When to cancel a cycle?

[Linzeeee]

Hi all I have DOR and currently on an agonist stop antagonist protocol. After 5 days of stimulation with FSH, there is only one 10mm follicle and 4 tiny ones about 2mm . Doc suggested to up the stim Meriofert) to max dose of 450IU and scan after 5 days but I am not hopeful I will get more than 1 egg. E2 is 290 at day 5. This is my second cycle and my last one I only had one egg which didn’t fertilize. Wondered if I should go through with this and decide in 5 days or abandon ASAP, save the meds for next round and tweak protocol. Not the most easy or obvious choice for me. Any tips on how you decided to abandon a cycle if you have ? Thank you!

[JudithSS]

Morning darl, That’s a tough one! Depending on what your AMH is that could be what your body produces. One of my friends she only ever had one follicle, one egg each and every time. Our last cycle we were asked if we wanted to abandon as I didn’t respond to the drugs and I had two follicles. We were asked if we cancelled it how would we feel next time around if that same thing happened or we had one follicle’ or potentially more - so we went with it, and in our minds we already spend the money. I guess those are the questions you need to ask yourself. Whatever decision you make will be fine 💖

[MrsOrangejuice]

This is a horrible pressure on you and sorry you're having to make the decision. For my last round I had one follicle of 15mm after 7 days of low-ish stims. Clinic didn't expect it as I have high AMH. The nurses basically told me to 'sit down' as they had bad news and said cancel as either that one would become a cyst and no egg, or I could just get that one egg and 'waste' a funded round. The problem was they didn't have any good alternative ideas so I didn't feel they could give me a better option. I'd also had a previous round where I took forever to respond, had one big at first and they kept upping the meds and finally I got 9 eggs. So I asked them to up the meds and carry on - tbh the nurses and the clinic made me feel awful about my decision and the weight of the financial consequences was a lot. But for me it was the experience from the previous round, no good alternatives being suggested and frankly just being so fed up. Plus I tried to focus that even if we got only one that could be the one. Within a few days more follicles came through, the big one slowed and we got (after 17 days of stims) 5 eggs, including from the big one. So it just happened to be that it was the right decision but it could not have been; I think I just needed to feel it was our decision and that it felt right at the time.

Your numbers sound better then mine on both rounds for the stage you're at but if you got only one last time on the same protocol it's difficult to say it will be different this time. If no follicles had come through for us within a few extra days, or if the big one had become a cyst so it looked non viable we would probably have made a different decision. So perhaps if you can wait a few days to see if there's any change and make a more informed choice that would be better. I think overall it's looking at all the options and outcomes, and deciding which you feel most at peace with. I don't envy you at all though as I felt so conflicted, and angry for some reason, maybe being put in that position without any alternatives or explanations. I hope your clinic is more supportive X

[AuroraXen]

5 days of stims seems quite early for a first scan to me Linzeeee - for my last 2 cycles, the clinic hasn't done a baseline scan so the first one was on day 8 of stims each time. So maybe there's still time for improvement? It's really hard, but I'd personally wait to see what happens on your next scan. Sometimes follicles really can come from nowhere! On my 3rd cycle we could only see 2 follicles on the day 8 scan. I was really tempted to cancel but like Judith, the doctor said maybe this was the best I could get now 😩and next time might be worse! If only we had crystal balls... We kept going that time and by our final scan 3 tiny follicles had grown loads and we managed to get 5 eggs. Those 3 eggs from the slower follicles were not mature enough to fertilise, sadly, but you never know. So if it were me I'd keep going and see what the next scan says xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi Linzeeee. A cycle is considered complete at egg collection. If you end before egg collection, then you are owed a cycle. Hope all goes well with the follicle you have, if you go ahead with egg collection. You never know, the extra 5 days stims might just do the trick. Diane