. Had bloodwork and transvaginal ultrasound this morning. The tech counted 19 follicles, which she said was "good". Trying not to go down a rabbit hold and wait til we have more pieces of the picture.

I appreciate all this great advice!

Be hopeful but also realistic. Fertility treatment works for many, but also fails for many. I tried to view it just from a medical standpoint and keep all emotion as best possible out of it. I didn’t expect any handholding or hugs from the doctors or staff and I had an idea of my limits-meaning if I tried ‘X’ number of treatments and they didn’t work, it was time to stop.

Yes, get your husband tested too. They will probably balk at this, but get it down now.

Read the book Waiting for Daisy

Good luck!!!

Similar to real estate, you should talk to your partner and have a plan before you start. Once you are in it, it is so easy to feel "just one more time" or "we are so close, let's do the new protocol and that will work." Just like it is so easy to think a house is worth 200,000 more than you wanted to pay.

Having a plan and some guiderails will be hard but important.

I did the shared risk program for IVF and am pregnant now after IVF #1, so I spent more money than just paying for one, but have the peace of mind that I can go for several more tries if this one doesn't hold.
So I suppose my advice is, the shared risk program is worth the peace of mind even if it would have been cheaper otherwise in retrospect.
(I had three failed iUis before trying ivf.)

As other said, test your spouse. All the tests.

My bloodwork and testing were perfect. My husband’s sperm, not as. We were told IUI would work. Nope. ISCI would work. It didn’t. THEN we learned about DNA fragmentation. But by this time, I was 39 and suddenly the RE is pushing donor egg (as they do) and donor sperm...we just gave up.

The whole process was frustrating and since we had no insurance, more so.

Just go to SART and learn your odds before getting too far down the infertility rabbit hole.

Anonymous wrote:OP here - husband has not been scheduled yet but I am supposed to pick up a specimen cup when I go in tomorrow for him to use sometime soon.

re: DNA fragmentation - will ask about this. Is this test typical or something I should expect pushback on?

My RE at Shady Grove suggested this herself.

OP here - husband has not been scheduled yet but I am supposed to pick up a specimen cup when I go in tomorrow for him to use sometime soon.

re: DNA fragmentation - will ask about this. Is this test typical or something I should expect pushback on?

Get your husband's DNA fragmentation tested for sure. I wasted a good 8 years at shady grove and they never tested that till the last year. Currently pregnant with CCRM

Start taking Coq10. Has your husband also been scheduled for sperm testing?

I’m in a very similar position as you. Trying for almost the same amount of time, missed miscarriage and chemical during that time. I’m 40. I recently had all the tests done. So far so good. We will see once I start treatment but I am interested to hear how others respond to this.

Hi, I am going in for bloodwork and ultrasound tomorrow at Shady Grove to begin exploring treatment for secondary infertility. I have one four year old and have been TTC for a year and a half, with one missed miscarriage at 12 weeks this fall (needed a D&C). Anything you wish you would have known at the beginning of your journey that I should keep in mind? I am 39 and husband is 40, if that matters.