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Low Ovarian Reserves
54 replies to this topic
Posted 04 August 2010 - 07:59 PM
Thanks GG for that information I will def ask about those patches.
Sorry your cycle didnt work how I hope the patches help with the next one. When is your next cycle?
Posted 04 August 2010 - 08:02 PM
Hi Mrs L,
My AMH is 2. I'll be 36 next week and it certainly is a shock to be told that. Yes, AMH is an indicator of ovarian reserves, not quality. DH and I have had all the tests... Everything is all inorder, except for the low reserves. FS said that after the first round of IVF we'll know what we are working with. If the quality is good, we can continue, if not so good then that may be the end of the journey. We are scheduled for EPU in November so we'll have a good idea of what we are working with then.
Best of luck to you. My FS tells a story of a colleague of his who had an AMH of 1 at the age of 30. She has had two successful pregnancies and reached menopause at 33. There are some happy stories out there.
Keep in touch
Posted 04 August 2010 - 08:02 PM
I'm on Day 14 now, and start the patches on Day 25, finishing on Day 2 of the next cycle when I start the jabs again - so a couple of weeks to wait still !!
Posted 04 August 2010 - 08:24 PM
Hi Mrs L,
I'm a bit of the odd one out here as I haven't had the AMH test. However, after 5 stim cycles and only one FET my FS knows I have a low ovarian reserve and there is no use having the test as I will just become "stressed and focused on the number".
Welcome.......I hope your journey here is short and sweet.
Posted 05 August 2010 - 09:56 PM
Sounds like we are all in the same boat.
GG good luck in the coming weeks, what dose of Gonal are you on?
Causeway that is a good story give us all hope.
Puddy cat sorry to herar that your cycles havent been succesful have they tried on different protocols?
Posted 06 August 2010 - 08:25 PM
Mrs Louise, welcome - sorry to hear about your test, but as you say it is much more about quantity than quality it seems. My AMH was 4.5 a year ago and Im sure had fallen further by my first IVF cycle cos I only got 2 eggs. But my second cycle after 4m DHEA was much better, with 8 eggs, chemical pregnancy from the fresh cycle and 2 frosties. Never was expecting that!
Having said that Im not entirely sure it was all the DHEA, as I had a scan leading up to O this cycle and they only saw 6 antral follies, which would probably equate to 2-4 eggs at EPU if I had been stimming. So obviously for me things fluctuate wildly....
Have you had any IVF cycles yet? Perhaps DHEA or testosterone patches could be something to suggest to your FS.
Causeway - sorry to hear about AF, and what a bummer that you'll miss the action part of next cycle. You never know though, if you O early and you BD just before you leave...That is a great story about the 30 year-old - hope we can all follow in her footsteps.
Puddycat - I like your attitude and good on you doing the back-to-back antag. This one has to be it!!
BTW - I think you have a good point about being stressed and focussed on the number - that's all Ive been since finding out!
GG - great that you have a new strategy and your FS is so pro-active. Hope this one is the one for you. I intend to ask my FS abt assisted hatching too.
AFM - FET on Mon if all goes well with the thaw. I am a bit worried about my cycle in general though, as they think I O'd on Weds, but the scan showed only a 14mm follie at that stage. No idea why I am O'g such a small follie - surely it isnt mature, and perhaps this is part of the reason I havent had success naturally so far. It makes me worry about the hormone levels and the environment the embie is going into, but I guess I have to trust that the FS would have canx the cycle if they were worried. So I have everything tightly Xd...
Posted 07 August 2010 - 06:10 PM
Petal - I cant help you on your question. I wouldn't worry though, as as you said, the FS would cancel the cycle if they thought it wasn't right. Are you thawing both? Good luck on Monday.
Gordo's Girl - I asked my FS receptionist if my FS used the testosterone patches. She didn't think so, but I will ask him on Thursday when I go and see him for sure. I'm very interested in them. I told the receptionist about you, and she said to let her know how you go!! I will be following your cycle with great interest.
Mrs L - What has your FS said to you regarding your result? Whats the plan for you?
Well, I started jabbing today. I'm thinking that if this cycle doesn't work that I might ask for a change in protocol. My first ever cycle was a down reg on 150iu, where I only got 1 egg. Since then I have only done antagonist cycles on 450iu. Best result was 4 eggs.
In 3 weeks and 5 days we are on holidays!! Yay! Cant wait.
Have a lovely weekend everyone. I'm having a nice quiet night at home with DP.
Posted 07 August 2010 - 10:41 PM
Petal good luck for Monday I hope the embryo thaws nicely, pls let us know how you get on.
Thanks for the information on DHEA and patches our FS didnt mention either.
Puddycat all the best with your cycle, is 450 the highest amt you can go on? Antagonist is the short cycle with no pill is that right?
My FS said IVF prob wouldnt work for me with amh of 1 as my ovaries would prob only produce one egg, so really no better than trying at home. I am getting a second opinion with another FS but cant get in to late Oct, will def ask about DHEA and patches.
What is exactly does the DHEA do?
Hope everyone else is having a relaxing weekend.
Posted 08 August 2010 - 07:15 AM
MrsLouise I hope the second opinion with a FS gives you more information. I am concerned that the first FS told you IVF probably wouldn't work with an AMH of 1. I really think there is hope for you. As I've said before my AMH is only 2 but they do think that IVF will increase my chances of conceiving. We are still using Clomid leading up to IVF in November. I ovulate naturally and regularly but apparently this can help. Our FS says that there is still no reason why we couldn't conceive spontaneously as everything else is in order but as time isn't on our side we are hurrying things up. He anticipates that we won't be a couple who gets 15 eggs, it just takes 1. The one thing we don't know is the quality of my eggs, so I hope and pray that they are still up for the job!
Please let us know what your 2nd FS comes back with.
Posted 08 August 2010 - 11:03 AM
MrsLouise - I agree with Causeway that it seems a bit like your FS is dismissing your chances before you've even tried. THere are also other options like mini-IVF where they just give you very low doses of FSH to encourage the one egg you would O naturally to develop, and then they do IVF in the normal way. Ive heard that can be an option.
DHEA is a hormone precursor. They dont know exactly how it works, but it seems to raise estrogen & testosterone levels in the ovary, and encourages the baseline follicles to develop. Ive heard that its almost trying to create polycystic ovaries, in that it makes many eggs start to develop, and then IVF encourages them the rest of the way. But there have been quite a few natural pregs on DHEA as well.
Here is some info from the American clinic that pioneered it.
I think they are hyping it up a bit, perhaps b/c they have a patent on it in the US. But it does seem to work well in some ppl.
Puddycat - yay for starting jabbing. I really hope this is the one for you. I always have a plan about future cycles though, I think it can help us cope.
Causeway - hope the clomid works for you and you dont need the IVF!
Hope everyones having a great weekend!
Posted 08 August 2010 - 04:43 PM
Causeway and Petal71 thank you for your advice. It makes pefect sense what you are saying not getting alot of eggs but I guess you only need a few.
Petal71 thanks will check out that link.
Causeway I asked about clomid but he said no point as I already ovulate on my own, it is so strange how one FS recommends it and another doesnt.
Has anyone tried chinese meds for fertility?
Posted 08 August 2010 - 06:28 PM
MrsLouise - thanks for replying... very interested to see what the second FS says as this one seems to not be giving you many options.... My FS is still quite confident that we can achieve a pregnancy, although we all know that if my eggs are no good then that will be the end of the line. If this is the case, I'll probably still seek a second opinion - might be flogging the proverbial deadhorse but I'd be gutted to find out in 5 years time that there was something we could have tried but it wasn't offered and now its all too late. Fingers crossed for you
Posted 08 August 2010 - 06:33 PM
Petal - thanks for your wishes. Not sure if the Clomid will work this month as I'm away for work CD12-14 but we'll give it a try beforehand and also when I get back. I think after this cycle we'll only have one more on Clomid and then I'll be on the Pill getting ready for IVF in November. Not sure what date in November yet, I'll ring the clinic if this cycle is not successful to see what the plan is.
Fingers crossed to all members of our little community.
Posted 09 August 2010 - 12:06 AM
I hope you don't mind me posting in here as I am not really supposed to be in the primary infertility section, but, when I was doing IVF the first time, there were a lot of poor responders (me included) and I got given some invaluable advice.
The boards weren't split the first time I was doing IVF and it was actually really handy to get some advice off some veterans who popped back to help us out.
As you can see from my signature - I had a failed Flare and Down Reg cycle where my ovaries just basically shut up shop. We then moved onto Antagonist without Pregnyl where we got an okay result - actually got to transfer but no bfp.
I was allowed to 'then' introduce pregnyl and start my Orgalutran earlier - this finally worked for me.
I have had a failed FET recently and a dismal Antagonist where all my eggs degenerated.
This last and most recent Antagonist - I started my pregnyl injections on CD3 when I started my 300iu of puregon, then started Orgalutran on CD6 and my DH and I also remembered to take COQ10 (which we did on cycle 4 but forgot on cycle 5).
Also - my eggs are quite bad quality and therefore my clinic use calcium during the ICSI process to help with fertilisation.
Much better result this time - got 8 eggs at pick up, all ICSId only two fertilised on day 2. Then they called on day 3 and they were at 7 cells and another one had amazingly fertilised and was at the 6 cell stage. So SO FAR good news but anything could have happened between Saturday and tomorrow morning.
I am not sure that a higher amount of Puregon is always the best as it can be at the detriment of the egg quality. The pregnyl is what seems to work for me. Are any of you using pregnyl?
So once again, I hope you don't mind me posting, but when I was having terrible results at EPU any advice I was given was taken on board and thought about.
Posted 09 August 2010 - 11:51 AM
Thank you for your message and sharing your experience.
I have heard many people say the same about the high dose (being detrimental to the quality of the eggs) which makes sense as any high dose of meds must have an effect on the quality I am guessing.
Puregon is the same as Gonal F isn’t it? What is the pregnyl used for in the cycle?
I have not heard or read anything about Calcium during IVF, also are you doing ICSI cause of MF also or just to increase fert rates?
Sorry so many questions!!
I hope you had some good news this morning, fingers crossed for you.
Posted 09 August 2010 - 12:10 PM
I'd be interested to hear about the Pregnyl and also the Calcium - neither of those have been included in my cycles (yet).
I am taking to CoQ10 this time as well - although DP isn't, so not sure if I should have him on them as well - it sounds like they are suppose to improve sperm quality. We have MFI as well as my dodgy eggs - hence doing ICSI as well.
My FS said to me that he could increase my Gonal F from the 300mg, but said that research had shown that it didn't increase your chances any more (going to 450 or 600), and in fact he said to me that it was more of a psychological thing for the patient to feel like they are getting more. I'm not convinced of that one yet - and I'm pretty sure I will want it to be upped if my next cycle doesn't work. Not sure what you all think ... seems to me that every FS has their own opinions of what works and what doesn't.
It's such a shame that there isn't just a 'one size fits all' option isn't there?
AFM: I'm on Day 18 of this cycle - patiently waiting til Day 25 to start the Androderm patches. I'm also on Week 3 of my new exercise regime ... feeling much better, but haven't lost a single kg!! How does that work? I'm telling myself that muscle weighs more than fat - so I must have plenty of muscle in there somewhere
Hope you're all having a good Monday.
Posted 09 August 2010 - 01:35 PM
I'd be interested to hear about the Pregnyl and also the Calcium - neither of those have been included in my cycles (yet).Me too please Rezza! Ive only ever used Pregnyl AFTER my transfer. What does it do if you use it during your cycle?? Rezza, we have had this conversations before, but gee our cycles are similar. How are your embryos going??? When is your transfer?? Good luck honey!
Gordo's Girl - Im on 450iu of Gonal-F. He wont go higher than that. Too much risk of poor egg quality.
Day three of jabbing for me. See the FS on Thursday for my first scan. I always get nervous of that first scan. I always go in there hoping for 4 follicles, but always get disappointed. Grow little follicles grow.
I don't mind if this buddy group gets moved to the general buddy group area? Or even combined with the DHEA one???? I always lurked in the DHEA one, but couldn't join as I wasn't taking DHEA. But other LOR topics were also discussed in there. While I do feel that there is a higher chance of some of us not achieving our dream of having a child, I also think that there is a lot of value in having other people (like Rezza) around. I don't think this post was initially started purely from a primary infertility point of view???
What do you girls think??
Posted 09 August 2010 - 01:40 PM
The pregnyl is just to help with my egg quality as they are quite hard and therefore ICSI has to be done very vigorously.
We started IVF due to DH having antisperm antibodies - no issues with me. But then when we started it appeared I also have low egg quality and quantity.
The calcium is used to help with fertilisation as my clinic find my eggs and DH sperm are a difficult combination to fertilise. Because they have to be quite rough, a lot of my eggs get damaged (not that we have a lot to start with).
The boss of my clinic wanted to up my Puregon (which is the same as Gonal F) to 450iu but the embryologist said 'no - all this would do is perhaps create eggs that might not have normally been and they would be abnomal' - he just wanted me to use the Pregnyl for longer.
He seemed to be right and FWIW I ALWAYS speak with the head embryologist (after a failed cycle) rather the Nurses and my Doctor as they are the ones that are the most important I think. I had my FS tell me to 'consider donor eggs' after our second failed cycle and the Embryoligist tole me 'no way - he had gotten harder cases than me pregnant'.
When I was doing IVF the first time, a lot of the ladies who were poor responders were using Pregnyl with Antagonist cycles and having success - so that was why I tried Pregnyl. I also found that starting the Orgalutron A LOT earlier helped.
We have a blast for transfer today and I have NEVER gotten to blast stage before. They are hoping the second one catches up a bit and we wiill hopefully have a second blast to freeze.
My DH and I both took a high dose of COQ10 this time and there was a big difference. I also take Blackmores Pregnancy Breastfeeding tablets and have him on the Blackmores Male Multi vits.
Edited by *Rezza*, 09 August 2010 - 01:43 PM.
Posted 09 August 2010 - 01:46 PM
PS- I am going for transfer soon - but tonight I will give you a run down of my cycles and what # of eggs they produced and what protocols were used. I have chopped and changed a lot and have had huge variations in my egg quantity and quality. There doesn't seem to be as much help for poor responders as when I was in here a couple of years ago.
Puddy - I put in the message below about my embies. Miracle I have maybe two blasts and a third that fertilsed on day 2 and is going quite slowly so they more than likely won't freeze tomorrow. We are praying this cycle works as financially, this is our last shot for this year. Also, doing so many stims - they seem to be getting harder and harder on my body.
Posted 09 August 2010 - 04:53 PM
Hi guys - pleased to report that my embie behaved very well, did all the right things and is now back in the right place. Have spent this arvo chilling and having acu.
My FS wasnt overly concerned about my follie size, & reckoned it would still form a good corpus luteum. But I still have it in the back of my mind as something to look into more closely if no joy this time round.
Rezza - lovely to have your input! I have heard of low-dose pregnyl in the stim phase working for other poor responders as well. Very interesting. And also that your embryologist had so much useful info. I will be pumping mine for info if this cycle doesnt work! Good luck for TF today and for a frostie or frosties as well!
Puddycat - GL for Thurs - yes agreed, the first scan is scary! I hope it shows good things.
Im completely happy to have this thread moved to the Buddy Groups. I was in the DHEA one but it has petered out and so its great to be able to talk to others about strategies. After all, it's not just DHEA that can be useful as many have shown.
OK, back to the couch!
Posted 09 August 2010 - 11:36 PM
I do apologise again as I didn't realise this was a BG - I thought I was just replying to a thread.
For your info though-
IVF/ICSI #1 - Flare Cycle - 150iu of Puregon and Synarel from CD4 to 10. Trigger on CD10. Four terrible eggs at pick up. One wasn't mature, two didn't fertilise one did fertilise but stopped diving at day 2.
IVF/ICSI # 2 - Down Reg - Lucrin injections since day 21, then started 200iu of Puregon at CD3 to CD8, then upped to 250iu until CD14 - Trigger on CD15. Got 4 eggs once again, one not mature, two that were mature didn't fertilise and there was one genetically abnormal egg. After this cycle it was decided I would try Antagonist as it seems my ovaries shut down with the suppression drugs.
IVF/ICSI # 3 - Antagonist - 300iu Puregon from CD 3 to CD12. Started Orgalutran on CD9 (which in hindsight was too late I believe). Trigger on CD12. Three eggs at pick up, one was abnormal, two fertilised, one stopped diving on day 2 and the other was transferred on day 3 - it was at the 8 cell stage. I wanted to use Pregnyl during this cycle and the Nurses wouldn't let me. Got a BFN.
IVF/ICSI # 4 - Antagonist - 300iu Puregon from CD3 to 13. Started Pregnyl (only a very small 75iu) on CD7, and Orgalutran on CD8. Trigger on CD13. Got 6 mature eggs at pick up and one immature. Three fertilised. Had two embies transferred on CD3 and one frozen. I got my BFP this cycle and DD is almost two.
FET # 1 - BFN
IVF/ICSI # 5 - Antagonist - 300iu Puregon from CD3 to 10. Started Pregnyl on CD7 and Orgalutran on CD9 (which I think was too late). Trigger on CD10. 6 eggs at pick up, only one mature but by that afternoon 4 more mature. Clinic called the next morning, ALL five eggs degenerated during ICSI.
IVF/ICSI # 6 - Antagonist - 300iu Puregon from CD3 to CD10. Also started Pregnyl on CD3. Much earlier this time. Started Orgalutran on CD6 - also much earlier. Trigger on CD10. 8 eggs at pick up, 4 mature and 4 immature. Had 6 mature eggs by ICSI stage but only two fertilised. One one degenerated this time! The next day a third egg had fertilised too. Let them to go blast and had transfer today of a day 5 blast. The other good quality embie was a day behind, so they were hoping it caught up to a day 5/6 tomorrow so they can freeze. The other one doesn't look any good.
I hope that helps and it makes sense. Lots to type out. Basically there are LOTS of different things you can try and it seems in my case we go for quality over quantity and it really does only take one! My embryologist doesn't beleive that upping the dose of your meds is going to produce more eggs or better quality - quite the reverse.
Another interesting thing was that on cycle # 4 and #6 I injected my Puregon and Orgalutran as well as took my trigger on the same night. Whereas cycle # 5 - which was a fricking disaster, the Nurse specifically told me not to and I think she made a mistake. So make sure you question everything..........I wish I had called and spoken to another Nurse.
Hope I have helped out a bit - I think it is always interesting to find out other protocols because I know that you will try anything in the hope it works.
Posted 10 August 2010 - 08:32 AM
Petal71 and Rezza glad you have your embies on Board, I hope you both have some good news very soon.
Rezza thanks so much for typing that all out, I am finding it very intersting reading about different protocols and I have noted about the pregnyl during the stimming phase, it is def something I am going to ask about.
Puddycat I dont mind if it is moved, whatever is easiest.
GG's I hope your cycle is going quickly and you can start the patches soon.
CoQ10 - for those who took this, what quantities did you take? Did both of you take it?
Posted 10 August 2010 - 09:22 AM
Rezza and Petal - Good luck my dears! I truly hope this is the one for you and you can escape this crazy ride.
Rezza - Your a gem. Thanks for typing all that out. Its very interesting reading everyone elses cycles. Do you know exactly what the Pregnyl does when you take it during your cycle? Also, why do you think you should have started the orgalutron earlier? Doesn't it just stop you from ovulating? Also, this isn't an "official" buddy group. We just sorta turned it into one! So no need to apologise.
Mrs L - In regards to CoQ10, I have just stopped taking it a few weeks ago. I don't feel it was helping. I was taking 100mg a day. Mind you, in saying that, Maybe it was. Cause my last cycle was the worst. And I had just stopped taking it. Hmmm......now you have me thinking!!!
GG - Are there any side effects to the patches?
Posted 10 August 2010 - 09:36 AM
Hi Puddycat ... not sure about side-effects yet. It's quite difficult to get any good info on "Dr Google" as a lot of it relates to males. I'm hoping that after 5 days of them I don't end up with a moustache and hairy back ... but other than that, prepared to give it a go if it's going to help.
I'll start my first patch this weekend, so will be able to give you all an update over the next couple of weeks. Based on my 'normal' cycle, I'll start injections on 19th August.
Just off to work now, but will write some more later.
As for this moving into the Buddy Groups - I'm keen!
Posted 10 August 2010 - 10:32 AM
Rezza - wow, thanks for all that info on your cycles - v useful! And congrats on being PUPO! Hope this is the one for you.
Girls I have PM'd a mod so hopefully we will have an official BG soon in the general section.
Re CoQ10 - the dose I am on is much higher than you can get in health food shops etc here. It is 300mg twice a day & I ordered it online from the states. I used this dose b/c they were going to do a study on this dose in Canada but couldnt recruit enough women. So it is entirely unproven (exept in mice I think!) but I figured it couldn't hurt and perhaps it has contributed to better embie quality for me at my last stim cycle - but who knows with so many factors in the mix...
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