27 replies to this topic

[Ania]

Hello,

 

I hope that everyone is safe and healthy during these strange times.

 

I am 37; and I am single with a LOW AMH.  I am looking to freeze my eggs, and the doc expects me to retrieve under five eggs.  Do you think it is still worth pursuing this?

 

I am not in a situation where I can freeze numerous times.  

 

Do you think I could retrieve more eggs based on your experiences with a LOW AMH?

 

Any advice for me?

 

Thanks!

 

 

[Cotton]

It depends on alot of factors. (Isn't that so helpful???!!!)

 

If your cycle is a bust, can you totally not afford an egg donation cycle? Are you willing to consider other paths to parenthood?

How is your health in general? Is there any chance you're looking at a surrogate pregnancy too?

How badly do you want your child to be genetically related?

Are you willing to try a few IUIs first?

 

Factoids you may not already know:

Low AMH means more meds which means more $$$ (unless you do a natural or low stim cycle, something to look into)

Embryos freeze better than eggs, but that means committing to the male component now. I have heard of people defrosting a whole batch of eggs from their mid 30s and none of them making it.

 

I have to warn you all IVF cycles seem to be put on hold so the wait lists will only be stretching out during this time.

 

I had a low AMH but good AFC and overall had a good outcome, but I had a naturally conceived baby from before IVF with the same partner, so alot of other fertility issues were ruled out. In my case the eggs retrieved was closer to the AFC than what the AMH would have predicted, but they did give me a stiffer dose of meds.

 

If you're in Ontario it might be worth doing at least a single cycle for the peace of mind. You're still going to be out probably $10k even with a funded cycle, mostly due to med costs.

 

[SynchroGirl]

Hi Ania, I did an egg freezing at 37 with a low AMH. I only managed to get 4 eggs and my doctor at the time said that was probably the best I could do so I proceeded. When I finally went to use that batch, it resulted in one embryo that made it to blast but it tested PGS abnormal. I then had to start the process again at 39. I did a lot of research and requested a prescription for DHEA which I took for 5 months while I was doing IVF. Also took ubiquinol and a bunch of other recommendations from the book It starts with the egg. My best cycle I got 18 eggs and 4 embryos, 2 PGS normal. Looking back, that $9k I spent for 4 eggs was just not worth it. Especially if your cycle is delayed with COVID I recommend looking into options to increase your egg count before you spend the money. I also agree with Cotton that embryos freeze best but i was in the same boat as you and wanted to keep my options open best of luck to you!

[happyfrog]

Hi, you might consider doing acupuncture or mesotherapy treatment to ovaries (PRP) that might improve your ovarian reserve x

[Ania]

Thank you to everyone who replied to my topic.  I will be proceeding with egg freezing hopefully in July or August.  I do want a biological child; and since I am single, I don't have the opportunity to freeze embryos.  I am in B.C., so there is no government funding here.  My doctor is not that optimistic since my AMH is so low, but he said they would be using a high dose of drugs.  I believe that I will be using lupron and Gonal 450.  The cost will be closer to 13k a cycle.   I am now considering more than one round (which is stressful). I did ask my doc about DHEA, but he said that studies do not confirm it's effectiveness. The doc believes that I will retrieve under five eggs.  I guess, at this point, I don't want to regret that I didn't try.

[happyfrog]

Good luck x

[CharlieIVF]

I would have you look into mini stim cycle.  I have done two full stim cycles with no success and recently found a doctor that specializes in women with low AMH (which I too have) that do mini stim cycles.  They use a fraction of medications, so you are not wasting money on the fertility medications that don't help women produce more eggs with low AMH; and putting all that medication into our bodies.  It is far less cheaper as well.  So far, I am having better results than any full stim cycles.  Good luck to all! 

[Ania]

Thanks CharlieIVF 😊. May I ask what clinic you are at? My current RE feels that high dose meds are best way to go...my first cycle will be this summer:-).

[CharlieIVF]

Hi Ania,

 

I am actually in the United States.  I am not the doctor and I would go with what your doctor says is best for you and your story. Your doctor is the one with all the experience and has all your test results. 

 

I can only tell you my experiences from my story. I started fertility treatments at age 36.  I have done 3 IUI, 2 full stim cycles with different doctors, and when I found my current doctor after much research he has given me better results than ANY other cycle attempt (which I am currently in).  He is a believer that women with DOR (which I have) respond nearly the same with mini stim vs full stim, and in my case, truth.  He puts his clients on Estrace before all the fertility drugs/shots for many medical reasons I will let you look up.  A mini stim is a much cheaper procedure and medications, by a lot! I can tell you that my doctor works at a hospital.  I have learned that when I went to private clinics, which were all my other attempts, you forget its a for-profit clinic and they get paid by each big cycle.  My current doctor does not get paid by cycle or the success, he works on salary.  If you are interested in looking up his published journal articles his name Orhan Bukulmez, MD.  I hope this helps and only wish you the best success in your journey! 

[N1111]

How many eggs did you get in a mini stim cycle? Im curious too. I havent had the best response with the full cycles.

[CharlieIVF]

I have one ovary that is not working, so I only have one to work with.  Nonetheless, I got 5 or 6 follicles, 4 mature eggs, three made it to blastocyst. 

[Ania]

Thank you, CharlieIVF. I will look up that published journal:-). Wishing you great success and happiness!

[Cotton]

Ania if you're going to do more than one cycle do them back to back. The second cycle gets a "bump" from the meds from the prior cycle. I have also heard mini stim cycles are good for DOR and maybe you could afford 4 of them for the same price as 2 full cycles. I would try to find an RE who specializes in mini stim cycles in DOR women if you can.

[Ania]

Thanks, Cotton! Its a difficult journey with so many unknowns so I appreciate your input:-).

[Paris2020]

Hi All, 

Could anyone help me finding an IVF specialist in Toronto please, I am a new immigrant and I dont know anyone for referals, at the age of 38 and AMH of 1.7, i had one IUI session and I started IVF medication (Gonal F, Lupron and Menopor) but my doctor cancelled my plan since there was no eggs in my ovarian after 5 days of taking the medications. 

Thank you everyone

[returnable]

Hi All, 

Could anyone help me finding an IVF specialist in Toronto please, I am a new immigrant and I dont know anyone for referals, at the age of 38 and AMH of 1.7, i had one IUI session and I started IVF medication (Gonal F, Lupron and Menopor) but my doctor cancelled my plan since there was no eggs in my ovarian after 5 days of taking the medications. 

Thank you everyone

 

Welcome! I assume that you have been here at least 3 months to have the provincial health coverage? With any fertility clinic, you can self refer. Some of the bigger ones in Toronto (not in ranked order as that is not a given): Create, Hannam, Markham and Trio.

 

Any idea what the units of your AMH are? What were your FSH and AFC? What were your doses in your first IVF?

[Paris2020]

 

Hi All, 

Could anyone help me finding an IVF specialist in Toronto please, I am a new immigrant and I dont know anyone for referals, at the age of 38 and AMH of 1.7, i had one IUI session and I started IVF medication (Gonal F, Lupron and Menopor) but my doctor cancelled my plan since there was no eggs in my ovarian after 5 days of taking the medications. 

Thank you everyone

 

Welcome! I assume that you have been here at least 3 months to have the provincial health coverage? With any fertility clinic, you can self refer. Some of the bigger ones in Toronto (not in ranked order as that is not a given): Create, Hannam, Markham and Trio.

 

Any idea what the units of your AMH are? What were your FSH and AFC? What were your doses in your first IVF?

 

Yes, I have actually been living here for 3 years now, sorry for misleading, by new i mean i dont know much people and i dont have many connections as one might have in a city

[Paris2020]

Thank you Returnable, My test results are from December 2019, AMH 1.7 pmol/L, FSH of 14.4 and I dont see the AFC in the results.

[returnable]

Thank you Returnable, My test results are from December 2019, AMH 1.7 pmol/L, FSH of 14.4 and I dont see the AFC in the results.

 

AFC is a standard so I am sure they measured it. Which clinic were you at? Your FSH was pretty high and some REs would have cancelled your cycle (if that is when your FSH is from) as you would respond poorly. Your AMH is pretty low. A long while back I wrote this summary on AMH that you may find helpful: https://ivf.ca/forum...it-explanation/

 

I am by no means a doctor, but based on my experience and those of others if you do respond to stims, you'll be a poor responder. I know that doesn't help you much. If money is not a limit for you, I'd suggest going to Hannam as they can really do a catered approach from the get go to your cycles, though others may have other opinions. I suggest you get all your paperwork from your previous clinic to share with your new clinic. Either way, your RE should have been upfront with you as to your chances of success.

[Paris2020]

Thank you Returnable, I was with Nahal clinic but have heard they are not as professional as my case needs, My current doctor suggested to restart the cycle with a different plan, to cut the LD and lupron, as I only get one funded ivf cycle i want to have my chance with a more specialized team, Could you explain more about the stims please, havent heard from it.

[returnable]

If you haven't used up your funded IVF cycle, then go with another clinic. You really should be at one of the bigger clinics. Just a warning though, that the wait times for a funded cycle are long, and even longer now that everyone was delayed during the Covid-19 shutdowns.

 

The stims are your Gonal-F and Menopur. What doses were you on? I don't mean to say this to discourage you, but for you age, your AMH is very low and you may be running out of time to have a child with your own eggs. You would be extremely lucky if you had a good response on your funded IVF, so you may need to do more out of pocket. Most of the clinics will take you on quickly for a cycle if you are paying out of pocket. I know it is so early to have someone say this, but in the end you may need donor eggs to have a child.

[Paris2020]

Yes, That is exactly what my doctor suggested, since my stim dosage was pretty high, i was taking Gonal F 450 per night and Menopor 150, I am hesitated between Hanam, CreAte and Trio as I have read a lot about them and they seem all professionals.

[Ania]

Paris2020 - I would suggest that you see Dr. Nayot at Trio.

[returnable]

If you are.deciding between those three (though I wouldn't discount Markham), Hannam or Trio.

[Misskika007]

Hey Paris- my AMH is similar to yours and I just finished my third IVF. I was at a smaller clinic before and just switched to Hannam for my last retrieval. I got one high quality embryo from the cycle and waiting to hear if it is genetically normal (we did optional PGt-a testing). I have had such a positive experience with the clinic and my doc, Dr. Garbedian. She specializes in low ovarian reserve and poor responders, and has provided such personalized care. Its more expensive, but I dont think any other doctor/clinic could have achieved these results. I just wrote a post on the Microdose Lupron Flare post that is in this forum that details what my protocol was like and how the doc focused on quality vs quantity of eggs. Wishing you success on your journey and keep the faith