Ghost - Another Question re: poor responders - Long

[sciteacher77]

Hi Ghost,
I went in for my blood test this morning and a meeting with my doctor. He now says I am a poor responder. My first IVF cycle was cancelled due to lack of follicles. We then increased meds and I had 7 eggs at my first retrieval (2nd cycle as 1st was cancelled.) Of the 7 eggs, 4 fertilized. We transferred 2 embryos - one labeled perfect and a second 'B' quality. We froze one ('B quality) and we were told the other was not growing well enough to freeze. We had one take and my 1st beta was 272. Of course, as you know, we lost our beloved daughter at 23 weeks due to IC. My 1st cycle back at my RE was again cancelled. I had 6 follicles, but he felt they were growing too slow. We triggered to start ovulation and then transferred our one frozen embryo. All of my negative HPT were correct and I am not pregnant. He said my next cycle will be 2 weeks of BCP, followed by Lupron to start my period and then half doses of Ganirelix and estrogen tablets for 7 days. After a scan and blood work, we will then add low dose HCG and Follistim 375 twice a day. Have you heard of this protocol? Does it work? I am getting so discouraged and am wondering if my only chance at being a mom was taken from me already. Everything I read on the Internet about poor responders suggests they have less than 4 follicles. I have more than that. If I am not a poor responder, will this protocol hurt me? If I am a poor responder, do you think this could work? I am 33 years old & the doctor who will be placing my TAC (transabdominal cerclage) likes to do them pre-pregnancy. I have been avoiding this because I do not want an invasive surgery that I will never get to benefit from. Thanks so much for taking the time to respond. You are wonderful!!!! Sorry for the long post, but my daughters original due date is approaching and I am having a hard time & that seems to result in long, rambling, unclear posts.
Thanks again!
Michelle

[Ghost]

Hi Ghost,
I went in for my blood test this morning and a meeting with my doctor. He now says I am a poor responder. My first IVF cycle was cancelled due to lack of follicles. We then increased meds and I had 7 eggs at my first retrieval (2nd cycle as 1st was cancelled.) Of the 7 eggs, 4 fertilized. We transferred 2 embryos - one labeled perfect and a second 'B' quality. We froze one ('B quality) and we were told the other was not growing well enough to freeze. We had one take and my 1st beta was 272. Of course, as you know, we lost our beloved daughter at 23 weeks due to IC. My 1st cycle back at my RE was again cancelled. I had 6 follicles, but he felt they were growing too slow. We triggered to start ovulation and then transferred our one frozen embryo. All of my negative HPT were correct and I am not pregnant. He said my next cycle will be 2 weeks of BCP, followed by Lupron to start my period and then half doses of Ganirelix and estrogen tablets for 7 days. After a scan and blood work, we will then add low dose HCG and Follistim 375 twice a day. Have you heard of this protocol? Does it work? I am getting so discouraged and am wondering if my only chance at being a mom was taken from me already. Everything I read on the Internet about poor responders suggests they have less than 4 follicles. I have more than that. If I am not a poor responder, will this protocol hurt me? If I am a poor responder, do you think this could work? I am 33 years old & the doctor who will be placing my TAC (transabdominal cerclage) likes to do them pre-pregnancy. I have been avoiding this because I do not want an invasive surgery that I will never get to benefit from. Thanks so much for taking the time to respond. You are wonderful!!!! Sorry for the long post, but my daughters original due date is approaching and I am having a hard time & that seems to result in long, rambling, unclear posts.
Thanks again!
Michelle

Lots of people use a mixed low-dose hCG + FSH protocol, even if they don't know it. At least one popular FSH product has a low amount of hCG in it. Many others have LH, which does basically the same thing. In fact, it's LH they are trying to mimic with the hCG.

The protocol works.

I would consider you on the low side of normal responders, but not all that low. My clinic would accept you for IVF without question. Your chance of pregnancy is less than with a patient with a better response, no question, but it still seems quite possible from what I can tell from your post.

I cannot agree with transferring a thawed embryo after ovarian stimulation. We had a doctor try that and I still tease him for it.

[Kiwi expat]

Hi Michelle - I'm so sorry you are going through such a hard time. Like you, I had an (IVF) miscarriage at 9 weeks and although it is encouraging that we can get pregnant, the emotional pain is still with me over 2 yrs later. I hope your next cycle is better.

If you don't mind, GHOST I have a question related to your reply to Michelle.

You wrote:
"I cannot agree with transferring a thawed embryo after ovarian stimulation. We had a doctor try that and I still tease him for it."

I have 2 frozen embryos left. Each time I attempt a FET cycle my lining isn't thick enough (7-8mm only). Clinic would like it to be around 8-10mm.
When I got pregnant it was on a fresh IVF cycle and my lining was 11mm. On a natural cycle it measures around 10mm on a good month.

My clinic is now giving me the choice to go on a stimulated FET cycle where the ovaries are stimulated like a regular egg retrieval (altho there will be no ER. I am over 40 and my egg quality is questionable.) I guess their rationale is that the estrogen produced by the ovaries will go directly to help thicken the uterus lining - Whereas when I did the previous FET, the high E2 levels I had in blood tests (taken from tablets & patches) were obviously not translating to the resultant lining thickness.

What do you think of a stimulated FET cycle in these circumstances?

Many thanks
Andrea

PS Michelle - sorry again for crashing your thread. Al the very best of luck for your BFP! - You're young and it will happen!

[Ghost]

Ovarian stimulation is not good for endometrial receptivity. There's more to it than thickness.

It seems that ovarian stimulation makes the endometrium less receptive. It might advance it a couple of days, perhaps causing receptivity to occur too early.

[sciteacher77]

Thanks, Ghost. I always value your feedback.
Michelle

[Kiwi expat]

Thank you Ghost - you have a great week!

Andrea