Any hope for a poor responder?

[Grey]

I would love to hear any success stories from those of you out there who are poor responders. Quick history of my IVF saga:

IVF #1 was in 8/2007. I had 14 or so follicles, 8 eggs retrieved, 4 fertilized, but only 2 made it to transfer. I got a BFP but found out I had a missed miscarriage at 11 weeks due to Trisomy 13.

IVF attempt #2 was in 3/2008. I did acupuncture for 3 months prior to the cycle. My left ovary was completely lazy, and my right ovary only developed 4 follicles. I converted to IUI, BFN.

Attempt #3 was a no-go because of high FSH (11.4). This had never been an issue for me before; the highest it had been before was 8.

Attempt #4 was a no-go because of high E2 and a early follicle. FSH was OK.

Attempt #5 was this month - I took Cetrotide prior to the start of this cycle, and my FSH and E2 were fine. I had 7 follicles, but only 2 eggs were retrieved. One fertilized, but it didn't develop past 4 cells.

I recognize that donor eggs might be in my future, and I'm open to that - but I have 2 more IVF tries that will be covered by insurance (my insurance says a big NO to DE).

Any poor responders out there that finally get the BFP that stuck? What do you think made the difference?

Thanks!

[lynniecat]

They did not do the round because your FSH was 11! What, mine is higher than that and I got PG with twins off of 5 eggs total and 3 embryos. I miscarried though.

My next round made two very low grade embryos.

I am starting my third round.

[Grey]

They did not do the round because your FSH was 11!

It was more of a suggestion than an outright refusal. They told me that their research suggests that the likelihood of a cycle's success decreases quite a bit once the FSH is above 10. Because I have three tries paid for by insurance, I want to do all I can to maximize the potential for success for each attempt.

[Thechosenone]

Are they suppressing you when they do those cycles? I think you should jump straight into stims versus suppression. Maybe that will help.

[Grey]

Are they suppressing you when they do those cycles? I think you should jump straight into stims versus suppression. Maybe that will help.

The first two stimming attempts I was on Lupron for a couple weeks prior to my cycle, then on Follistim/Menopur (is that the "long Lupron" protocol?). This last try they did exactly what you suggest - started me on Follistim/Menopur right off the bat, then added Ganirelix when my follicles got to a certain size. At least I made a few more follicles this time - but most were egg-less.

[MzTia]

Have you asked about a "Flare lupron" protocol? You start lupron ont he 2nd day of your cycle then add in stims the 3rd and no ganirelix. I am doing this my next cycle with no down regging.

[Grey]

Have you asked about a "Flare lupron" protocol?

Funny that you should ask - I've been reading about how that protocol can work well with poor responders. Anyone have any first-hand experience?

[lynniecat]

My first two cycles were flares. One worked well producing 3 grade 1s out of 5 follies. I miscarried due to lupus ( a cvs has confirmed a perfect baby girl).


My second flare cycles was horrible with 4 follies, 2 fertilized embries and none that lived.

We are now doing a no supression round. No bcps, no lupron.

[NY4thtry]

Just curious what is cetrocide?

[Much Hope]

Hi NY, Cetrotide tells your brain not to ovulate, so you dont before your trigger shot. I just asked my nurse the same thing since I am on it.

[Mellie_1233]

Here's my story

---Age 35, diagnostic cycle revealed an fsh of 11.4. Looked like I had plenty of follicles. Clinic had poor IVF success rates so we decided to find a new clinic in case we needed IVF.

---Changed clinics. Dr said that I had as many as 15 follicles in a good month and that my ovarian reserve wasn't bad just not good. My fsh was never over 10 again. Dr said I was "young" (just turned 36 at this point) and that we should be conservative. Tried 1 cycle of clomid (1 big follicle and resulted in a cyst that made us stop treatment for several weeks). 1 cycle of injectibles w/IUI. Resulted in 1 or 2 (they weren't sure) follicles. Tried IVF. Failed to suppress on bcp. Tried IVF again w/ganirelex acetate as a suppressor and an intermediate aggressive protocol. Cancelled due to poor response.

---Although that was considered one the best clnics in the Chicago area we decided to bring out the "big guns" and moved to the Colorado Center for Reproductive Medicine (CCRM). Started with a phone consult w/Dr. Schoolcraft. He said that my ovaries were responding like someone who was 40-43 years old. He said that he didn't think my previous cycles really started w/15 follicles and that clinics sometimes count wrong. Said that he had a 60% pregnancy rate in my age group but would cut that in half for me based on what he saw in my file. He said we really wouldn't know until we got the eggs out of me and saw the quality of my embryos. He said that, especially at only 36 years of age, I deserved to at least make it to retrieval.

---Went to CO for a day of tests. They counted 10 follicles. My AMH came back at 0.6 (1.5 is normal). This test measures quantity and quality of eggs I think. We were very stressed about this result.

---Started IVF w/CO. Failed to suppress on bcp (again!). Next try, used estrogen instead. Then a very aggressive protocol. 7 follicles grew but only 2 were in the right "zone" (20-24mm). Two were over 30mm. 3 were small but measurable (around 12mm I think). Nurses thought I'd get, hopefully 2 eggs, maybe 3.

---The AMAZING lab at CCRM got 7 eggs out of 7 follicles. 6 were mature. 5 became embryos. We went in for our day 3 transfer and we kept waiting and waiting in the waiting room. It turned out that Dr. Schoolcraft was discussing our situation w/the embryologist. Our embryos were of such high quality that Dr. S. suggested we wait until day 5 unless I could look him in the eye and tell him I could reduce if there were triplets or quads. He said he'd want to transfer 4 on day 3 but could transfer only 3 on day 5 and reduce the risk of multiples. We were stunned! Never expected to have the option of a 5 day transfer. 4 embryos made it to day 5. 3 were transfered and 1 frozen.

---We are now 31 weeks pregnant with a beautiful baby girl!

Sorry so long! I remember that details like this helped me when I was looking for information. The best decision we made was going to CCRM. A top-notch lab is critical when you have few eggs and/or quality issues.

Good luck! I wish you all the best!

[Grey]

Thanks so much Mellie! That's really, really helpful & just what I was looking for Stories like yours give me hope!

And NY4thtry - I took Cetrotide just prior to the start of my cycle. According to my RE, doing so can help with FSH issues.

[lynniecat]

So you liked CCRM! I was thinking about going there if I fail this cycle. Not sure yet as I am moving to Northern Cal.