Anonymous
02/11/2021 16:55
Subject: How panicked should I be?
With DOR, one approach would do one round of max stim and see how you respond, then switch to other protocol if you don’t have good response or good embryo. Do not try donor egg, you are not over 40.
Or just do natural IVF, no stim at all to keep cost at minimum, but still takes up a lot of your time since usually takes more retrieval cycles.
Or just do natural IVF, no stim at all to keep cost at minimum, but still takes up a lot of your time since usually takes more retrieval cycles.
Anonymous
02/11/2021 12:47
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:There’s no point in panicking. Yes, 14.4 FSH is high, but given your age, you can probably still find a doctor willing to work with you if you want to proceed with IVF. There are also supplements you can take to reduce your FSH (wheatgrass etc) though I am not sure they make much difference in your egg retrieval numbers. Most likely you will see reduces response to stims, but that’s not a death knell. What were your other numbers, like AFC, AMH? And this was done in CD 2-3 of your period yes?
Yes, this was day 3 testing. My other numbers:
Estradiol: 40.8
LH: 10.0
TSH 1.02
Updated to add AMH: .68
HSG set for Friday. Husband does his labs/sperm analysis that day too. Then I can get my referral I guess. Not feeling especially confident. Have already added Coq10 and DHEA to the mix. I guess vitamin C and E could help too? Caffeine levels are down (not fully eliminated yet), alcohol also limited. I’m just not sure what else I can do at the moment.
I’m about to be entering my fertile days soon. I’m finding it hard to muster up the optimism to try on our own this month.
I'm going to tell it to you straight. Those were almost my exact numbers and I did multiple rounds of IVF and never had success. I was 33-34 when I was doing IVF and got a maximum of 4 eggs, and some cancelled cycles for failure to respond. We tried many protocols and extras (HGH, PICSI, all of the egg quality supplements). I could never make blasts and the writing was on the wall after my second cycle of no blasts that my egg/embryo quality was much poorer than it should have been for my age. Since I can speak from experience, let me say that I would recommend 2 rounds of IVF. If your embryos are good and you get blasts, then I think you've got a good shot of having success eventually with your own eggs (OE). Maybe you'll get lucky quickly or maybe it will take 3-4 rounds, but most people who are younger and make blasts have success eventually. Don't wait, egg quality can drop QUICKLY. But if after your second round (preferably on different protocols) you haven't made a high quality blast or two, then take a break and think hard about what you want your next steps to be. Decide if you would rather not have a second child or would rather do donor egg or donor embryo. Then you can decide on how many more OE cycles you're willing to try before throwing in the towel or moving on to donor options. We drug our feet on considering donor and by that point the age gap would have been huge and it felt too late. But if I had a crystal ball and could have seen where we'd end up, I would have jumped on donor earlier.
But keep trying, FOR SURE. You're still ovulating regularly (I assume?) and if your egg quality is good, you still have a shot every month. DOR impacts response to IVF meds, it doesn't necessarily impact current odds of success every month UNLESS it's coupled with poor egg quality (or MFI). But you won't know egg quality until you try IVF, so in the meanwhile give every egg a shot. Many people have success despite bad numbers on paper.
Anonymous
02/11/2021 12:22
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:There’s no point in panicking. Yes, 14.4 FSH is high, but given your age, you can probably still find a doctor willing to work with you if you want to proceed with IVF. There are also supplements you can take to reduce your FSH (wheatgrass etc) though I am not sure they make much difference in your egg retrieval numbers. Most likely you will see reduces response to stims, but that’s not a death knell. What were your other numbers, like AFC, AMH? And this was done in CD 2-3 of your period yes?
Yes, this was day 3 testing. My other numbers:
Estradiol: 40.8
LH: 10.0
TSH 1.02
Updated to add AMH: .68
HSG set for Friday. Husband does his labs/sperm analysis that day too. Then I can get my referral I guess. Not feeling especially confident. Have already added Coq10 and DHEA to the mix. I guess vitamin C and E could help too? Caffeine levels are down (not fully eliminated yet), alcohol also limited. I’m just not sure what else I can do at the moment.
always try! your numbers are not abysmal. I had a .4 AMH at 33! Second IVF worked and I have a daughter. Now trying for sibling has been a long affair but if your husbands numbers are normal range and you don't have any uterine issues and you ovulate on your own KEEP TRYING even between treatments. good luck!
I’m about to be entering my fertile days soon. I’m finding it hard to muster up the optimism to try on our own this month.
Anonymous
02/10/2021 21:36
Subject: How panicked should I be?
Sorry, OP. Not ideal, but I've been in your shoes (posted earlier) and have gotten pregnant naturally post-"diagnosis" so keep trying if you feel up to it.
Anonymous
02/10/2021 18:57
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:There’s no point in panicking. Yes, 14.4 FSH is high, but given your age, you can probably still find a doctor willing to work with you if you want to proceed with IVF. There are also supplements you can take to reduce your FSH (wheatgrass etc) though I am not sure they make much difference in your egg retrieval numbers. Most likely you will see reduces response to stims, but that’s not a death knell. What were your other numbers, like AFC, AMH? And this was done in CD 2-3 of your period yes?
Yes, this was day 3 testing. My other numbers:
Estradiol: 40.8
LH: 10.0
TSH 1.02
Updated to add AMH: .68
HSG set for Friday. Husband does his labs/sperm analysis that day too. Then I can get my referral I guess. Not feeling especially confident. Have already added Coq10 and DHEA to the mix. I guess vitamin C and E could help too? Caffeine levels are down (not fully eliminated yet), alcohol also limited. I’m just not sure what else I can do at the moment.
I’m about to be entering my fertile days soon. I’m finding it hard to muster up the optimism to try on our own this month.
Anonymous
02/08/2021 19:01
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:In my experience, the number that matters the most is the AFC. I had a crappy AMH and matching FSH and had a great IVF cycle because my AFC bailed us out. Like you we had a natural kid too (who took a year to conceive) which also helps you and and rules out uterine issues. When we started we knew we had male factor infertility and the low AMH was an unwelcome "bonus".
Actually, I take that back. The most important number is mom's age. 37 isn't great but not horrible either.
Untrue. Many uterine issues can be caused by pregnancy and childbirth - Asherman's, endometritis, scar tissue.
It rules out primary causes of infertility. There's no reason you'd get Asherman's or scar tissue unless you had a c section AND were unlucky, in which case the RE is likely to order a sonohisto. You would know if you had endometritis. No need to worry OP with obscure hypotheticals.
Wrong again. We didn’t discover I had antibiotic resistant endometritis until 3 failed transfers and 3 natural conception miscarriages. Zero symptoms but it took multiple rounds of cipro and flagyl to clear. Get involved with secondary infertility communities and you’ll see those kinds of stories not infrequently, especially when you’re dealing with RPL and secondary infertility. You have to self advocate, and you can’t do that if you are convinced these issues are “obscure hypotheticals.”
Anonymous
02/08/2021 18:04
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:In my experience, the number that matters the most is the AFC. I had a crappy AMH and matching FSH and had a great IVF cycle because my AFC bailed us out. Like you we had a natural kid too (who took a year to conceive) which also helps you and and rules out uterine issues. When we started we knew we had male factor infertility and the low AMH was an unwelcome "bonus".
Actually, I take that back. The most important number is mom's age. 37 isn't great but not horrible either.
Untrue. Many uterine issues can be caused by pregnancy and childbirth - Asherman's, endometritis, scar tissue.
It rules out primary causes of infertility. There's no reason you'd get Asherman's or scar tissue unless you had a c section AND were unlucky, in which case the RE is likely to order a sonohisto. You would know if you had endometritis. No need to worry OP with obscure hypotheticals.
Anonymous
02/08/2021 15:40
Subject: How panicked should I be?
Anonymous wrote:In my experience, the number that matters the most is the AFC. I had a crappy AMH and matching FSH and had a great IVF cycle because my AFC bailed us out. Like you we had a natural kid too (who took a year to conceive) which also helps you and and rules out uterine issues. When we started we knew we had male factor infertility and the low AMH was an unwelcome "bonus".
Actually, I take that back. The most important number is mom's age. 37 isn't great but not horrible either.
Untrue. Many uterine issues can be caused by pregnancy and childbirth - Asherman's, endometritis, scar tissue.
Anonymous
02/08/2021 14:54
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:My FSH was same as yours. You would be a good candidate for IVF. You might not want Shady Groove, try CCRM and Dominion.
Can I ask why? Kaiser only does their referrals to Shady Grove. But, I am a federal employee so I know my plan only covers IUIs anyway. But, if I’m at the point where I would need to go straight to IVF anyway, I’m not sure if I have the option to go elsewhere since it’s all going to be out of pocket either way.
Your amh is the most important indicator to predict if you respond well to IVF stim medicine. With Fsh so high I am jumping ahead to assume that your amh would be <1 and you have diminished ovarian reserve like I did. It means you have less eggs left and you might not respond well to IVF stim medicines. You spend several thousand and jab yourself daily and still might only have < 5 eggs retrieved, this makes you a less ideal candidate for Shady Grove puppy mill style treatment. They are good at making babies, out of fertile women.
Just make sure you consult with CCRM and Dominion, besides SGF.
Look into doing back to back minimal stimulation IVFs. There's no point spending 8-12k on drugs if you're only going to make 3 eggs anyway
Anonymous
02/08/2021 14:51
Subject: How panicked should I be?
In my experience, the number that matters the most is the AFC. I had a crappy AMH and matching FSH and had a great IVF cycle because my AFC bailed us out. Like you we had a natural kid too (who took a year to conceive) which also helps you and and rules out uterine issues. When we started we knew we had male factor infertility and the low AMH was an unwelcome "bonus".
Actually, I take that back. The most important number is mom's age. 37 isn't great but not horrible either.
Actually, I take that back. The most important number is mom's age. 37 isn't great but not horrible either.
Anonymous
02/08/2021 11:17
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:My FSH was same as yours. You would be a good candidate for IVF. You might not want Shady Groove, try CCRM and Dominion.
Can I ask why? Kaiser only does their referrals to Shady Grove. But, I am a federal employee so I know my plan only covers IUIs anyway. But, if I’m at the point where I would need to go straight to IVF anyway, I’m not sure if I have the option to go elsewhere since it’s all going to be out of pocket either way.
Your amh is the most important indicator to predict if you respond well to IVF stim medicine. With Fsh so high I am jumping ahead to assume that your amh would be <1 and you have diminished ovarian reserve like I did. It means you have less eggs left and you might not respond well to IVF stim medicines. You spend several thousand and jab yourself daily and still might only have < 5 eggs retrieved, this makes you a less ideal candidate for Shady Grove puppy mill style treatment. They are good at making babies, out of fertile women.
Just make sure you consult with CCRM and Dominion, besides SGF.
Agree with this. SGF will push you to donor eggs quickly, which is fine if that's what you want. I was with GW and they missed something big by following the guidelines strictly (so not aggressively proactive testing, but not bad either), but they were very willing to try different protocols when I turned out to be a poor responder. If it wasn't for my particularly bad luck, I think I would recommend them strongly for DOR. CCRM also tends to insist on growing embryos to blast, which can be a non-starter for a lot of DOR patients. If you do a cycle and can't make blasts, don't bother doing more cycles unless they give you the option to transfer at day 3. In hindsight, I wish I would have had a consult at Dominion, they seem to have the most focus on DOR.
Anonymous
02/08/2021 00:21
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:My FSH was same as yours. You would be a good candidate for IVF. You might not want Shady Groove, try CCRM and Dominion.
Can I ask why? Kaiser only does their referrals to Shady Grove. But, I am a federal employee so I know my plan only covers IUIs anyway. But, if I’m at the point where I would need to go straight to IVF anyway, I’m not sure if I have the option to go elsewhere since it’s all going to be out of pocket either way.
Your amh is the most important indicator to predict if you respond well to IVF stim medicine. With Fsh so high I am jumping ahead to assume that your amh would be <1 and you have diminished ovarian reserve like I did. It means you have less eggs left and you might not respond well to IVF stim medicines. You spend several thousand and jab yourself daily and still might only have < 5 eggs retrieved, this makes you a less ideal candidate for Shady Grove puppy mill style treatment. They are good at making babies, out of fertile women.
Just make sure you consult with CCRM and Dominion, besides SGF.
Anonymous
02/07/2021 23:11
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:What about Amh and follicles?
It sounds like she doesn’t have those numbers yet. My OB never offered to do AFC so she’ll probably need an RE consult for that.
Aren’t those the two that matter? Did you get pregnant early three years ago? Seems odd that your fertility would just fall off a cliff.
That’s exactly what mine did. Had no idea I was headed toward premature menopause, but I think my first child was my last good egg. 3 years later at age 33 and my egg quality was totally shot. Really sucks, but it does happen.
Anonymous
02/07/2021 21:55
Subject: How panicked should I be?
Oh hugs, I remember being in your exact shoes. FSH was 14.5 and it gutted me. I did not respond well to IVF (AMH was .7 and AFC was 5-8), but got pregnant 3 times naturally. Mine were losses, but I had an undiagnosed uterine issue that most likely contributed. Keep trying, all hope is not lost.
(Also think really carefully about donor eggs. If you really want that second child and you don’t have success quickly with treatment, there’s probably an egg quality issue. Don’t keep trying and trying unless you’re really okay with it not working out.)
(Also think really carefully about donor eggs. If you really want that second child and you don’t have success quickly with treatment, there’s probably an egg quality issue. Don’t keep trying and trying unless you’re really okay with it not working out.)
Anonymous
02/07/2021 20:14
Subject: How panicked should I be?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:What about Amh and follicles?
It sounds like she doesn’t have those numbers yet. My OB never offered to do AFC so she’ll probably need an RE consult for that.
Aren’t those the two that matter? Did you get pregnant early three years ago? Seems odd that your fertility would just fall off a cliff.
Yup. We got pregnant in month 2 of trying with my son. It’s part of why I feel so blindsided by these test results.
Don’t worry. Keep trying, but make an appointment with an RE.