Poor Responder -- need some encouragement


#1

My husband and I have been TTC for over 6 years. About 3 years ago, I started with an RE, and on the same day he informed me we needed to start intensive fertility treatment due to low AMH, I found out I was pregnant. Unfortunately I miscarried. Fast forward 3 years and we are still not pregnant and my AMH is almost undetectable. No other problems for me and husband is fine. We have done 6 or 7 IUIs (some with Clomid, some with Gonal-F) and now are on to IVF. My first cycle was a non-starter due to a cyst. 2nd cycle was long Lupron and we were cancelled at stim day 5 due to non-response (estrogen in the 30s). We are on estrogen primed micro dose Lupron flare this cycle with 525 IU Gonal-F and 75 IU MenoPure each day. My cycle day 5 estrogen was only 94.5. There was only 1 “measurable” folly with 5 additional “tiny” ones visible. I am worried we will be cancelled again and/or no viable eggs will be found at ER. I guess I’m just looking for encouragement from some other poor responders with low AMH. Thanks for any stories or words of encouragement you all care to share.


#2

[FONT=‘Verdana’,‘sans-serif’]I was almost cancelled on day 5 too. My E2 was less than 100. They didn’t do an US at that time so I don’t know how many follies I had. I asked for two more days. They did BW only but said the E3 jumped enough to keep going. I had my first US yesterday (stim day 9) and I had 4 follies between 12-14. While my RE explained the risks with so few visible follies (i.e. nothing to transfer) we decided to go for it. [/FONT]

Here’s a link to my post with the same concerns you posted. The awesome ladies of this board posted great encouragement. I :pray: things work out for both of us. I’ve been around long enough to see lot of women have healthy babies with only one or two egg retrieved. Good luck!

http://forums.fertilitycommunity.com/vitro-fertilization-ivf/2020214080-help-low-e2-day-5-a.html


#3

My AMH is pretty low - .23. I also did the micro dose lupron flare protocol - and got four eggs. Which I think is prety good considering the AMH. I did this protocol because the antagnoist didnt work - but that is what works best for DOR. I have a dominant follie issue so thats why the RE figured MDL would be better.


#4

I would not give up hope. It takes some time for us slow responders to see a response. Your ovaries may just need a little more time to kick into gear.

Also, just because one protocol doesn’t work for you doesn’t mean another one will not.

I completely understand your frustation. My cycles are constantly delayed b/c of cyst.

I am surprised your RE put you on a long lupron protocol. This is an absolute no no for someone with low AMH. If you dont’ respond this cycle, there are certainly others you can try. I sometime don’t respond at all, will try again, and then repond much better with a different protocol. Plus, ladies with low AMH tend to fluctuate in their response to the same protocol each month. So, just b/c this protocol didn’t work this month, does not mean it would not work another month.

I would make sure your RE specializes in poor responders and has a good success rate. I kind of question it given the amount of IUIs you have tried and the starting of the long lupron protocol. If not, I would switch to another RE.


#5

Hang in there. I am the slowest responder. My amh is 0.4 I have done 8 cycles and only made it to transfer twice. The only protocol that produced eggs, we got 5 was clomid day 3-7 and gonal 75 day. Some dr’s believe low stin is better fir slow responders. I have done 450 menopur abd 375 gonal and produced one egg. Age is on your side. Houston made some good points. Good luck.

Alicia.


#6

[LEFT]I know, its so not fair, that we are not able to get that many eggs. Keep your head up and you should get some with different protocols, keep trying, its so worth it in the end! [/LEFT]


#7

I don’t have low AMH so my situation will be different. … but I was told that I was a “poor responder” by my home clinic and thus had IVF cycle 1 and 2 cancelled. Cycle 3 wasn’t even that great for me either…

I went to CCRM and we found success there… and we found out I was not a poor responder, but that my home clinic had me on too much medication therefore they fried my eggs.

[QUOTE=carolinababy]My husband and I have been TTC for over 6 years. About 3 years ago, I started with an RE, and on the same day he informed me we needed to start intensive fertility treatment due to low AMH, I found out I was pregnant. Unfortunately I miscarried. Fast forward 3 years and we are still not pregnant and my AMH is almost undetectable. No other problems for me and husband is fine. We have done 6 or 7 IUIs (some with Clomid, some with Gonal-F) and now are on to IVF. My first cycle was a non-starter due to a cyst. 2nd cycle was long Lupron and we were cancelled at stim day 5 due to non-response (estrogen in the 30s). We are on estrogen primed micro dose Lupron flare this cycle with 525 IU Gonal-F and 75 IU MenoPure each day. My cycle day 5 estrogen was only 94.5. There was only 1 “measurable” folly with 5 additional “tiny” ones visible. I am worried we will be cancelled again and/or no viable eggs will be found at ER. I guess I’m just looking for encouragement from some other poor responders with low AMH. Thanks for any stories or words of encouragement you all care to share.[/QUOTE]


#8

[quote=Melanie01]I don’t have low AMH so my situation will be different. … but I was told that I was a “poor responder” by my home clinic and thus had IVF cycle 1 and 2 cancelled. Cycle 3 wasn’t even that great for me either…

I went to CCRM and we found success there… and we found out I was not a poor responder, but that my home clinic had me on too much medication therefore they fried my eggs.[/quote]

Not to hijack the post, but what is your AMH and what amounts of meds did they have you on at both clinics? I am curious what amount they fried your eggs with?


#9

I second everything Houston said. I posted my success story on that thread earlier today, but in sum, my AMH was “less than 0.1” and my 3 week old daughter from my 4th IVF cycle is sleeping next to me right now :). I am a big believer in low stim protocols for poor responders and saw a huge difference for the better when I switched from high stim to low. I know it’s counter-intuitive, but I had much better response with low stim and I know my story is not unique. As Houston said, finding an RE that specializes in DOR is so important. Wishing you lots of luck!


#10

What exactly was your protocol? I am curious as I will likely switch to low dose if this one is not successful. I like to tell them what I think I should do! LOL


#11

Suma - what were your dosages on the MDL?


#12

My dosages were high - 450 IU Bravelle and 150 IU Menopur.


#13

I was on EPP with MDL, stim doses were 150iu of follistim + 75iu of menopur per day. That was essentially it! Worked so much better than my second cycle with the “everything and the kitchen sink” protocol using max dose stims (see my sig for more details). I highly recommend the low stim and wish I would have gone to that approach sooner. Best of luck to you!


#14

I am also a poor responder with almost undetectable AMH levels and so far I am responding far better with this current protocol then I did even with my successful cycle with DS 4 years ago.

My current RE took the kitchen sink approach and I am doing a testosterone/estrogen priming Flare protocol.

This is my last ditch effort for sibling to round out our family and I am praying that it does the trick.

Since it appears that this is your first IVF cycle its not uncommon that it may take more than 1 attempt to find that correct protocol for you. If you are cancelled take it as an opportunity to revamp your RE’s approach so that they are taking into account your past IUI cycles as well as this IVF cycle.

Good Luck to you