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Trying to conceive. Had missed abortion and failed IVF. Mestruation have reduced. Chances of conceiving?

Mar 2013
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Practicing since : 1998
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I am     40 yrs of age and husband 35 yrs have been TTC for one and half year had a missed abortion/D&C in October 2012 at 6&1/2 weeks pregnancy after conceiving naturally and one failed ivf with own eggs in XXXXXXX 2013. After the failed ivf my duration and quantity of mensuration have been reduced (2 to 3 days from 4 to 5 days). have only spotting on 3rd day (heavy flow only for half day on the first day). Now I would like to conceive naturally again. How to improve the chance of conceiving and the endometrial lining. The description of the tests are as below
Husbands Test
Semen Count:      77 million
Semen Motility: 70% forward progressive

Wife's Tests
Thyroid ( TSH ): 1.810
Anti Mullerian Hormone:     0.2
Prolactin(PRL):      12.8
FSH: 8.39 (3rd day)
LH: 2.78(3rd day)
E2: 21(3rd day)
Posted Tue, 22 Oct 2013 in Infertility Problem
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.
I have gone through your reports.
They are all normal, except for 2 of your tests.
The first is AMH ( anti mullerian hormone ).
This is very low ( less than normal ) in your body.
Also, FSH is higher than normal.
These two tests indicate the Ovarian Reserve ( OR ).
Ovarian reserve indicates the reserve capacity in a woman to produce good quality eggs and good number of eggs.
A woman is born with limited number of eggs, and each month, eggs are used up during menstruation.
With increasing age, the number and quality of eggs declines.
After 40, this decline occurs drastically.
Frankly speaking, the chances of spontaneous natural conception for you are quite low.
This is because due to age, the ovarian reserve has declined, this is the reason that you are having scanty flow during periods.
I would not advise you to wait for long, but to undergo further attempts at IVF.
If you waste few more months or years, you might not even respond to proper supplements containing DHEA are prescribed to women with low ovarian reserve, and they cause mild improvement, but in your case, time is of the essence, because you are already 40.
The endometrial lining can be improved by vaginal or oral estrogen tablets, but they should be taken alongwith the stimulation given for IVF.
I would not recommend waiting for a natural pregnancy in your case.
All the best.
Please feel free to ask for further clarifications.
Above answer was peer-reviewed by
Follow-up: Trying to conceive. Had missed abortion and failed IVF. Mestruation have reduced. Chances of conceiving? 23 hours later
I had visited to the OBGYN who had advised me to go for one more IVF with own eggs with an advance procedure which has a 50% success rate . The reason she had cited for poor lining was due to D&C. Wanted to know how far the reason is correct. Can it be due to the earlier ivf when the ovaries were highly stimulated? Also want to know what is advanced ivf ? Keeping in view my age what is the expected success rate? She has prescribed me Tab Lynoral 0.01 mg for 3 weeks, Tab Maprate 10 mg for 1 week, Tab All-9 and Tab DHEA Sure.
Answered by Dr. Aarti Abraham 30 minutes later
Brief Answer:

Detailed Answer:
Hello again.
Yes, as I advised you, you should definitely go for further cycles of IVF.
At present, no method can guarantee you a 50 % success rates.
In the best of hands, the success rate of IVF is 30 - 35 % , and with your age, if you use your eggs, the percentage would be lower than that, however with donor eggs, it would be higher.
There is no such scientific term as advanced IVF, your doctor might be planning to use higher stimulation techniques and more detailed protocols for maximum egg yield.
Poor uterine lining can be due to 2 reasons - one is excessive scraping off of the layer during D and C, and also due to advanced age, where the blood supply of the endometrium decreases, leading to poor growth of the lining.
All the best.
Above answer was peer-reviewed by
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