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Is Successful Pregnancy Possible While Having Low Ovarian Reserve?
Question: Hi, I recently got first IVF done after two failed IUIs.
I want to know if there is any issue in the protocol followed by the doctor so that I can take crucial decision of whether to undergo second IVF in the same center or not.
At the start of the cycle my AFC was Rt ovary-2-3(9,2), Lt ovary 3-4(5,5,2,2).. I was given Ovastore/My DHEA 25mg thrice a day, calciferol XXXXXXX for 3 weeks, lycored and folvite.
Doctor carried out multiple tests.
Day2 FSH-4.35,LH-1.71,E2-32,Progesterone-0.43. She said all other reports are normal.However I saw these issues: Transferrin Saturation-11.6%, RDW-14.1,Ferritin-10.4ng/mL. She also got my husband's semen C/S done which had few issues and she recommended Augmentum 625mg to him. In the start of the cycle, she gave the same medicine to me also twice for 5 days as she suspected there was some infection in my Lt ovary as I had some pain during ultrasound. From day 2 she started Menogon 300 iu for 4 days, then Menogon 375 iu for another 3 days, along with this ovrelix 0.25 for 3 days. After finishing this she started Menogon 450 iu for 2 days, ovrelix for 2 days. After this she called me for egg retrieval. 7 eggs were retrieved, they took two semen samples as they found first one was not of good quality. On second day of egg retrieval I called up the doctor and was informed that only 3 out of 7 got fertilised and that my ET is scheduled for next day. The next day I was informed to my despair that those two embryos also got degenerated. Please advise if there is any issue in the protocol. My tests reports are as follows:
AMH-1.1.ng/mL
Tubes:Patent
Biopsy:OK
thyroid-no issue
I have taken 6 cycle clomid and two failed IUI on Gondotropin. Please let me know if you need any more details.
I want to know if there is any issue in the protocol followed by the doctor so that I can take crucial decision of whether to undergo second IVF in the same center or not.
At the start of the cycle my AFC was Rt ovary-2-3(9,2), Lt ovary 3-4(5,5,2,2).. I was given Ovastore/My DHEA 25mg thrice a day, calciferol XXXXXXX for 3 weeks, lycored and folvite.
Doctor carried out multiple tests.
Day2 FSH-4.35,LH-1.71,E2-32,Progesterone-0.43. She said all other reports are normal.However I saw these issues: Transferrin Saturation-11.6%, RDW-14.1,Ferritin-10.4ng/mL. She also got my husband's semen C/S done which had few issues and she recommended Augmentum 625mg to him. In the start of the cycle, she gave the same medicine to me also twice for 5 days as she suspected there was some infection in my Lt ovary as I had some pain during ultrasound. From day 2 she started Menogon 300 iu for 4 days, then Menogon 375 iu for another 3 days, along with this ovrelix 0.25 for 3 days. After finishing this she started Menogon 450 iu for 2 days, ovrelix for 2 days. After this she called me for egg retrieval. 7 eggs were retrieved, they took two semen samples as they found first one was not of good quality. On second day of egg retrieval I called up the doctor and was informed that only 3 out of 7 got fertilised and that my ET is scheduled for next day. The next day I was informed to my despair that those two embryos also got degenerated. Please advise if there is any issue in the protocol. My tests reports are as follows:
AMH-1.1.ng/mL
Tubes:Patent
Biopsy:OK
thyroid-no issue
I have taken 6 cycle clomid and two failed IUI on Gondotropin. Please let me know if you need any more details.
Brief Answer:
Low ovarian reserve is the concern
Detailed Answer:
Hello,
Thanks for your query.
I have read you query and I understand your concerns.
Following is my reply:
1) Protocol followed by your doctor is good.
2) You seem to have low ovarian reserve as number of eggs are less as per AFC and also AMH value is lower.
3) In women with low ovarian reserve , it is common to have low quality eggs. Hence probably your eggs didnt fertilize and didnt survive further.
4) Hence you can think about donor egg IVF as an alternate option. If not willing ,you can try another cycle of IVF with a different protocol ( chances of success are lower though)
5) you need to consider the fact seriously that your ovarian reserve is low and hence these problems have occurred with IVF.
I hope I answered you query and addressed your concerns.
Let me know if you wish to ask any further questions. I will be glad to help you.
Regards,
Dr. Mahesh Koregol.
IVF & Infeertility Specialist
Low ovarian reserve is the concern
Detailed Answer:
Hello,
Thanks for your query.
I have read you query and I understand your concerns.
Following is my reply:
1) Protocol followed by your doctor is good.
2) You seem to have low ovarian reserve as number of eggs are less as per AFC and also AMH value is lower.
3) In women with low ovarian reserve , it is common to have low quality eggs. Hence probably your eggs didnt fertilize and didnt survive further.
4) Hence you can think about donor egg IVF as an alternate option. If not willing ,you can try another cycle of IVF with a different protocol ( chances of success are lower though)
5) you need to consider the fact seriously that your ovarian reserve is low and hence these problems have occurred with IVF.
I hope I answered you query and addressed your concerns.
Let me know if you wish to ask any further questions. I will be glad to help you.
Regards,
Dr. Mahesh Koregol.
IVF & Infeertility Specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have heard people with AMH <1 conceiving through proper IVF protocol which is not generic. Why then do you say that I should go for DE straight away.
Also, I am not even 35 which means my egg quality should not be that bad eventhough the count is low.
Why are you suggesting me to go for DE, please advise.
Also, I am not even 35 which means my egg quality should not be that bad eventhough the count is low.
Why are you suggesting me to go for DE, please advise.
Brief Answer:
Low pregnancy chances with your eggs
Detailed Answer:
Hi,
Age is not a single criteria. Ovarian reserve can reduce even in women below 30 years.
Percentage of women who have AMH less than 1 and conceive are relatively low. There are high failure rates in such group.
Considering your low AMH, AFC and previous IVF reports, I feel DE will help you more than self.
Let me know if you need any more clarification.
Low pregnancy chances with your eggs
Detailed Answer:
Hi,
Age is not a single criteria. Ovarian reserve can reduce even in women below 30 years.
Percentage of women who have AMH less than 1 and conceive are relatively low. There are high failure rates in such group.
Considering your low AMH, AFC and previous IVF reports, I feel DE will help you more than self.
Let me know if you need any more clarification.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks!
Could you advise what are or possible can be complications of conceiving through DE. What are the chances because it still has to implant on a foreign uterus.
Will pregnancy from DE be normal or will have complications, can an individual continue to work after conceiving through DE or will there be complications liks high BP during pregnancy or other things which are shown on the net.
Thanks again!
Could you advise what are or possible can be complications of conceiving through DE. What are the chances because it still has to implant on a foreign uterus.
Will pregnancy from DE be normal or will have complications, can an individual continue to work after conceiving through DE or will there be complications liks high BP during pregnancy or other things which are shown on the net.
Thanks again!
Brief Answer:
No extra complications for DE
Detailed Answer:
Hi,
Chances of pregnancy thrugh DE are very good. There are no complications though it is growing in foreign uterus. Just see to it that you have same blood group donor.
Pregnancy from DE will be like any other normal pregnancy. No extra complications are anticipated. You can work even after conceiving through DE. Chances of hypertension or other things during pregnancy are same be it De or your own eggs.
Let me know if you need any more advice or details on DE or stimulation protocols.
I request you to contact me directly next time by pasting following link in your browser:
http://bit.ly/askdrmaheshkoregol
No extra complications for DE
Detailed Answer:
Hi,
Chances of pregnancy thrugh DE are very good. There are no complications though it is growing in foreign uterus. Just see to it that you have same blood group donor.
Pregnancy from DE will be like any other normal pregnancy. No extra complications are anticipated. You can work even after conceiving through DE. Chances of hypertension or other things during pregnancy are same be it De or your own eggs.
Let me know if you need any more advice or details on DE or stimulation protocols.
I request you to contact me directly next time by pasting following link in your browser:
http://bit.ly/askdrmaheshkoregol
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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