Is mild IVF better?

[finup0321]

Started IVF 1 year ago at age 37, diagnosed with both unexplained and DOR. We’ve been unable to conceive since we started trying at 32, fobbed off by every doctor in the US and UK for years because “you’re so young, just keep trying.” I’ve been embryo batching at CRGH since summer 2022, having done 6 full rounds all with low yields. Did one FET with my only euploid blast, but BFN, it didn’t even implant. Continuing to embryo batch, now on round 7! This will be my last cycle using full antagonist stims. I will likely try mild stims next, as my yields are so low (2-4 eggs per retrieval) it’s not worth the headache of having to constantly dope myself up, it makes me feel like a farm animal .

Is anybody else here batching? I’m especially eager to hear more about mild stim results.

Thank you for any input

[DianeArnold Partner Nurse Fertility Network UK]

Hi fin up. Just might be an idea to do a mild round so you’re not using the antagonist which slows follicle growth so you don’t ovulate. See what your specialist advises. Good luck. Diane

[finup0321 in reply to DianeArnold]

I didn’t know that about the antagonist! I thought it just stopped ovulation. Thank you for the advice.

[slinky00]

Hi finup0321

I wanted to say I also was diagnosed with DOR and low AMH, I never responded well to high stim protocols and would never even get to retrieval stage as always developed cysts or follicles stopped growing.

I went on to have a number of low stims cycles, after 3 - 6 months taking DHEA and low stim cycles where I was not on DHEA and I found that my ovaries responded much better. Still low numbers 3 - 4 eggs per retrieval but mature and always got at least 2 embryos to do fresh transfers. I haven't had a live birth yet (I'm a little older than you at 41) as I decided to stop IVF all together for a while and I am older than you. All the hormones were really making me unhappy on many levels.

Mild stims worked better for me as my ovaries just didn't respond to high levels of stims and completely shut down whereas when they were slowly coaxed, they seemed to prefer that with better quality eggs. It is also a lot easier on the bank balance when not having to purchase so much meds but end up with the same amount of eggs or more.

Hope this helps, all the best 💛

[finup0321 in reply to slinky00]

It’s a long tough road for us DORs, thank you for your supportive words. I’ve been on DHEA (75mg) for about a year, except for 2 months while prepping for transfer. I’m honestly doubting its purported magic abilities. I’ve also been on CoQ10, DHA, probiotics, prenatal, myoinositol.. a true rainbow of supplements. It’s really just come down to what my cycle is doing and how much my body is willing to tolerate. I love the idea of mild but my consultant suggested that it does not improve quality, it merely reduces the quantity and overall stress on the body. Sadly there’s not much to be done about quality at this point, so we just have to retrieve as much as we can, and that’s what scares me about mild stims. If this is a numbers game, then does it actually help to lessen the dose and perhaps the numbers? Every time someone says “you only need one” I get so upset, because it will take me 1200 cycles to get just that one. I’m sure you know the feeling!

PS age hardly means a thing if our AMH and response is the same! We have to remember this isn’t our fault and we are doing our very best. Sending you warm vibes and hopes for a smooth journey onward xx

[Pipidugacarapa]

So, I had only one stim cycle but mine was “weird”. I’m with clinic that is doing all “modern” stuff so when doctor heard that I wanted to test all embryos (automatically goes to freeze all cycle) he decided to put me on mid-luteal protocol. I’ve never heard for that before but apparently it’s a thing when there’s no time to wait for down regulation etc (pending breast surgery when women has cancer for example). So, they did all checks, tracked my ovulation, confirmed 5 days after with ultrasound and blood and started me on Gonal F 4 days, then added Menopur and antagonist for next 8 days. I responded great and they had me trigger only with Lupron to prevent OHSS. My period arrived 4 days after ER and I started to feel normal at that time (I was extremely bloated towards the end of stimulation). They started me with high dose of Gonal F (never had cycle before so we didn’t know how I’d respond) but after 4 days (I was on 450IU per day) they lowered it (to 225 plus 75 Menopur) for two days and then even more (150 and last two days to 75IU, Menopur was 75 all the time). I don’t know what is this strategy but it worked great. My doctor is more like scientists (has phD) and not really “friendly” with good bed manners but we really got great results after one stimulation (and now we’re pregnant hopefully good 🤞🏻🤞🏻🤞🏻 after first FET). There are many protocols and I think that if one doesn’t work you should search for another one that will work. They say that first cycle is trial and error and I’m lucky that doctor chose protocol that worked for me first time.

[finup0321 in reply to Pipidugacarapa]

Wow, a mid-luteal protocol! How interesting, thanks for letting me know about it, could you please DM me the name of your clinic?

You are incredibly lucky, it’s always uplifting to hear of anyone succeeding at this. Now go buy a lotto ticket, haha xx

[Peacock08 in reply to Pipidugacarapa]

Hi may I know your clinic's name please? I'm so confused about choosing the right Doctor and clinic. Please help!

[Pipidugacarapa in reply to Peacock08]

I’m in USA, California, so not sure how helpful it is, but you can PM if you are interested. I was researching quite a bit before deciding where I wanted to go for initial appointment, check reviews and success rates. When he put me on mid luteal protocol I was very suspicious but decided to trust the process and I’m really glad I did. Find doctor that you can trust and follow his protocol. Good luck 🙏🏻

[Skittles11]

Hiya, I can't really comment on mild IVF as I haven't had that but your situation reminded me a lot of my own so thought I'd drop a message. I am also 37 and have been trying to batch PGTA tested embryos, had multiple cycles last year in my attempts. Like you, I have diminished ovarian reserve and have struggled to get many eggs. I had a total of 4 blastocyts tested from those cycles and from that suppply, one tested normal (haven't tried to implant it yet).

It is totally exhausting going from cycle to cycle and not knowing what will yield best results. I found it really tough. Good luck with whatever you decide. Sometimes going with your gut feeling is the best thing to do xx

[Hopecontinues]

Hi,There is a lot of conflicting information out there on this subject. All I can say is that I had a lot of high stim ivf rounds because of my age and would get a lot of eggs, but only 2-3 would fertilise and make it to day 5. Also, I got OHSS a few times which was not pleasant. I then went to a clinic in Greece who put me on a mild protocol and I only got 3 eggs, but 2 of them fertilised and grew. Basically the same result in the end and I hardly noticed I was on stims, the meds were a fraction of the price because of the low dose and recovery was quicker.

It was a bit weird to go from 19-25 eggs in previous rounds to 3 in the low dose, but in hindsight it was a much better protocol for me.

In the end I went to a clinic in Spain and had all the tests, found out I had hereditary thrombophilia and was put on a specific protocol for that, but by the time I had found this out I had to move to donor eggs. They put me on a downreg first for adenomyosis and gave me a mock cycle and then blood thinners and now I'm 24 weeks pregnant. I'll never know if any of the previous eggs would have worked had I known about the issues I had. If nothing is working, I'd try getting tested for other things and speaking to different doctors.

Wishing you the best of luck and I hope you find your answers soon.

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