Slow Responders - does this mean decreased ovarian reserve?

[MoJoe]

I am new to this site. I have a 10 year old son from my first marriage, now 40 yers old, 41 next month, and married less than a year to a wonderful man. He does not have children, and we have been TTC for over a year. 2 natural pregnancies and 2 miscarriages back to back Chrsitmas through Valentines. First IVF April 2011, stimmed 12 days, 13 follies, 10 eggs, 9 embryos made to 5 day blast, biopsied for day 6 transfer , PGD-CGH array ALL chromosmally abnormal. No transfer. Heartbreak. Felt like a 3rd miscarriage (would have been if we had transferred any). Took summer off - planned to do a triathlon but fell and broke my back - ugh! Now Sept 2011 - did 2nd IVF in Aug: 2 parts Bravelle 2 parts menopur 2x day, Lupron microdose. Went 12 or 13 days stim, got 7 follies, 4 eggs. 4 fertilized, all made it to morula, by day 6 only 1 grade c blast to biopsy and freeze. right back in 2 weeks later to IVF #3 - even slower response this time. 3 bravelle and 1 menopur with longer Lupron this time (similar to cycle 1). been doing acupunture for 2 months. Day 8 of stims today and only have 4 follies: 2@9 and 2 @7. Plan to do pgd again and try for fresh transfer. Dr said if this one doesnt yield any normal embryos, it's time for donor eggs. Heartbreak again. I know there are 4 in there, but the odds of them making it to blast and being normal is pretty slim. Feel awful. Nothing medically wrong with me, no problem getting pregnant and carrying baby, just have OLD EGGS. "Advanced maternal age" is the ugliest phrase I have ever heard. And I'm only 40 and incredibly healthy!
SO....does anyone lese have a similar story - hopefully with a happy ending? Feel so desolate.
Does the fact that I am such a slow responder and keep gettign fewer eggs mean my ovarian reserve is diminishing and I don't have many eggs left? Will I be hitting menopause early?

please, any advice is welcome.....

[Irish_Angels]

I am in a "sort of similar boat" but a little more convaluted. I am 39 with "diminished ovarian reserve" the key is the AMH number. Mine is .23 it should be around 1 (represents quality of eggs). My FSH is high also 12.7 (represents number of eggs). I have tubal issues as well so I have a double whammy. Only one tube left due to ectopics. My remaining tube is blocked. I can't get an RE to even perform an IVF on me without using donor eggs. Now, some maybe good news for you - I read a study from Tel Aviv (your doctor may have read it) that said that women over 40 who took DHEA (not DHA), but DHEA for six months prior to IVF responded with better quality and quantity of eggs. My RE said there wasn't enough data to support it but to take the DHEA wouldn't hurt. You can purchase it at any vitamin store or online. It's fairly cheap, like $20 a bottle. I took 50 mg for six months, but since we have an almost completely blocked tube I think it was a waste of money. I know donor egg is a hard thing to wrap your head around. I struggled with it myself, but I had to look at the odds (usually with donor eggs it's 70% success rate), plus you usually have extra snow babies to freeze for siblings later on maybe or you could donate the extra to a loving couple. Anyway, I have made my peace with donor eggs and am now trying to come up with the money for a donor cycle. It's still your baby, you carry it, you love it, you can pick a donor that looks like you. It's a hard thing to be told, I know it felt like another mc when I found out I couldn't do IVF again. God Bless and good luck with whatever route you travel. Try the DHEA for a while, it can't hurt. I've also heard good things about accupuncture. I'm here if you want to talk, seems like we have, unfortunately, a lot in common.

[lou71]

I'm a poor responder to stims and although my AFC is good and FSH/AMH normal, RE said I had decreased reserve because of the poor response to maximum stim doses. My last cycle, I took DHEA 25 mg three times a day and had acupuncture every week for 3 months prior to stims. The protocol didn't work well for me (3 eggs vs 6-10 on previous cycles) as we tried estrogen priming but I believe the quality was better. I never did PGD or CGH on my embryos, but had one m/c due to trisomy 18 on my only BFP in 5 transfers. Try #6 left me with only one embryo to transfer from those 3 eggs.... The result is that I'm almost 37 weeks with a healthy baby girl! There's definitely hope with one embryo. Plenty of hope. Good luck!

[MoJoe]

Thank you so much! It's nice to know I am not the only on going through this. I will try DHEA - I hope it's not too late...
I am looking into donor eggs now, but my DH is still holding out hope for our 4 follies. Saying LOTS of prayers. I have no idea what my FSH is/was, but the RE said it was normal. I don't know...
We are probably stimming 13 or 14 days this cycle and hoping for the best. We have already spent over $60K on IVF and I have never even had a transfer.
Talked my my fertility-specialist psych (PhD) yesterday...she thinks chances are slim of coneciving on our own based upon the poor response the past 2 times and the high number of chromosomal abnormalities in the 1st cycle. Suggested having a second opinion with Dr Scott in Morristown NJ. Don't know. I do like my doctor, when I get to see him.
Trying to tee up donor eggs, but my clinic will not talk to me until we have stopped trying on our own. I am wondering if I shoud look into a national database instead where I can see pictures and "go shopping" for lack of better term, to try to find someone who looks like me.

Good luck to you all as well. This is a heck of a roller coaster ride journey

[Irish_Angels]

Also, just thought about it. It's too expensive for my blood (around $6,000 per stim cycle plus meds), but my clinic CMC -Women's Institute in Charlotte, NC is doing a "study" where they keep stimming you, retrieve eggs, freeze them and do it again until you have a bank of eggs to work with before they will do the transfer. She mentioned it to me as an option for women with diminished ovarian reserve. In essence you bank your eggs in the freezer until you have enough to make an IVF transfer "worth it" - have enough that will fertilize and grow. Just thought I'd mention it, I forgot about it before....

[MoJoe]

Hi there. Update - day 11 of stims, now have 5 but not growing well 1 at 13 and half, 1 at 12 and half, 1 at 11, 1 at 10 and 1 at 7. May add more menopur into my shots depending on the bloodwork results. I just hope they don't cancel my cycle. started DHEA yesterday- my doctors have not even heard about it - got it from a health food store. Probably stimming out to 13 or 14 days. Nurse is not optomistic. I am considering doing another cycle next month. I have an appoitnment with the egg donor director next week. need to keep things moving and at least pretend I have some control over the outcome. I really don't know wehere we will get the money for it all. My insurance is exhausted, I am exhausted...but I am determined and stubborn.

[lou71]

Mojoe- I hope your five continue to grow. Is your estrogen rising? DHEA provides most benefit when taken for 2-3 months prior to your ivf cycle. I don't think it can hurt now but definitely make sure you stop it on your egg retrieval day. It is converted to testosterone in your body and if you get pregnant with a female fetus, you don't want too much circulating. Good luck! It really does only take one!

[brit1612]

I have a kind of similar story, but I am not 40, actually I was 23 when we started IVF for the first time. At this "young" age, I was a slow responder and ended up with 5 eggs. The doc made some adjustments and we got a little better results (not much) the next couple of rounds. We could not afford to do PGD, so we were most likely transferring embryos that were abnormal. 4 fresh cycles ended in two negatives and two miscarriages. At that point we decided to turn to donor embryos. It was the best decision we ever made! Our little boy is 18 months today, and I would never regret him not being "ours". I don't know if money is an issue for y'all, it certainly was for us, but donor embryos are a lot cheaper than donor eggs. I hope you have success this cycle and don't even have to worry about that!

[riogirl71]

DHEA only wrks if taken 3-4 mos before and I think RE said to stop mid cycle. I also took COQ10 for 3 mos, I have normal numbers but poor response, DHEA doubled my # of eggs and I was 39. Good luck!