IVF Pregnancy Information

1. ejtiew
   
   

   I am trying to reconcile very different feedback I have gotten from 2 docs. I am going to be 34 in 2 weeks and TTC for 1.5 years. Done 4 clomin and IUI cycles. Have finally decided to do IVF and am getting conflicting information from 2 very well respected drs. The first dr. has been testing FSH and E2 and says that I have good chances with IVF - I have an FSH of @10.

   The second dr. I went to did the AMT test and said I have very very poor eggs due to my result of 0.3.

   I went back to first dr. and asked why he did not do AMH test months ago. He said that for someone my age he is not convinced that the AMH test can really tell egg quality. He does believe I have dimished reserve, but still thinks the chances of using my own eggs doing IVF would be ok. Second dr. has me thinking about donor eggs. Who to believe? This is the biggest decision of our lives and I am getting such conflicting information. I hope to start my cycle this month, but now do not know which dr. to trust. Any advice for me out there?

3. mariofreitas
   
   

   I know it is difficult bc we definitely get conflicting info. from RE's all the time. Here is my experience with the whole thing. I think that your outcome from IVF is a combination of several things-FSH level, AFC (antral follicle count), AMH, how well you respond to the stim meds, etc.

   FSH can vary each month bc it only measures that month's eggs, not your entire reserve. One month I had an FSH of 5 and 4 months later, it measured 10, which is borderline high, especially for someone my age at the time-30.

   AMH measures your entire reserve and doesn't vary from month to month so is supposdely the newer, more reliable method of measurement. They are looking for anything above a minimum of .5. Over 2 is very good. Mine was a 2.1.

   AFC is also important-how many resting follicles do you have in each ovary each month-the more the better although you don't want tons bc that indicated PCOS.

   I have a borderline FSH, a very good AMH, and a midrand AFC. I didn't not produce many eggs each time (10) on max dosages, only 3 eggs each time were mature, and the made terrible embryos.

   So my point is, those numbers don't tell all...with a good AMH, I should have done great, but I didn't. I think you actually have to try a cycle to see how your body is going to respond. That said, they might try a nontraditional protocol with you since your AMH is low, to try and maximize the # of eggs produced.

   Good luck!

   PS I am now pg via Donor Egg!

4. ejtiew
   
   

   Congratulations! That is great news!

   Thank you for your input. It is hard to know what to think of all these tests. You are right, we really will see what happens when I start my IVF cycle. (I begin on 10/21) and how I respond to the meds. I am not taking Lupron. I will be on a gonal \"Antagonist\" protocal. Not sure what that really means but I am about to find out!

5. Les_petits_debr
   
   

   Hey ejtiew- just wanted to let you know that i also have low amh- 0.5

   The amh level at our age really isn't an indicator of egg quality- simply a marker that shows we have a diminished reserve of eggs. Yes, it is possible that their may be fewer good eggs b/c we are nearing the end of the pot- but i think at our age, I am also just 34, that we still have good ones left. Unfortunately it's the expense of IVF that makes it less worth while to try with our eggs and pushes many of us to go to donor egg. With a level of 0.3 on the right protocol, Antagonist is probably a good one, you have a chance of pregnancy. The success rate for our age category with diminished ovarian reserve across the country- so bad clinics, mediocre and good clinics mixed in is b/w 13-25%. But at an awesome clinic that success rate could be around 40%.

   So i think both of your doctors are right, but in different ways- based on your FSH and E2, not bad although the fsh is a little elevated, and your age is definately a plus. But the amh is very low- and indicative of poorer response, success really is based upon the number of eggs retrieved and fertilized. But- doesn't mean we can't be successful.

   My previous doctor told me he would rather have a young patient with low amh than an older patient with a normal amh. That b/c of our age we do have better chances.

   May i ask where you are cycling??? success greatly depends on that and your response to the stim drugs.

   I am also doing an antagonist cycle while I wait for donor egg profiles, i started stims thursday night, in my case i don't expect to be successful,but alot of that is self preservation. But I know women who are only getting 2-3 eggs on a cycle with high fsh, low amh etc and go on to have healthy pregnancies. Granted, doesn't happen for everyone but it happens.

   As mariofreitas pointed- our numbers don't always tell the whole story.

   This time i had 6 resting follicles- first time ever No birth control pills.

   This is my 5th ivf drug start- i have made it to retrieval and transfer 3 times.
   IVf #1 age 30- me normal, dh severe MFI ++pg (long lupron)
   ivf #2 age 33- cancelled day of trigger, low estradiol, only 4-5 folllices(long lupron)
   IVF #3 age 33 1/2, 6 mature eggs- 3dt, 2 good embryo's, 1 okay- twin pg, m/c 9 weeks after 2 heartbeats seen. (antagonist cycle) then found amh 0.5
   IVF #4- age 34, bigger better clinic, microdose flare lupron- BUSt- only 3 mature eggs- donor sperm- BFN
   IVF#5- age 34 1/2- antagonist again ( max dose follistem, microdose ovidrel, adding in ganirelix) if it doesn't work

   IVF #6 DONOR EGG HERE I COME

   Feel free to pm me.
   Jen

6. andpapaf
   
   

   I was 32 at the time of my cycle. My AMH was .4. My FSH varies, but the highest it has been was 18. I have a decreased response to the meds b/c of my DOR, but I made average embryos. I am almost 30 weeks pregnant. Thus, I think while it may indicate DOR, it does not indicate you cannot get pregnant. Oh, I am a poor responder, as indicated by my low AMH, and had only 4 mature eggs.

7. Les_petits_debr
   
   

   andpapaf- congrats - you are an inspiration- where did you cycle?? I just got the most ever eggs on a cycle- 12- although today only 8 fertilized- but hey- i am thrilled- will get the call tomorrow to see how they are doing. Maybe this will be my lucky one.
   Jen

8. ejtiew
   
   

   Hi. I have an update to the beginning of my thread. I was on the antagonist protocal and responded well (for me anyway)- 8 eggs retrieved, 4 fertilized w/out ICSI and 3 embryos.

   2 grade one embryos were put back, one went on to creat a blast and is now frozen.

   Unfortunately I found out last week that I am not pg. I am already starting another cycle. My RE kept my protocal exactly the same in that he thought I responded better than expected on it.

   My low amh score still haunts me as the reason I did not get pg - esp. since I had such a good response.

   I am day 3 on stim now and have my first u/s tomorrow. Hoping that i did not cycle too quickly but my RE said it was fine. Let me know if anyone has thoughts on this. Thanks!

9. Les_petits_debr
   
   

   Mskramer- i am now 6 weeks pregnant from this last cycle- i also did very well on the protocol- got 13 eggs- 8 fertilized with ICSI. Transferred 3 great embryo's on day 3- (2) 8 cells, and a 7 cell- u/s last week just a gestational sac so far- u/s tomorrow PRAYING there is a little one growing- my beta's have been fine.

   If i were you I would have them icsi the eggs and do AH so that you get more fertilized this time around. I hope you have success.

   I would just keep plugging away.
   Jen

10. ejtiew
    
    

    Mskramer- i am now 6 weeks pregnant from this last cycle- i also did very well on the protocol- got 13 eggs- 8 fertilized with ICSI. Transferred 3 great embryo's on day 3- (2) 8 cells, and a 7 cell- u/s last week just a gestational sac so far- u/s tomorrow PRAYING there is a little one growing- my beta's have been fine.If i were you I would have them icsi the eggs and do AH so that you get more fertilized this time around. I hope you have success.I would just keep plugging away.Jen

    That is amazing news!!! I am really happy for you. I will send good thoughts your way for the u/s tomorrow.

    I will keep plugging along. Hoping to respond as well if not better this time around. Of course the response can be great and no pg, to that is ultimately what I pray for.

11. Les_petits_debr
    
    

    ms. Kramer- yep- my ob doc said it wouldn't happen- and my chance of success was only 13%- but on day of transfer my Re said based on my embryo's 40% chance of success- it all SOOO depends on how the cycle goes and how the embryo's look- every cycle can be different- and i have heard of many other women with very low AMH getting pregnant- i mean like 0.1 levels.

    My u/s showed cardiac activity and ob said it looked fast and good- go back on wednesday at 7 weeks 2 days for another- and weekly- just praying it all goes well.

    GOODLUCK TO YOU_ praying you also get a bfp. OH i wanted to add- my doc did an emdometrial biopsy right before starting stims-APPARENTLY some research shows it increases the chance of the embryo implanting b/c it makes the endometrium start generating- some big clinic is Israel did it and did a study and had good pregnancy rates, and some U.S. clinics have also replicated it.

    I also did AH

    Jen

12. ejtiew
    
    

    Hi Jen. I am so happy to hear things are going so well! I feel there is a certain bond between women who know what it it like to now be able to conceive a child on their own so this makes me very happy. Your story is inspirational to me in that we are the same age - 34 and both have low AMH.

    I just found out that I am getting HCG tonight. If estrogen is still high I will go for retrieval on Wednesday. Keeping my fingers crossed that this time will be the one.

    You asked me before where I was cycling and I forgot to respond I am at IVF of FL. This is my second round of the antagonist protocal (menopur, folistim and ganerelix). My RE said that since I responded well last time he did not want to change protocal. I know a lot of women say that is not a good thing. I guess we will have to wait and see. Where did you cycle? Also, forgive my ignorance, but what is AH?

13. rosemdavid
    
    

    I also have low AMH.

    ejtiew - I know IVF FL where you are a doesn't test AMH and I was told the same thing there - that with a very good FSH (which I have) I should do well. That AMH wasn't the \"gold standard\" and it wasn't as reliable.

    I\'ve had 2 IVF cycles (not at IVF FL).
    Cycle #1 Long Lupron - I made a good number of eggs (13 mature I think) and 12 fert. by day 5 I didn't have a single blast, we transfered 2 morulas and all my embies were poor quality. That ended in in a chemical pregnancy.

    Cycle #2 New RE - Antagonist (which I do think was better for me) - I made about 9 or 10 eggs, 8 fert. and we had 2 excellent embies on day 3 and 3 good ones. We transfered 3 total. I ended up with a blighted ovum and sadly am scheduled for a D&C Monday. (I have waited for 2 weeks for it to happen naturally but my hcg just kept going up). Blighted ovum is associated with poor egg quality, good enough to implant but not good enough to make a healthy baby.

    So, I'm starting to think that the AMH was right. I'll try one more time to find that golden egg (I signed up for a 2x plan with the new RE) but I don't know if I can continue to try with my own poor eggs. I don't have the energy and certainly don't have the $. I'm sure that this isn't true for everyone but for me it looks like it was right.

14. Les_petits_debr
    
    

    i am sorry i never came back and posted- rosemdavid_ keep hope- give it one more try if you can stomach it or afford it.

    i am now almost 16 weeks along from an ivf cycle my doctors said would almost certainly NEVER work.

    AH- is assisted hatching which can help the embryo attach to the uterus, hatch out, sometimes the embryo shell can be too thick and the embryologist usually can tell if AH needs to be done. I didn't need it at 30 but have needed all 3 of my last cycles.

    I keep praying daily this baby will make it to delivery- b/c right now- i am done- it won't happen again- my dh had an affair that i recently found out about- and well, we won't be doing this again.
    Jen

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