Poor response, despite plenty of follicles.

I’ve just had my second short cycle. Only 3 eggs retrieved, two mature and only one fertilised. So going for a day 3 transfer. The last cycle I got 3 mature eggs that all fertilised, got to blastocysts, one good grade transferred but ended in a miscarriage and had none to freeze, as other two were poor quality.

The first cycle I was on meriofert 300 alternate 375 but over the 14 days was increased to 450. This second cycle I started on the 450 menopur and only did 11 days of stims as I had a better response with follicles and was expecting more eggs but the follicles must have been empty. Think I had about 6-7 follicles this time. Last time only 4 follicles but still got 3 eggs. So far worse response on the higher dose!

Think the doctor would like to try the long protocol on the next cycle if needed. Fingers crossed the day 3 transfer will be ok.

Would a milder cycle be better or natural cycle? I’m 38 and got low AMH. My husbands sperm is normal. Thanks in advance x

[Orla9298]

I have low amh and this is how my 5 retrieval’s went against dosage:

450iu - 2 eggs

450iu - 4 eggs

75iu - 3 eggs

150iu - 6 eggs

225iu - 3 eggs.

My 150iu round I got 5 blasts! The other doses I didn’t get any blasts...

I never did long protocol. I don’t like the thought of all the extra drugs x

[Hidden in reply to Orla9298]

So maybe the lower doses are the way to go. Yes I could try the long protocol, but then it’s a gamble and may not get any. It’s so uncertain x

[Orla9298 in reply to Hidden]

Meriofert is a mix of fsh and LH and my consultant moved me to Bemfola (like gonal f) which is fsh only. It could be worth changing to that drug at a lower dose maybe...?

[Hidden in reply to Orla9298]

Yes it will be worth discussing this. Thanks for your advice, I really appreciate it x

[Hidden in reply to Hidden]

🤞this 3 day transfer will be genetically fine! X

[Rainbow_leopard]

Hi, my experience is similar. Round 1 450 menopur-10 follicles-7 eggs. Round 2 450 gonal f 12 follicles - 6 eggs. Round 3 (I drastically cut my DHEA intake)300 gonal f 150 menopur-6 follicles-2 eggs. Each time I’ve had 2-3 left by day 5 but the quality hasn’t been great. I always do long protocol. The 3rd round, with the least eggs, has given us the best quality embryo yet despite me having the worst response. What I have found is that my estrogen levels are a better indicator of eggs than my follicle count on scans. The Consultants have said this is unusual. I tried a double trigger this time around in the hope that more eggs would mature and be extractable. I’m now thinking that , for some reason, I just produce a lot of empty follicles. I am also curious about trying a milder approach but my consultant was adamant this wasn’t the way to go. I can see why, however there are clearly women for whom this approach suits. I can’t help wandering if I am one of them. Hopefully neither of us will need to find out! Good luck. X

[Hidden in reply to Rainbow_leopard]

Thanks for your reply. Interesting about the estrogen level, I’ll speak to my consultant about this. Because I think i’m susceptible to empty follicles. Are you currently on a cycle? X

[Rainbow_leopard in reply to Hidden]

I didn’t know this either until the embryologist mentioned it after my second collection. I can’t remember the unit of measurement (I’m in the uk) but it is approximately 1000 per egg. I asked the nurse this time and it was 2700 so I was hoping I’d get 3, perhaps the 3rd was t quite ready. It did mean I was prepared though, instead of expecting 4/5. My OTD is Saturday. 🙏🏻🤞🏻 X

[Hidden in reply to Rainbow_leopard]

I think I’ll look at checking the estrogen next time. Just had a call from the embryologist, my one egg that fertilised hasn’t divided so, bad news. I’ll have to wait until January to have another go. But I’ll definitely have a good chat with the doctor about lower dose drugs and I’ll probably do a long protocol. All the best with your test, good luck xx

[Hidden in reply to Hidden]

Think I’ll have a look at the DHEA I’ve not tried this. I may wait 2-3 months til my next cycle and make sure I am in the best health as possible, I eat healthy but going to cut back on alcohol, was thinking of not drinking at all. I exercise and I’m a good healthy weight. Also going to take co-enzyme q10. X

[Rainbow_leopard in reply to Hidden]

I’m so sorry to hear that. This process is so cruel. Be careful with DHEA as it can have adverse affects too. Ideally it needs monitoring but not many clinics here do that . The book “It Starts With an Egg “ is worth reading if your exploring that route. Please take care of yourself today. X

[Hidden in reply to Rainbow_leopard]

Luckily I’m a nurse in gp practice so I can get my bloods done whenever I want so I could keep an eye on my levels. I’ve just started reading that book. It’s interesting about all the plastics and changing household products x

[drfairy]

Hi Jokiekin! At least you have one fertilised, so hope is still there! I just read a scientific paper that in the case of only one embryo available, it is better to transfer on Day 3 than to let it go on into blastocyst stage, in term of clinical pregnancy and live birth rates.

Our situation is quite similar. I'm also 38, with low AMH, and no male factor. I'm on the 2WW of a 3 day fresh transfer. How many cells is your embryo?

Wishing both you and me a lot of baby dust!

[Hidden in reply to drfairy]

Hi, yes we are very similar. Yes it is better to transfer on day 3 if there’s only the one, as not need to wait til day 5 for selection, plus better in its natural environment.

My transfer will be tomorrow so I’m not sure how many cells. The embryologist will be calling me today to say what time I need to get there tomorrow. When was your transfer? Good luck x

[drfairy]

Aaaaa. My transfer was on Saturday, 7th November. So today I'm day 8 post transfer. The waiting is really killing me! Hope you will hear some good news from your embryologist! Keep us updated, if that's OK with you.

[Hidden in reply to drfairy]

Not long to wait now! I know how you feel it seems to drag the 2ww. Hope you get a positive, good luck 🤞.

I’ve just had a call, the embryo isn’t dividing as it should so bad news. Won’t be having a transfer now. X