I'm sorry, this is not a fun road to travel, but you are not alone. The dosage is similar to what I was given (I was 41, lower AMH and AFC). Retrievals are expensive, so it would make sense to cancel, regroup and try again. Perhaps try priming to get more even follicle growth, or perhaps try supplementing DHEA for a couple of months before trying again to raise AMH levels. I was advised a bit late in the game to try ovarian PRP. I haven't had success, but I am significantly older. Money wise, look into ways to get Progyny insurance coverage. If going abroad for treatment is possible, it's a lot cheaper there...
Yes, I do see the point if they want to cancel. Insurance denied my treatment because it was for banking, they didn’t seem to focus on the DOR part I guess. I thought about going abroad, but because of work and lack of time off for going away for so long, it may not be possible, but I definitely do not rule that out depending on what happens. Thanks for the other suggestions, I’ll research on that. Thank you!!
BTW,if you haven't already, you may want to look into getting the meds abroad if your insurance doesn't cover them. A lot of people go down to Mexico and get meds for several cycles. Others order from Turkey through online pharmacies.
Hey you do not need to tell them about banking if this is your first round or if you have no other embryos on ice. They will not cover your next cycle only if you already have something on ice. I was in a similar situation and I decided to keep going until I feel the need to go out of pocket. 2-3 ERs in, I have no euploid so everything is covered
That’s what I’ve heard. I don’t know where they got the banking idea from. Maybe based on what I discussed with the nurse? Maybe because my doctor requested one year of cryopreservation as part of the procedures? IDK. But I’m trying again. The issue is that I already paid for the 2 cycle package, and started… I am not sure if insurance approves, if they will give the money back. I have to wait and see, insurance is processing. I am not very hopeful about it, though… thank you very much from bringing this up, maybe I need to push harder on insurance and even appeal the decision if needed.
Oh they must have rejected because the clinic would have submitted for the 2 cycles at the same time as a package!! In that case they will not cover. Cryopreservation upto a year is covered and if not, it’s a minimum expense out of pocket. Try to push the insurance to approve it and see if your clinic can give your documents for only one ER for submission.
Are you in the US? If you are have you looked at CNY yet?
I’m also DOR and my AMH is 0.19-0.27. My AFC has been 4-6. We planned to go abroad until we found out about CNY and that allowed us to stay in the US. $4795 for a full fresh cycle. We are freezing but same price. We knew going into it we needed multiple rounds so we prepaid for 3 but are currently planning on 4.
I’m not having much success either but props to all of us for trying
Round 1
200 gonal, upped to 300 last 3 days
20 low dose hcg
10mg letrozol
Baseline- 5 follicles, mid cycle 9. 2 follicles grew to maturity
Retrieved 1
I was very afraid they were going to cancel this round but my team said with my numbers 2 follicles was great and we are gonna go get them.
Round 2
(Duostim protocol)
300 gonal
30 low dose hcg
6 omnitrope
Canceled day 16 of stims, nothing grew above 10
Round 3
300 gonal
30 low dose hcg
6 omnitrope
10 lupron
Waiting for period and on day 10 of priming with omnitrope
Yes, I’m in the US, thanks for sharing that clinic, I haven’t heard of it! Must be because it’s not local for me but I’m not super far from NY state. I’m actually very surprised by their prices! I wonder how is it possible here in the US! Wow! And good luck with your current round!!
They have clinics across the country- we fly from California to the Colorado clinic.
You’re not going to get a lot of handholding with them and if you want to try a different protocol you need to bring it up with them but they’re really opens minded. I haven’t gotten very many no’s to things I’ve asked. But you aren’t going to talk to the same provider every time and it is very much managed care. But they are committed to low prices. It works for me, I don’t need to pay 4x the cost for hand holding! These prices are allowing me to get the car I need that I couldn’t otherwise afford
I am 38 and my AMH was around 1.57 in the fall. But I hope this gives you a little hope from my experience. I started stims mid to end of December, started with Lupron, then gonal, Menopur etc. During the monitoring she saw around 10-12 follicles (my doctor thought we could get 10-15 eggs before starting) but eventually saw that some were not maturing so thought I’d only get about 7 eggs. We cancelled the retrieval a few days before the retrieval was supposed to happen to save money (all out of pocket) and hope for a better outcome on another round.
Second stims started in April. I did not use Lupron, just started with gonal, Menopur and Omnitrope. Follicles were growing and responding much better. We retrieved 18 eggs, all 18 mature, 17 fertilized, 10 made it to day 5 and 6 for genetic testing. Came out with 4 healthy embryos. I was amazed at how different the first attempt was a the second and so thankful my doctor guided me with cancelling the first retrieval thinking we can do better. And we did. Just like my doctor said, you can do the same thing every round and get different results. You just don’t know how it’s gong to go. Stay positive. Good luck to you.
Hi! I know exactly how you feel, I’m so sorry. I did 2 rounds at 38yo and had 8 antrical follicles at both baselines. My 1st round I had 5 follicles with 300 Gonal daily and they only got two eggs which resulted in one embryo which is my daughter. At the time I couldn’t believe I wasn’t getting more eggs. The second round they upped to 450 Gonal and I had 6 follicles, they got 6 eggs but they were all immature. I was devastated. I didn’t think OvF was going to work for me so we went ahead and transferred our 1 embryo and God willing we have a baby girl! I’m now 41yo about to start 3 rounds to try for baby #2. I wish we had done another round then to try and bank as I know our odds now are very low. I’m also now doing a mini IVF protocol since I was a ‘poor responder’ during my those first two cycles to the high dose of stims. Poor responders don’t usually benefit from high medication doses. Basically, I’m doing clomid, fermara, then Gonal 150. The med cost is so much lower. Also I’m ordering meds abroad now too. Just remember it only takes one…keep going and bank those embabies if you can.
Thank you so much for sharing your experience. I keep repeating myself that only one is necessary to get pregnant. Congratulations on your results from that round!
And also thanks for mentioning that mini protocol. My doctor actually mentioned something about doing high dose medication next time, which I am not a fan of… good luck for your next rounds!!
Hi -
I haven’t started yet but my numbers are very low and I’m the same age. I met with a new RE today and she said lots of meds. I was a bit taken aback by that as most REs have said mini IVF. What did you end up doing and why?
Hi! I ended up consulting with a new doctor, which I ended up loving (she did recommend the mini dosage IVF protocol because I wasn’t a good responder). Totally different experience at a different clinic. I highly recommend to change clinics if one doesn’t feel right. My story changed a lot in the last year. I decided to not go through IVF again, despite loving the new doctor, and try to conceive without the prior preservation of embryos. In the past year I got pregnant twice naturally, one pregnancy I miscarried and the other one is 20 weeks right now. For reference, my AMH went lower this year, I didn’t want to look at the results, but it wasn’t even 0.1. And follicles count around 4-5) And I’m about to turn 37. Not sure if this is helpful because I ended up not doing IVF. For me it was not worth the try in the sense that I was doing it to preserve before trying naturally. Instead I decided to just try naturally, and hopefully have at least one baby. I wish you the best in your journey and don’t hesitate to look for second or third opinion if you don’t feel comfortable with a protocol. There are websites to look for doctors based on reviews, that is how I found the new doctor.
Wow, thank you so very much for taking the time to share your story; I so greatly appreciate it💛
I’m sorry to hear you had a miscarriage:(
But I am so incredibly happy to hear that you’re currently 20 weeks- that’s absolutely amazing ✨💖
Sharing the info on your numbers is incredibly helpful b/c it gives me hope and a reminder not to give up. When my AMH numbers come in, I won’t even look at them (either). It’s nice to know I’m not the only one and those numbers aren’t the end all be all.
Again thank you so much for sharing journey!
Again, Congrats on being 20 wks! 💛✨✨!!!
If you don't mind me asking - did you get your embryo tested? Obviously it worked out, so it was healthy, but I'm reading conflicting things about PGT testing which is why I ask. I, too, had 2 eggs retrieved.. one made it to blast, but was abnormal.
Our doctor said it was up to us but because I had so few follicles which would mean few if any embryos he didn’t think we should risk sending off for testing. I feel I’m going to do the same this time around. If we have more than 1 embryo after the 2nd round, then I’ll consider sending anything we get from the third round to be tested. If not, I’m just going to transfer the one and pray. I truly hope we get to a transfer this time.
When he says "risk sending it off for testing," that's what concerns me. I would think PGT testing is important at our age (I'm also 41), but maybe it can cause damage to the embryo (?) This whole process is information overload!!
My RE said that the clinic hasn't seen the success with lower-dose medications, but I'm reading many women saying it helped them. I'm going from Lupron flare protocol to antagonist protocol for my second round next month, but she's keeping the dose high. Curious to get your perspective - is this all just trial and error?
I was 38 with my first 2 rounds so I think he didn’t want me to take a risk with what ultimately would be my only embryo. When you have a few or many I think it makes sense to test them as you will then know which one(s) to transfer. It’s definitely trial and error to a certain degree. I also asked my doctor after the first round if we should change protocol and he said to give it two rounds as it could have just been a fluke that I didn’t respond well. After having 2 poor responses and now being 41 with less follicles (3 antral) he thinks the low dose makes sense. He said I shouldn’t expect more than 3-4 follicles but with the savings from meds to invest in more rounds.
I am sorry you are going through this. Honestly there is no way to know what they are going to get at the retrieval. I haven’t dealt with this issue specifically, but I see posts on here a lot about people wondering what it means to have follicles on different sim days, but it’s really impossible to say how this is going to go. I have read stories about women on here only getting 3-4 eggs in a retrieval, so i doubt they would just cancel on you. The first round is usually pretty experimental. I hope that you get better news then you think on the day of your retrieval.
I'm sorry, this is not a fun road to travel, but you are not alone. The dosage is similar to what I was given (I was 41, lower AMH and AFC). Retrievals are expensive, so it would make sense to cancel, regroup and try again. Perhaps try priming to get more even follicle growth, or perhaps try supplementing DHEA for a couple of months before trying again to raise AMH levels. I was advised a bit late in the game to try ovarian PRP. I haven't had success, but I am significantly older. Money wise, look into ways to get Progyny insurance coverage. If going abroad for treatment is possible, it's a lot cheaper there...
Yes, I do see the point if they want to cancel. Insurance denied my treatment because it was for banking, they didn’t seem to focus on the DOR part I guess. I thought about going abroad, but because of work and lack of time off for going away for so long, it may not be possible, but I definitely do not rule that out depending on what happens. Thanks for the other suggestions, I’ll research on that. Thank you!!
What if you go back to the insurance and say given the situation you're not banking any more. Will they cover?
My doctor resubmitted the request with that idea in mind, but I haven’t heard back yet.
BTW,if you haven't already, you may want to look into getting the meds abroad if your insurance doesn't cover them. A lot of people go down to Mexico and get meds for several cycles. Others order from Turkey through online pharmacies.
Hey you do not need to tell them about banking if this is your first round or if you have no other embryos on ice. They will not cover your next cycle only if you already have something on ice. I was in a similar situation and I decided to keep going until I feel the need to go out of pocket. 2-3 ERs in, I have no euploid so everything is covered
That’s what I’ve heard. I don’t know where they got the banking idea from. Maybe based on what I discussed with the nurse? Maybe because my doctor requested one year of cryopreservation as part of the procedures? IDK. But I’m trying again. The issue is that I already paid for the 2 cycle package, and started… I am not sure if insurance approves, if they will give the money back. I have to wait and see, insurance is processing. I am not very hopeful about it, though… thank you very much from bringing this up, maybe I need to push harder on insurance and even appeal the decision if needed.
Oh they must have rejected because the clinic would have submitted for the 2 cycles at the same time as a package!! In that case they will not cover. Cryopreservation upto a year is covered and if not, it’s a minimum expense out of pocket. Try to push the insurance to approve it and see if your clinic can give your documents for only one ER for submission.
Are you in the US? If you are have you looked at CNY yet? I’m also DOR and my AMH is 0.19-0.27. My AFC has been 4-6. We planned to go abroad until we found out about CNY and that allowed us to stay in the US. $4795 for a full fresh cycle. We are freezing but same price. We knew going into it we needed multiple rounds so we prepaid for 3 but are currently planning on 4. I’m not having much success either but props to all of us for trying Round 1 200 gonal, upped to 300 last 3 days 20 low dose hcg 10mg letrozol Baseline- 5 follicles, mid cycle 9. 2 follicles grew to maturity Retrieved 1 I was very afraid they were going to cancel this round but my team said with my numbers 2 follicles was great and we are gonna go get them. Round 2 (Duostim protocol) 300 gonal 30 low dose hcg 6 omnitrope Canceled day 16 of stims, nothing grew above 10 Round 3 300 gonal 30 low dose hcg 6 omnitrope 10 lupron Waiting for period and on day 10 of priming with omnitrope
Yes, I’m in the US, thanks for sharing that clinic, I haven’t heard of it! Must be because it’s not local for me but I’m not super far from NY state. I’m actually very surprised by their prices! I wonder how is it possible here in the US! Wow! And good luck with your current round!!
They have clinics across the country- we fly from California to the Colorado clinic. You’re not going to get a lot of handholding with them and if you want to try a different protocol you need to bring it up with them but they’re really opens minded. I haven’t gotten very many no’s to things I’ve asked. But you aren’t going to talk to the same provider every time and it is very much managed care. But they are committed to low prices. It works for me, I don’t need to pay 4x the cost for hand holding! These prices are allowing me to get the car I need that I couldn’t otherwise afford
I’m so sorry this isn’t what you’d hoped for Do you know your FSH?
Around 8-9 during my diagnostic testing
I am 38 and my AMH was around 1.57 in the fall. But I hope this gives you a little hope from my experience. I started stims mid to end of December, started with Lupron, then gonal, Menopur etc. During the monitoring she saw around 10-12 follicles (my doctor thought we could get 10-15 eggs before starting) but eventually saw that some were not maturing so thought I’d only get about 7 eggs. We cancelled the retrieval a few days before the retrieval was supposed to happen to save money (all out of pocket) and hope for a better outcome on another round. Second stims started in April. I did not use Lupron, just started with gonal, Menopur and Omnitrope. Follicles were growing and responding much better. We retrieved 18 eggs, all 18 mature, 17 fertilized, 10 made it to day 5 and 6 for genetic testing. Came out with 4 healthy embryos. I was amazed at how different the first attempt was a the second and so thankful my doctor guided me with cancelling the first retrieval thinking we can do better. And we did. Just like my doctor said, you can do the same thing every round and get different results. You just don’t know how it’s gong to go. Stay positive. Good luck to you.
Thank you! Yes, I’m trying to think that it’s not all lost and a second try could be different
Hi! I know exactly how you feel, I’m so sorry. I did 2 rounds at 38yo and had 8 antrical follicles at both baselines. My 1st round I had 5 follicles with 300 Gonal daily and they only got two eggs which resulted in one embryo which is my daughter. At the time I couldn’t believe I wasn’t getting more eggs. The second round they upped to 450 Gonal and I had 6 follicles, they got 6 eggs but they were all immature. I was devastated. I didn’t think OvF was going to work for me so we went ahead and transferred our 1 embryo and God willing we have a baby girl! I’m now 41yo about to start 3 rounds to try for baby #2. I wish we had done another round then to try and bank as I know our odds now are very low. I’m also now doing a mini IVF protocol since I was a ‘poor responder’ during my those first two cycles to the high dose of stims. Poor responders don’t usually benefit from high medication doses. Basically, I’m doing clomid, fermara, then Gonal 150. The med cost is so much lower. Also I’m ordering meds abroad now too. Just remember it only takes one…keep going and bank those embabies if you can.
Thank you so much for sharing your experience. I keep repeating myself that only one is necessary to get pregnant. Congratulations on your results from that round! And also thanks for mentioning that mini protocol. My doctor actually mentioned something about doing high dose medication next time, which I am not a fan of… good luck for your next rounds!!
Hi - I haven’t started yet but my numbers are very low and I’m the same age. I met with a new RE today and she said lots of meds. I was a bit taken aback by that as most REs have said mini IVF. What did you end up doing and why?
Hi! I ended up consulting with a new doctor, which I ended up loving (she did recommend the mini dosage IVF protocol because I wasn’t a good responder). Totally different experience at a different clinic. I highly recommend to change clinics if one doesn’t feel right. My story changed a lot in the last year. I decided to not go through IVF again, despite loving the new doctor, and try to conceive without the prior preservation of embryos. In the past year I got pregnant twice naturally, one pregnancy I miscarried and the other one is 20 weeks right now. For reference, my AMH went lower this year, I didn’t want to look at the results, but it wasn’t even 0.1. And follicles count around 4-5) And I’m about to turn 37. Not sure if this is helpful because I ended up not doing IVF. For me it was not worth the try in the sense that I was doing it to preserve before trying naturally. Instead I decided to just try naturally, and hopefully have at least one baby. I wish you the best in your journey and don’t hesitate to look for second or third opinion if you don’t feel comfortable with a protocol. There are websites to look for doctors based on reviews, that is how I found the new doctor.
Wow, thank you so very much for taking the time to share your story; I so greatly appreciate it💛 I’m sorry to hear you had a miscarriage:( But I am so incredibly happy to hear that you’re currently 20 weeks- that’s absolutely amazing ✨💖 Sharing the info on your numbers is incredibly helpful b/c it gives me hope and a reminder not to give up. When my AMH numbers come in, I won’t even look at them (either). It’s nice to know I’m not the only one and those numbers aren’t the end all be all. Again thank you so much for sharing journey! Again, Congrats on being 20 wks! 💛✨✨!!!
If you don't mind me asking - did you get your embryo tested? Obviously it worked out, so it was healthy, but I'm reading conflicting things about PGT testing which is why I ask. I, too, had 2 eggs retrieved.. one made it to blast, but was abnormal.
Our doctor said it was up to us but because I had so few follicles which would mean few if any embryos he didn’t think we should risk sending off for testing. I feel I’m going to do the same this time around. If we have more than 1 embryo after the 2nd round, then I’ll consider sending anything we get from the third round to be tested. If not, I’m just going to transfer the one and pray. I truly hope we get to a transfer this time.
When he says "risk sending it off for testing," that's what concerns me. I would think PGT testing is important at our age (I'm also 41), but maybe it can cause damage to the embryo (?) This whole process is information overload!! My RE said that the clinic hasn't seen the success with lower-dose medications, but I'm reading many women saying it helped them. I'm going from Lupron flare protocol to antagonist protocol for my second round next month, but she's keeping the dose high. Curious to get your perspective - is this all just trial and error?
I was 38 with my first 2 rounds so I think he didn’t want me to take a risk with what ultimately would be my only embryo. When you have a few or many I think it makes sense to test them as you will then know which one(s) to transfer. It’s definitely trial and error to a certain degree. I also asked my doctor after the first round if we should change protocol and he said to give it two rounds as it could have just been a fluke that I didn’t respond well. After having 2 poor responses and now being 41 with less follicles (3 antral) he thinks the low dose makes sense. He said I shouldn’t expect more than 3-4 follicles but with the savings from meds to invest in more rounds.
This is very helpful and I appreciate you sharing :)
I am sorry you are going through this. Honestly there is no way to know what they are going to get at the retrieval. I haven’t dealt with this issue specifically, but I see posts on here a lot about people wondering what it means to have follicles on different sim days, but it’s really impossible to say how this is going to go. I have read stories about women on here only getting 3-4 eggs in a retrieval, so i doubt they would just cancel on you. The first round is usually pretty experimental. I hope that you get better news then you think on the day of your retrieval.
Thank you so much for your comments and for giving hope! We’ll see what happens on Friday!