Hi everyone I'm on my third round of ivf/icsi with severe male factor infertility. I am now 37 with an amh of 7 and AFC of 10. I have had my day 8 scan today and have 4 follicles between 11-16 and I have another 6 that have only reached 5mm. I have been told to continue on buserlin and menopur 300 until Friday when I have another scan but they don't think the 6 will now grow enough to be contenders. My question is this is my 3rd round and each time where it has looked I'm not responding my clinic refuse to change anything or add anything. I have no blood tests at all and have had no further test from them since before my first round in January. Is this normal, does anyone else have blood tests through their cycle. Has anyone else had their dosage of stimulation changed halfway through their cycle? I just feel like this clinic keep repeating the same thing and expecting a different response.
Ivf at 37: Hi everyone I'm on my third... - Fertility Network UK
Ivf at 37
Heya. I’m sorry for the frustration. My clinic have in the past changed my dosage mid-protocol when they thought it was needed (from 225 to 300) - but they only do blood tests if they are concerned about over stimulation…. I do think they should do tests more often. It’s a difficult balance, because you also want to avoid over stimulation, and some clinicians don’t believe in using higher doses than 300u in women under 40…. It’s better to have fewer, good quality eggs than loads of eggs which then don’t do well.
I’m sorry this is not very helpful!
But I’d say definitely try and speak to them again, really get them to explain their rationale if you’re not convinced , but do remember that there’s an element of luck and sometimes doing the same again is the right thing ….
Good luck!! 🤞🤞 xx
Hi thanks for your reply, yeah that makes sense I'm just frustrated as I know from previous rounds a number of my eggs have been damaged in the icsi injection so if I only get 4 and then some are damaged in the injections it just reduces our chances even further. I'm hoping the other 6 have a sudden growth before Mondays egg collection but I'm not holding my breath. Thanks again 😊 xx
Yes I can totally understand, it’s so hard…. See how you get on - on my last cycle the nurse who did my last scan said she reckons I’d get about 8-10 eggs and I wasn’t at risk of OHSS - ended up with 16 eggs and borderline OHSS! (Only 3 made it to day 5). Remember the trigger shot also gives everything a final push , fingers crossed for a good result 🤞🤞 xx
Yes that's true. Just wish there was something else you could do to help the follicles along. Fingers crossed they catch up over the weekend. Hope everything is going well for you?xx
Oh I know. One of the hardest aspects of IVF is that so little of it is in your control 😔 Thank you - the fresh transfer didn’t work, I’m currently in the 2WW with our first frozen one from this cycle, one more in the freezer 🤞 xx
Hi, I've only had one round of IVF at one clinic. I had blood tests alongside every scan I had and they changed my dosage depending on the results of those blood tests.
Good luck and sorry you're having to deal with this frustrating situation.
Hello Gillian84, my clinic does a blood test with every scan and more in between. My medication also got changed throughout cycle. But in saying that, quality is almost more inportant than quantity. Sometimes this business can be like flipping a coin.
If you are feeling thungs are not right. Can you get another opinion somewhere else perhaps?
Hi I live in Plymouth so we only have 1 clinic here unfortunately. If this round doesn't work then I think we will try and find a clinic in Bristol or maybe even London. Problem is cost with the ivf and then travel on top xx
Hi Gillian,
I completely understand your frustration. I remember feeling exactly the same during my third round of ICSI. My clinic had kept me on pretty much exactly the same protocol (long) through three rounds and we weren’t getting great results (one early mc, two bfn, never anything to freeze). My AMH and AFC was pretty much identical to yours, I was 34 at the time. Also had male factor issues.
After our third round ended in a negative, we decided to give it one last shot with a new clinic. Spoke to a few and got similar vibes to our current clinic and then found one in London that we just found an instant connection with (sounds cheesy but it’s true 😂). My new consultant changed my protocol to short, different stims and we had blood tests throughout. My progesterone dose was changed after blood tests showed it was low. From that one round we got three frozen embryos, the first we transferred is my 12 month old daughter and the second I’m currently 10 weeks pregnant with.
I guess the moral of my story is not all clinics are the same. I was convinced IVF was never going to work for me after our failures but it did. It definitely sounds like you need to look at getting a second ( or third or fourth!) opinion until you find a clinic that you feel is the right fit for you xxx
I think for your AFC, the ratio looks fine. My last cycle was at 37 and AFC of 20. I had 12 eggs collected and 7 matured eggs but all fertilized and 5 blastocysts. So my ratio is about 35-40% will grow and usable. I did 5 cycles in total with different protocols and medications from 34 and each time the usable eggs are only about 7-8. I think they have to balance the quality with quantity. Less eggs with better quality is better than more eggs with average quality. They are hardly all grow at the same time. Maybe you can ask to change the medications. I found I have more blastocysts when I change to gonalf or similar mix from menopur.
I'm also 37, had my first NHS round at 35 which was cancelled when I didn't respond how they wanted for my high AMH and then covid delayed everything. Had next round at 36 and was started on something very low like 150 gonal f but again due to very little happening that was upped fairly quickly in stages to 300. Mine took forever to do anything and had very little going on until day 10, and it was only by day 17 that I was ready. Got nine eggs but only around half fertilized with ICSI (due to male factor that time). Had another round a couple of months after and was started on a higher dose.I got one really big follicle and rest were tiny but I asked to continue - by day 17 more had caught up and a load more were coming through. I got 5 eggs and all fertilized with ICSI (male sample was much better) and continued fine to blasts. The first round was NHS and I had blood tests every other day the second was private and I don't think they did a single blood test. The NHS changed the dose of meds a lot in a kind of panic whereas the private just kept suggesting cancelling and starting over but without any concrete ideas on what to change. So neither was great and I think unless you have amazing care, they don't seem to be able to tailor it to non-standard responses. To me, your numbers sound good (at least compared to where I was at that stage) and all mine caught up eventually, plus new ones came through so maybe ask them about stimming longer? I have had to argue to continue to stim and then to transfer against their advice, but I felt like this had dragged on long enough and they couldn't give me any reassurances they could change anything. Plus from advice I got on this forum, I asked for different forms of progesterone even when they didn't think I needed it or it would make any difference. I'm 10weeks today from the one they told me I had a 'one in a million' chance of working. It could all be chance but from my experience, don't be afraid to push for answers and rationale, and maybe go with your gut (or uterus!)
Im on short protocol. When I have spoken to the about stimming for longer they said I would lose the bigger ones and the smaller one wouldn't catch up which I do understand. I just find it frustrating when my fsh is on the high side so it doesn't make sense to me to put me on a high dose of stims in the first place. What progesterone were you on? Congratulations on your BFP that's brilliant news 🥰 xx
Thank you! I was on the short protocol for both rounds where I got to collection (the first cancelled round was a long protocol) - they also told me both times I would lose the bigger follicles and the small ones were unlikely to catch up, but after 17 days of stims i got eggs from the biggies and top quality blasts. So it just seemed to take a long time for me and they don't know why with my amh. But it did really worry me at the time that the quality may have been affected or i'd end up with no eggs at all. I was on 2x cyclogest rectally for two transfers but they ended in chemicals around 5/6 weeks. Then I asked to change to Ultrogestan vaginally as my problem seems to be progesterone resistance (not low levels) and apparently that can help it get to the uterus better. Also got put on lubion injections. No idea if it was that, chance or something else. X
Hi Gillian84. That first scan of the cycle is always the worst when it doesn’t show what you were hoping for.Those little ones might not grow big enough to be mature but you never know. They may also find more in your next scan they didn’t see today. That’s happened to me too
I think 300 is quite a high dose of meds.
In my experience I’ve been on 225, 265,300,350 and 450. The best dose for me is around the 265 mark. Anything over that doesn’t work any better. Higher doses have actually been detrimental to my cycles.
All the best with getting your BFP 💕
That is really annoying. I am no expert but when my first round got cancelled because my follicles didn't want to respond, my clinic moved me from 300 Gonal F to 450 Menopur. This seemed to do the trick as my follicles responded. I had 7 eggs collected with one reaching morula stage by day 5 which failed to implant sadly. So the next round I think I was on 150 Gonal F plus 300 Menopur. I then got 15 eggs and 6 reached blastostage. When I spoke to the clinic they did say that when follicles don't respond and it's a cancelled round the clinic will change up the meds and it's unlikely to get a second cancellation. Plus the more IVF meds we have the more our bodies get used to it and accept what it's meant to do.So just from my experience alone I would be pushing them to mix it up or you move onto another clinic. Unfortunately clinics have different protocols and how and where they want to push, which is so frustrating for us. I would maybe ask on here for recommendations of clinics from anyone who has gone through the same. Best of luck xx
ps I was 38 when I got 15 eggs collected - I see someone above posted that some clinics don't allow under 40's to have more than 300iu....but mine did. Happy to provide you details via pm. x
Thank you. I have sent you a pm 😊 x
I feel your pain. I had 6 fresh rounds at the same clinic and aside from switching protocol once they never changed anything. I feel now like I wish I had moved to a different clinic but at the time my OH was really cynical about clinics offering loads of tests etc just to make money and trusted our consultant so we stuck with it. We did have a couple of chemicals and a later miscarriage so I suppose you could say it sort of worked, but we never did get our baby and some rounds we had 2 eggs fertilise, or poor response etc.
I would insist on a review appt before the next transfer. and if you don't get answers I would definitely look elsewhere for a second opinion if nothing else.. but probably bear in mind this will come with lots more ££ investments. Good luck xx
Hi, I am also 37 and have been going through icsi/ivf. I've done 2 rounds so far and am hoping to do a third round after February next year. Are you in the UK? And may I ask what clinic you are at?My clinic didn't give me any blood tests after the first cycle either. And the bloods were done before the start of the first cycle. So I've never had any bloods done during a cycle. I have a low AMH too, but lower than yours so I don't stimulate as well. I was able to discuss with them what medication I was on, and I was able to request Menopur on my second cycle as I was on Gonal F on the the first cycle. . But they won't allow me to have a say in the amount of medication I am on. I was on 450 both rounds, as I have a low AMH I've heard that a mild stimulation could help as I only produce 1 mature egg each time. So 450 is pushing my ovaries to do something that they simply can't do. And from what I have read mild stimulation could help someone in my position and help egg quality. But my clinic do not practice mild IVF and so refused to lower my dose 😔
I could go to a different clinic that do practice it, but unfortunately it's 3 hours away and I don't drive so I can't get to it 😔 and they would charge more than my clinic and we simply can't afford it.
It is really frustrating when you feel that a different plan would be better for you, but they won't allow you to do it.
We'd be paying for it, and it's my body, but I can't have a say in it. It really angers me. So I feel where you are at.
Hi I will send you a PM as I don't think I'm allowed to say clinics name on here xx
Hi Gillian, I’m the same age and going into 3rd round next round. My consultant has decided to increase my menopur from 375 to 400 and I was getting between 9 and 12 eggs but of course ended up with just one for FET. Has your clinic offered IMSI with the ICSI? We saw an improvement with IMSI. All the best x
Hi
I understand what you are going through. I think when there is male factor clinics just blindly repeat the same protocol with us ladies.
4 is still a good number and you still have a really chance, maybe see if can increase dose?
But if you have to have another cycle ask for short / different protocol and look into issues more and ask for more tests, maybe even look at another clinic altogether.
But focus on now, 4 is good and the trigger shot gives it a final push too. I can PM you if need more information.
Yeah that's exactly what they seem to be doing and pushing for me to use an egg doner almost blind to my OH declining samples. I love in Plymouth so there aren't any options for clinics nearby. Hopefully this round works but if not I will look in Bristol I think for another opinion. Only a couple of hours drive then xx
Jumping on this - I did Exeter to Bristol and Cardiff for my last two - it's tough but doable x
Did you stay up there or drive/train up for your appointments? Xx
Drove - maybe 90mins to Bristol and 2hrs to Cardiff and was lucky with traffic. But a lot was during semi-/lockdown and before vaccines so was a bit nervous of trains and they kept asking you to isolate etc. Sure it would be fine now. I asked the clinic in advance to bear my travel in mind and do either very early or last thing appointments to fit around work where possible. It was stressful getting there for collection though so would recommend staying over the night before that. X
Thank you. If this round doesn't work I will definitely look into changing clinics. Can I ask you to pm me the clinics you used if you don't mind? X
I can absolutely understand your frustration and would support the other suggestions that you should get another opinion. After our failed first round, so glad we changed clinics but before that, we explored consultations with 3 other clinics and chose the one that felt right.
It will obviously cost you more but it might mean being more satisfied with the suggestions. I think suggesting donor egg when you are 37 is premature snd I will certainly get a second opinion. All the best 🙏🏾
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