Hi .. i am 43 with a low AMH. I am about do do a round of IVF and the doctor has recommended a dose of 450 bemfola, which I am not too keen on, as I think it's too high (worried about the impact on egg quality, when it's obviously already going to be not great). When I asked about trying with a lower amt, he said he's going with that amt due to my age.
Has anyone had an improved egg quality with a lower dose?
Hi Ellebee, I’ve just done a round on 450 gonal f (similar to bemfola) - the previous round albeit a year prior I was on 375 bemfola and was more successful for a retrieval/quality perspective (11 v 4eggs). They said they put me on the higher amount in the hope would have more follicles but in the recent review said next cycle recommend we now go with 300 as it don’t tend to make much of a difference over that anyway, which is contradictory to say the least.
Thanks .. i personally feel more comfortable being on a lower dose (back into trying again after last trying a long time ago).
Hello, I’m 40 with very low amh. I had 1 round on 450 meriofert with 3 eggs 2 fertilised but no success with embryos due to poor egg quality. Next had 225 bemfola 3 eggs again and 2 fertilised but this time 2x grade 1 embryos which are in storage. Third round same 225 and retrieved 3 eggs but no success again with any. My protocol was started slightly earlier on this last one but otherwise not sure why it wasn’t as successful. Could just been an off month for me. I feel so much better and well on lower dose I think it suits low amh much better. I’ve heard other ladies post similar on here too. Good luck with your journey x
Yes agree. Mentally, the 450 doesn't sit right with me (this will be my first fresh cyle in over 5 years, so i guess i need to test the waters first!). I will see how it goes, and if it doesn't work (not holding my breath), i will ask for a lower dose the next time.
What is your AMH? Mine was very low years ago, and I'm too scared to find out what it is now (although i am waiting for the current result at the moment). I asked the FS what it meant if it was negative (which i've read it can be) and he didn't see too phased on that. Who knows!!!
My AMH was 1.64 in 2018 when I was 38 and I had laparoscopy surgery to remove endometrioma cysts since after that result so I am the same... I dare not get a test now as sure it could be even lower!
That’s interesting about negative... gosh never even thought about that. I heard some clinics don’t accept ladies with less than 1.5 AMH but my clinic doesn’t seem too bothered. Their approach is low dose and low number of eggs which are hopefully better quality.
I only seem to have 3 follicles which produce eggs regardless of the dose even though I can a few more showing up on scans during meds.
Good luck with your first go in a while 😊
Thank you. I kinda think this maybe the right approach.
In my experience, if you ask your doctor, they cannot really answer this question due to lack of convincing research. Doctors would like to focus on the number of eggs they can stimulate for retrieval and therefore when AMH is low, they tend to prescribe high dosage of stimulant. With my first doctor, I did four cycles using very high dosage of Gonal-F (450 IU and then up to 600 IU), but my body did not respond at all. I had to cancel the first three cycles. Eventually, entering into the fourth cycle, I decided to go ahead and my doctor managed to retrieve 2 eggs -- both were fertilised but neither made it. I lost my confidence in this doctor especially because he insisted that I must use high dosage and I wasn't convinced -- I was more convinced that high dosage didn't work for me.
So, I changed to another doctor. After looking through my history, this doctor decided to use Clomid + low dosage. Actually, for this cycle, she only used 75 IU from the second week when she saw I had three good sized eggs. I got 3 eggs this cycle, only one fertlised and I am 16 weeks pregnant now. You only need one good egg!
My own experience seems to suggest that high dosage is not as effective. At my age (42), I would rather focus on egg quality.
Good luck.
My story is very similar to yours but I haven't had a positive outcome just yet. I am also convinced a low stimulus is better for those with low AMH I a far better response when doing so. I just wanted to ask whether you had a fresh transfer or frozen on your successful cycle?
congratulations and all the best with your pregnancy xx
My friend did 3 unsuccessful rounds on 600, changed fs, who put her on a round of 200. Pregnant first attempt, on 3 eggs each time (now has 2 children).
Hi, I am not on Bemfola but Menopur - I am 43 with a 'reasonable AMH for my age' think its about 9, I have always been on 450 and had fairly good results from it i.e between 9 and 13 eggs, when sperm was ok fertilisation rate of about 50% (but last round 85%) and I have always managed to transfer an embryo to date (really dont want to tempt fate) .. although we don't always wait until day 5. I have had one MMC and one chemical from my rounds so far. Good luck x
Good luck to you too!
Hello, I’m 43. My Amh is 10.6. I’ve had 5 x ivf in the last 3 years, all BFN.
I have a son following successful ivf in 2013, I was on 225 gonal f at that point. Subsequent cycles I was put on max stims 450ginal f - it was awful and I questioned this as my Amh is ok. My clinic was all about getting as many eggs as possible. I stuck with that clinic for 3 attempts, round one - 7 eggs - day 5 blast transfer - bfn / round 2 - 10 eggs - day 5 double blast transfer bfn / round 3 - 5 eggs - no transfer.
During these ivfs on high stims i felt hellish and expressed my concern at level of stims/ impact on my physical health - never got anywhere. All bfn. Lost all faith and trust in clinic. Changed clinic and new Dr said I was put on far too high stims for my Amh - and age which was not only a waste of money, not good for me physically and not good for impact on egg quality.
I’ve been put on 225gonal f - this is the same amount I was on 6 years ago when I had successful ivf. First round 5 eggs, 1 perfect embryo which arrested day 3/4 - gutted and now in second cycle. These cycle have been way easier on my body and I’ve had a double transfer and currently on 2ww. 🙏🙏
Go with your instinct and don’t be afraid to change clinic.
I personally feel high stims was a waste of time and energy and money for me. I wish I changed clinic sooner but I had an allegiance to my initial clinic as they helped me have my son. It’s definitely about quality not quantity in your forties.
Good luck 🌟
Thank you. I froze my eggs years ago and we just tried a round with them. 15/18 thawed. Only 7 fertilised. Two got to blast but were no good. Looking back, I wonder if my dose was too high (because my amh was so low. weirdly enough though, I did manage to get over ten eggs in some collections). Given our results with using my frozen eggs, and Before we try with using the rest of them, I feel in my heart I need to give it a go with a fresh cycle (odds are stacked against us, I know, based on age, amh and most recent results with eggs from 5 years ago).
And good luck to you too!
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