[QUOTE=kimberf]Lang - I’m a little bit older than you, but we have very similar stats. My FSH is a little lower than yours (about the same same E2), but my AFC is worse. An AFC of 12 for me would be good; my recent cycle my AFC was 8. My AMH has gone from 1.2 or so earlier this year to .5 - .6 in Sept/Oct. I had it tested twice because I thought the huge drop was wrong.
With those stats, I just did a cycle where I had 11 eggs retrieved and ended up with 7 blasts, so there’s definitely hope. I’m a novice to this myself, but I wonder if they should have stimmed you harder to start off. I started on 300 IU of Gonal-F and 150 of Menopur, and I had 8 follicles over 8 mm on day 5; I did half or less of that dose for the rest of the cycle. I’ve certainly seen women on here who do even more Follistim/Gonal-F to start out.
I don’t know which clinic you worked with here, but when I talked to local clinics and looked at stats, I had decided I’d go with Kaiser in Fremont if I stayed local. They’re #3 in the country for live birth rate for your age group (35-37) – ahead of CCRM. I was super-impressed with Dr. Farah-Eways when I talked with her, and she didn’t seem to turn anyone away. She mentioned that she’s had several patients over 45, even. I also know that she felt AFC is a better indicator than a lot of the other stats, so I bet she’d be happy to talk with you. I decided to go up to Oregon because for my age group there was a more significant difference in the success rate. Plus, Fremont / Santa Clara were going to be an hour drive each way with traffic, and if I was going to do that every time I needed bloodwork or monitoring, it was almost less hassle to go out of town.
I do have a friend who cycled with Dr. Zouves and loves him (she also had successful IVF at Stanford previously). She had 11 follicles and only 5 eggs retrieved, but she got pregnant with twins. Personally, I have an established auto-immune disorder and have done a lot of reading and talking to my specialists about some of the more esoteric immunology stuff that he does, and I personally just haven’t seen enough evidence to do all that extra testing or potential treatment, so I didn’t talk with him. His feedback in general is pretty glowing, though.
I didn’t have [U]any[/U] clinics, locally or out of state, that were not optimistic about my chances, though with a couple of them that was before we knew my AMH had dropped like a rock this year. They were all more than happy to welcome me as a patient. Personally, given the fact that I got pregnant twice (once on my own, once with Femara + IUI) during that drop and had a decent IVF cycle, I am not sure that AMH is such a strong indicator of response, or at least not always.
If you want to play with the SART data, you can filter on the cause of infertility, as Ghost mentions. CCRM, Oregon, and Cornell all have about the same proportion of DOR patients, not sure how it varies with others.[/QUOTE]
I did my first cycle at Kaiser Fremont with Dr. Shen. I did an antagonist protocol with Follistim 225 and Menopur 150. She was very optimistic for me (we had not done the AMH yet). Also, I had been pregnant with twins earlier in the year, conceived naturally. Unfortunately, they were identical and we lost them at 23 weeks due to complications. She is recommending a micro-flare protocol for the next cycle.
At this point, I think we are shopping around. I had read a lot about the estrogen priming protocol, and also heard good things about Zouves, so I thought we would switch to him. I don’t have any auto-immune issues, but I don’t mind paying extra for the workup if that’s what he requires.
I have not met with Dr. Farah-Eways, but I have also read good things about her. Maybe I will request a consult with her.
I’m wishing you the best!