Not responding to stimulation

[Janop79]

Hi all,

I’m hoping you can help/offer some words of advice or hope. I don’t know what to do anymore and just feel like giving up on this journey, on everything in my life. I’m so sorry if I sound dramatic but I’m really struggling. I’m really don’t know how much more of this I can take. In summary, it seems like my follicles are no longer responding to stimulation. In fact, rather than even just a minimal increase in size during stimulation, they just seem to be shrinking or disappearing. This is now the second month it’s happened. I’m confused. I had three mild IVF cycles last year and responded to the drugs well each cycle. This was with a slightly different protocol and at a different clinic. My consultant wants me to take Estradiol for 10 days as this can sometimes be effective in ‘bringing them back’.

Has this happened to anyone else? Any advice please?

[DianeArnold Partner Nurse Fertility Network UK]

Hi Janop. Oh dear, so sorry you are so distressed. It does sound as if it could be a low oestrogen problem, so hopefully the Estradiol should help. Obviously, I hope it does the trick. Thinking of you. Diane

[Janop79 in reply to DianeArnold]

Thank you so much for your response. I hope so. I’ve been Googling for some answers (I know that’s the worst thing to do) and I saw something about it possibly indicating that my ovarian reserve has been exhausted. I wish I hadn’t looked now. I feel even worse than I did before.

[keepfaith1982 in reply to Janop79]

Hi sorry to hear this ☹️ Its not an easy journey ive done one round of natural modified ivf due to low amh high fsh and endometriosis 😣 and managed to get a high quality egg on egg collection they say if low ovarian reserve its best to go for the egg your body naturally selects as its usually of higher quality and long protocol just wouldn’t work for me i also have changed my diet and have acupuncture sending hugs xx

[Janop79 in reply to keepfaith1982]

Hi Wintss, thank you so much for your message. It looks like we’re going to have to go down the natural modified route too since I’m just no longer responding to stims. It’s still such a shock that it’s just no longer happening when only last year I was. I’m glad to hear that you managed to get a high quality egg though! That’s great.Sending you lots of love and luck xx

[keepfaith1982 in reply to Janop79]

Hi hun are you on higher protocol now? and lower protocol last yr? Its weird how it works I always thought the lower amh the more injections you would have seems it not the case xx

[Janop79 in reply to keepfaith1982]

Last month’s cycle which had to be abandoned was definitely a higher protocol. 225iu rather than 150iu as I’ve had previously and a different medication too, Pergoveris rather than Bemfola.This cycle, I was back down to 150iu but I also did estrogen priming and took Tamoxifen (similar to Clomid) as instructed by the consultant. I didn’t take either last year.

I thought this approach would work better but it hasn’t at all

[Marisa32]

I never responded to stims. For me, natural cycle with no stims worked better. In both cases, with or without stims, I would only produce 1 egg. I think the quality of the egg was better without stims, so I gave them up. I have extremely low AMH and diminished ovarian reserve, meaning stims wouldn't do anything for me. It took about 12 cycles to find a good egg but I finally did and holding my 2 week old now. Me being 42 was the reason for trying that many cycles, as only 1 out of 10 eggs is good at this age. I would definitely get off the stims if it's not doing anything for you and try more mild or natural IVF.

[Janop79 in reply to Marisa32]

Hi Marisa,

Thank you for responding. I really appreciate it. I’m also 42. The consultant mentioned natural IVF also but also said it was risky because it’s relying on one egg. I should have asked the consultant this (I was in shock and too upset) but is natural IVF without the use of stims?

Aw that’s lovely. Congratulations!

Thanks again

J

[Marisa32 in reply to Janop79]

Yes, natural should be without stims and mild with very low stims. If you happen to be a poor responder getting just 1 egg with or without stims then pumping your body with injections isn't going to make a difference. People usually do at least 3 cycles back to back to collect the eggs.

[Janop79 in reply to Marisa32]

Ah yes, thanks.We have low sperm count and density to deal with too so we may have to do ICSI too. Always seems to be something else

[Marisa32 in reply to Janop79]

Yup, sperm issues definitely add more complexity to an already complex process.

[keepfaith1982 in reply to Marisa32]

Sorry to hear hear this - def ask questions to the doctors to get their view on it hoping allWorks out for you 🙏🏻

[VariR in reply to Marisa32]

Hi Marisa

Please can you let me know what your AMH level was? My consultant has told me that due to my low levels (4 Last year) they don't want me doing IVF at all and just ovulation induction with Clomid or meriofert with timed sexual intercourse. I didn't respond to meriofert at all and had no follicles in the scan.

Really pleased to hear your success

[Marisa32 in reply to VariR]

My AMH was 0.16 when measured last. I think here the measurement is in different units. I also did a round of Clomid and got the blighted ovum out of it. Even on Clomid though, it was still just one egg, so I dropped the stims entirely. If you have no other issues preventing you from getting pregnant like blocked tubes or sperm issues etc...timed intercouse is a good option, as IVF becomes unnecessary.

[VariR in reply to Marisa32]

Thanks Marisa, I think my AMH levels were done in pmol/l. We don't have any other issues with blocked tubes, sperm volume or motility, although DNA fragmentation was poor. So no reason why we can't pregnant but been trying for a year now, and at 43 years not sure how long we can keep trying.

Speaking to ladies like yourself on this forum, really help with the isolation and loneliness I feel..so thank you

[Marisa32 in reply to VariR]

Yeah, it's an uphill battle after 40. I started ttc as I was about to turn 40 and it took me year and a half.

[Judegreen]

I don’t have any advise but I just wanted to say I’m on the same boat and really understand your pain. It’s just so hard. What protocol are you? I’ve always responded better to long protocol and recently I got put on a higher dose of stims which didn’t make much difference at all, if not made it worse.. I hope Estradiol helps.

[Janop79]

Thanks Judegreen! I really appreciate you taking the time to reply. I can see from you latest post that you’re having a tough time of it too. Surely we deserve a break by now???I’m meant to be on a short protocol which works better for me due to my low ovarian reserve.

I really hope it works too but I’m too scared to be too hopeful as it’s been one disappointment after another so I’m expecting another one.

Praying that we both get our wish one day x

[VariR]

Hi Janop sorry to hear this. I'm in a very similar situation as the last two months I don't seem to have ovulated. Like you, last year I responded well to IVF stimulation. However this year the doctors said due to my age (43) and low AMH level (about 4 last year ) they would not do more IVF. So now I am on ovulation induction protocol with timed sexual intercourse. The first month I used Clomid and I had one good size egg, but the last two months I haven't produced any follicles despite injections meriofert. My urine tests have been negative too. I too am at a loss of any other options I can try. Please let me know how you get on.

There seems to be so many of us facing the same challenge.....

[Janop79 in reply to VariR]

Hi VariR, thanks for your response. I’m sorry to read that you’re struggling as well. Yes, we do seem to be in a very similar situation. I know I should try and keep positive but I don’t think these 10 days on estrogen is going to help at all do I suspect the next option will be similar to what you are doing now. I’ll definitely let you know how I get on.

I really hope that things work out for you. Sending lots of love and luck xx

[Cinderella5]

Awww Janop, I'm sorry to see your update!😔 I've no experience in this area but just wanted to send you hugs, thinking of you!xxx