IVF/ICSI Not Responding To Stims - Desperate Advice Needed.

[sparkle183]

Hi,

We've just started our first IVF / ICSI through the NHS. I've been on 0.5ml of Buserelin Injections since 3rd April and 450iu Gonal F Injections (the max they can give) since 2nd May. And have a low AMH level of 2pmol/l. We've just had our second of three progress scans which was 9 days on Gonal F and unfortunately only one follicle out of 2-3 is growing. So looking like we'll only have one egg when we have our egg retrieval on Friday 😔. My guess is that it means I've not responded to stimulants?. If that's the case I would like to know if anyone else has not responded to stimulants the first time but have responded to either a change in stimulants on a second try? Or have responded by another round of stimulants? (As in started again another month on same stimulants as the first time)

Tomorrow we're going to be asked if we want to proceed with egg collection this Friday and are lost on what we should do, so I'm trying to gather as much information and peoples experience from being in the same or similar situation as I can, to try and help make our decision. If we go forward with egg collection it would be our one and only try free through the NHS.

Many thanks

[N-A-58]

Can you not switch to IUI?

[sparkle183 in reply to N-A-58]

They think ICSI will be better for us as there is also mederate to sever male infertility.

[N-A-58 in reply to sparkle183]

I meant could you swap this cycle for an IUI and trigger that one egg?

[Skittles11]

Hi there. I have had a similar experience. I have low AMH and did my first IVF cycle last October. I was on a long protocol, with Buseralin to down reg and Gonal F to stimulate the follicles - same doses as you. Scans showed I was not responding well. We were given the choice to cancel but decided to continue in the hope of getting at least a couple of eggs. I ended up stimming for about 20 days I think it was. Anyway sadly for us, egg collection was pretty traumatic as no eggs were recovered. I dont want to worry you, obviously this is just what happened to me, apparently it happens in only 2% of cases so we were just very unfortunate. On the positive, we have had more success on the two cycles that followed. I was put on short cycles with Menopur instead of Gonal F. I also had a longer trigger time of 38 hours. 6 eggs were recovered both times. Our second cycle we even got two frozen which we were delighted about. In my case I am still waiting my BFP but despite that we certainly has a better IVF result in general, through changing the protocol type and the stimming drug.

Hope this helps

[sparkle183 in reply to Skittles11]

Hi,Thank you so much for your reply. I am so sorry that your first cycle no eggs were collected that must have felt devastating. I'm so glad the second and third cycle was a much better experience and outcome for you 😊 your message gave me so much hope, to hear someone in the same situation has produced a good egg collection. I keep my fingers crossed for you that you soon get your BFP.

We spoke to the dr and she told me she thinks that stimulants worked but that I have just that low of an egg reserve that I'm not likely to get a better result trying again so we decided to move forward. Two eggs were collected instead of just the one so we were very excited, unfortunately neither of the eggs survived the fertilisation prosses 😔 so we're now looking to go private for ivf. If you don't mind me asking how many follicles did you have? I had 5 before starting treatment, but only 4 once we started and have been told this doesn't change so it will only get less as time goes on. And it made me wonder if people may have as low AMH level as myself but have more follicles, and this could be why people have more eggs come collection. So thought I'd ask 😊

[Jumpppy]

If cancelling gives you another go with NHS, I'd cancel. Back to back stims can be really beneficial for low AMH (i.e. next cycle is likely better because of this cycle). If this is your only free cycle no matter what then take Skittles11 advice and push to stim longer and see what happens. All of my cycles were 15-20 days of stimming - this is quite typical where low AMH and slow responders.

Good luck!

[Carelia]

In case you can switch to different drugs and do another cycle as part of yourNHS cycle, I would also recommend to switch. I amnot a doctor but there are effectively different ‘drug families’ and Gonal -F belongs in the ‘follitropin alpha’ family while Menopur is in ‘follitropin delta’ family. If you are not responding to alpha then it is worth trying delta (and there is also a 3rd type too :). NHS also do a drug called Bemfola which is also in the alpha family so if they suggest Bemfola but Menopur is available, it is worth trying for the delta to see if there is a difference. I have tried both Gonal-F (did not respond well), then a mix of Menopur and Gonal F (responded better but not huge difference) and then switching 100% to delta drugs (Rekovelle which is not available on NHS as far as I know) and had a huge difference in egg quality and quantity. It is very individual, and it can take a few tries to get to the right drug type.

[Gemstar20]

Hi sparkle , I had a failed round of ivf with nhs, I was on cetetrotide and mediofert, I had 3 follicles only one growing. I decided to go for egg collection as they said they wouldn’t offer us a 2nd go. Unfortunately no egg. This time I have gone private, I’m on buserelin and then I’ll be taking 450i ovealeap. But I’m not that far into my journey yet, I’ll know Monday how many follicles I have. This time I have been taking CoQ10 and dhea , I’ll let you know if it makes a difference.

If you cancel ask if you get another go, they told me no unless I use donor egg, like you my amh count is low and I’m 36 . We didn’t want to use a donor so we made the decision to go for it. Ask them if you do cancel what would they do different this time ? Ask if you can take certain supplements to help xx

[letro112]

Hi sparkle123 currently in this situation myself .. only ever have 3/4 follicles.. 35 years old amh 5 .. first IVF stimmed with 300iu menopur most successful round .. 3 follicles, 3 eggs all fertilised all made to day 5 and had 2 AA blasts .. MC unfortuanately .. best round 225iu Gonal F and 150 Menopur - no response only 1 follicle converted to IUI, this time 325iu pergovaris - 3 follicles but there tiny .. so clinic wants to cancel again ..in for another scan tmw when we will decide ..

Next round I am insisting in menopur and might try either a duostim or a natural IVF cycle .. best of luck