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SIRM for DOR patients

DOR

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#1 sophia_cop

sophia_cop
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  • 14 posts
  • Gender:Female
  • Location:Canada
  • Dx:DOR

Posted 13 April 2018 - 09:18 AM

Just wondering if anyone has had experience with Sher Institute of Reproductive Medicine (SIRM), particularly with Dr. Geoffrey Sher himself?

 

After months of heartache and on the verge of using donor eggs due to multiple failures, we did some research and sought help from Dr. Sher, who specializes in DOR. He has specific view on what protocols work in DOR cases (basically he said all the protocols I have used were suboptimal and actually working against my condition)

 

We decided to do embryo banking with PGS and just finished our 1st round and my egg retrieval went better than ever. Got 10 eggs, 9 mature, 8 fertilized, 4 grew to 5 day blastocyst and were biopsied for PGS. Now anxiously awaiting the results.

 

Has anyone used this clinic or know of anyone who has? Would love to hear any other experiences. 


Me-37 (DOR), DH-33 (no issues)
Low AMH, normal FSH
Blocked tubes
Stenotic Cervix

High NK cell activity (diagnosed Apr. 2018)

June 2016 IUI #1- BFN
Aug 2016 IUI #2- BFN

Dec 2016 IVF#1: 4 eggs retrieved, 3 fertilized, 1 made to day 5 AB blastocyst-FET=BFN

July 2017 IVF #2: 3 eggs retrieved, 2 fertilized, both made to day 5 (AB, BC) blastocyst- FET=BFN

Jan 2018 IVF #3 (new RE): 6 eggs retrieved, 3 mature, 1 fertilized, day 3 fresh transfer (5-cell, grade 2)=BFN

Mar 2018 IVF #4 (new RE): 10 eggs retrieved, 9 mature, 8 fertilized, 4 made to day 5 & biopsied for PGS **awaiting results**

May 2018: IVF #5: 2nd IVF planned for embryo banking

 


#2 hopefuldadsomeday

hopefuldadsomeday
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Posted 13 April 2018 - 11:34 AM

Hi Sophia_cop, we ended up doing embryo banking ourselves due to my wife's poor egg quality.  We haven't officially been diagnosed with DOR but as you can see from our results we also have poor numbers.  We ended up doing our IVF cycles through our local clinic, but my wife did a lot of reading on Dr. Sher's blog.  We approached our RE about trying some of the protocols suggested by Dr. Sher.  While he did not agree with some of his thoughts, he did tweak the clinic's standard protocol for us.  Our 3rd cycle's protocol which was based on some of Dr. Sher's theories initially gave us the best result (11 follicles on ultrasound), but they only managed to retrieve 4 eggs for some reason...we were lucky to get 1 PGS-normal embryo from each batch, we're just trying to get my wife's lining thick enough for a transfer!

 

4 blastocysts is a great number!  We've only gotten to 2, 1, and 1 blastocysts in our respective IVF cycles, so I'm hoping you get more than 1 PGS-normal in this batch!


  • sophia_cop likes this

March 2016 - Miscarriage #1 (chemical pregnancy)

August 2016 -  Miscarriage #2 (Trisomy-16)

December 2016 - Miscarriage #3 (unknown - suspected chromosomal abnormality)

IVF #1 - Aug 2017 (estrogen priming antagonist protocol) - 9 eggs retrieved, 3 fertilized, 2 blastocysts, only 1 PGS normal embryo 5BB mitoscore 25.1 (frozen)

IVF #2 - Nov 2017 (estrogen priming antagonist protocol - with testosterone priming and growth hormone) - 7 eggs retrieved, 5 fertilized with ICSI, 1 blastocyst PGS-normal 5BB mitoscore 33.12 (frozen)

IVF #3 - Jan 2018 (estrogen priming antagonist protocol with growth hormone) -  4 eggs retrieved, 2 fertilized with ICSI, 1 blastocyst PGS-normal 6BB mitoscore 29.82 (frozen)

FET #1 - March 2018 - cancelled due to thin lining (6.25mm)

FET #1.2 - April 2018 - cancelled due to thin lining again! (4.85mm)

FET #1.3 - June 4, 2018 (lining 7.5mm!) - th_abfn.gif

ERA Aug 2018 - Pre-receptive by 1 day

FET #2 - Sep 18, 2018 (lining 6.9mm) th_abfp.gif  Beta #1: Sep 30, 2018 - 682  Beta #2: Oct 6,2018 - 6656 U/S: Oct 15 - measuring 6w4d (CRL 6.87mm), HR 127bpm! U/S: Oct 25 - measuring 8w1d (CRL 16.69mm), HR 168bpm!  Discharged to midwives!  June 7, 2019: It's a girl!  DD born 7lb 2oz babygirl.gif


#3 sophia_cop

sophia_cop
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  • 14 posts
  • Gender:Female
  • Location:Canada
  • Dx:DOR

Posted 13 April 2018 - 12:22 PM

Three PGS-normal embryos is fantastic!! - I hope we can be so lucky. I also have a history of thin lining - for my egg retrieval, started out at 5 mm and close to trigger day was only at 7mm, which Dr. Sher was not satisfied with so even though I wasn't doing a transfer, he put me on Viagra suppositories to see how I'd respond. My lining went up to 9mm after 1 day of treatment, so he knows to include this as part of my FET. What protocol is your wife on for FET?


Me-37 (DOR), DH-33 (no issues)
Low AMH, normal FSH
Blocked tubes
Stenotic Cervix

High NK cell activity (diagnosed Apr. 2018)

June 2016 IUI #1- BFN
Aug 2016 IUI #2- BFN

Dec 2016 IVF#1: 4 eggs retrieved, 3 fertilized, 1 made to day 5 AB blastocyst-FET=BFN

July 2017 IVF #2: 3 eggs retrieved, 2 fertilized, both made to day 5 (AB, BC) blastocyst- FET=BFN

Jan 2018 IVF #3 (new RE): 6 eggs retrieved, 3 mature, 1 fertilized, day 3 fresh transfer (5-cell, grade 2)=BFN

Mar 2018 IVF #4 (new RE): 10 eggs retrieved, 9 mature, 8 fertilized, 4 made to day 5 & biopsied for PGS **awaiting results**

May 2018: IVF #5: 2nd IVF planned for embryo banking

 


#4 hopefuldadsomeday

hopefuldadsomeday
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  • 725 posts
  • Dx:Unexplained
  • My Clinic:Olive Fertility

Posted 13 April 2018 - 04:59 PM

Hi Sophia_cop - my wife was on the clinic's standard medicated FET protocol.  She started with estrace 2mg three times a day oral, then when she didn't respond, they added estrace vaginally.  After that they added estradot patches.   We approached our RE about vaginal sildenafil as recommended by Dr. Sher.  He said their clinic's experience was it didn't help, but he agreed to prescribe it. We were told to just insert the regular tablets vaginally and my wife found they weren't dissolving well when used vaginally, so we ended up going to a compounding pharmacy to make them as vaginal suppositories.  Unfortunately our cycle got cancelled (after 3 weeks her lining still only at 6.2mm and there was fluid buildup) before we got to try them to see if it would have made a difference.

 

Our current cycle our RE wants to try a natural unmedicated FET, although my wife is contemplating using the vaginal sildenafil suppositories she had made up last time anyways.  Her first 2 IVF cycles on trigger day, her lining was also around 6mm, but for some reason her 3rd cycle was 9mm?  Not sure if that was due to a measurement error or not.

 

Please post back with any updates!  My wife has been following Dr. Sher's blog for awhile and she was thinking of booking a consult with him if our current FET is canceled again.


March 2016 - Miscarriage #1 (chemical pregnancy)

August 2016 -  Miscarriage #2 (Trisomy-16)

December 2016 - Miscarriage #3 (unknown - suspected chromosomal abnormality)

IVF #1 - Aug 2017 (estrogen priming antagonist protocol) - 9 eggs retrieved, 3 fertilized, 2 blastocysts, only 1 PGS normal embryo 5BB mitoscore 25.1 (frozen)

IVF #2 - Nov 2017 (estrogen priming antagonist protocol - with testosterone priming and growth hormone) - 7 eggs retrieved, 5 fertilized with ICSI, 1 blastocyst PGS-normal 5BB mitoscore 33.12 (frozen)

IVF #3 - Jan 2018 (estrogen priming antagonist protocol with growth hormone) -  4 eggs retrieved, 2 fertilized with ICSI, 1 blastocyst PGS-normal 6BB mitoscore 29.82 (frozen)

FET #1 - March 2018 - cancelled due to thin lining (6.25mm)

FET #1.2 - April 2018 - cancelled due to thin lining again! (4.85mm)

FET #1.3 - June 4, 2018 (lining 7.5mm!) - th_abfn.gif

ERA Aug 2018 - Pre-receptive by 1 day

FET #2 - Sep 18, 2018 (lining 6.9mm) th_abfp.gif  Beta #1: Sep 30, 2018 - 682  Beta #2: Oct 6,2018 - 6656 U/S: Oct 15 - measuring 6w4d (CRL 6.87mm), HR 127bpm! U/S: Oct 25 - measuring 8w1d (CRL 16.69mm), HR 168bpm!  Discharged to midwives!  June 7, 2019: It's a girl!  DD born 7lb 2oz babygirl.gif


#5 sophia_cop

sophia_cop
  • Member
  • 14 posts
  • Gender:Female
  • Location:Canada
  • Dx:DOR

Posted 13 April 2018 - 07:38 PM

If 9mm was correct, then that's promising that she can get to that point! The ones I used were compounded vaginal suppositories from a specialty pharmacy as well.

 

I'll definitely post back with any updates and look forward to any from you guys as well!


Me-37 (DOR), DH-33 (no issues)
Low AMH, normal FSH
Blocked tubes
Stenotic Cervix

High NK cell activity (diagnosed Apr. 2018)

June 2016 IUI #1- BFN
Aug 2016 IUI #2- BFN

Dec 2016 IVF#1: 4 eggs retrieved, 3 fertilized, 1 made to day 5 AB blastocyst-FET=BFN

July 2017 IVF #2: 3 eggs retrieved, 2 fertilized, both made to day 5 (AB, BC) blastocyst- FET=BFN

Jan 2018 IVF #3 (new RE): 6 eggs retrieved, 3 mature, 1 fertilized, day 3 fresh transfer (5-cell, grade 2)=BFN

Mar 2018 IVF #4 (new RE): 10 eggs retrieved, 9 mature, 8 fertilized, 4 made to day 5 & biopsied for PGS **awaiting results**

May 2018: IVF #5: 2nd IVF planned for embryo banking

 


#6 GeorgetteBabies

GeorgetteBabies
  • Member
  • 47 posts
  • Gender:Female
  • Location:Toronto
  • Interests:Horses, dogs, boxing
  • Dx:DOR
  • My Clinic:Mt Sinai

Posted 17 April 2018 - 06:06 PM

Hi Everyone.  I have DOR as well and am starting Stims in 2 days.  Can you tell me what you were stimmed with dose and schedule of meds? Thanks! 


TTC for 7 years

many unexplained miscarriages.  Ectopic rupture 2010 resulting in loss of right tube and ovary, remaining tube blocked

IVF funded waiting, large polyps removed

AMH 1.7, FSH 10, AFC 6

10/2017 Accepted for funded IVF

April 19th started stims 75 IU menopur 300IU Gonal F 

ER coming up

ER may 5/2018

ET May 8th (3 day - one 8 cell one 10 cell grade 2 embies)

POAS day 6 bfn

poas day 10 bfn

HCG beta day 11 less than one BFN Im out :( 


#7 hopefuldadsomeday

hopefuldadsomeday
  • Global 100+
  • 725 posts
  • Dx:Unexplained
  • My Clinic:Olive Fertility

Posted 17 April 2018 - 06:24 PM

My wife was put on estrogen priming antagonist protocol.  Estrace priming for 1 week before expected period, than menopur 150U morning and puregon 300U bedtime and orgalutran to prevent ovulation.  Our RE added growth hormone as well but can't really tell if that had any effect.  We were originally on 225u menopur and 225u puregon, but Dr. Sher was concerned too much LH may be detrimental to egg quality, so we adjusted the dosing on our 3rd cycle.  Good luck!


March 2016 - Miscarriage #1 (chemical pregnancy)

August 2016 -  Miscarriage #2 (Trisomy-16)

December 2016 - Miscarriage #3 (unknown - suspected chromosomal abnormality)

IVF #1 - Aug 2017 (estrogen priming antagonist protocol) - 9 eggs retrieved, 3 fertilized, 2 blastocysts, only 1 PGS normal embryo 5BB mitoscore 25.1 (frozen)

IVF #2 - Nov 2017 (estrogen priming antagonist protocol - with testosterone priming and growth hormone) - 7 eggs retrieved, 5 fertilized with ICSI, 1 blastocyst PGS-normal 5BB mitoscore 33.12 (frozen)

IVF #3 - Jan 2018 (estrogen priming antagonist protocol with growth hormone) -  4 eggs retrieved, 2 fertilized with ICSI, 1 blastocyst PGS-normal 6BB mitoscore 29.82 (frozen)

FET #1 - March 2018 - cancelled due to thin lining (6.25mm)

FET #1.2 - April 2018 - cancelled due to thin lining again! (4.85mm)

FET #1.3 - June 4, 2018 (lining 7.5mm!) - th_abfn.gif

ERA Aug 2018 - Pre-receptive by 1 day

FET #2 - Sep 18, 2018 (lining 6.9mm) th_abfp.gif  Beta #1: Sep 30, 2018 - 682  Beta #2: Oct 6,2018 - 6656 U/S: Oct 15 - measuring 6w4d (CRL 6.87mm), HR 127bpm! U/S: Oct 25 - measuring 8w1d (CRL 16.69mm), HR 168bpm!  Discharged to midwives!  June 7, 2019: It's a girl!  DD born 7lb 2oz babygirl.gif






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