I don’t know how I got lucky enough to have such a great network of knowledgeable people as I’m facing my own infertility diagnosis, but I am grateful. A’s SA should be back today and I have a phone consult with Dr. Travolta on Wednesday afternoon. I have many questions and am hoping you can tell me what else I should ask. Thanks!
1. My period was delayed 2 days last month by the double dose of Prometrium. But then I ovulated 2 days early. Is there any reason to think that the Prometrium caused a “false” delay and my Day 3 bloods were really Day 5? Would my FSH be high even fir Day 5? (I suspect yes, they are high, but not *as high* for Day 5.)
2. My clinic believes that high FSH and low AMH are a reflection of egg quantity, not quality. So they think I’d likely be a poor responder in IVF, but what dies it mean for chances of natural conception, since I seem to be ovulating every month and the dr saw lots of follicles in June?
3. Are there other tests we should do, such as an antral follicle count?
4. If we proceed with IVF, what are the chances of success, assuming we do single embryo transfers? Including FET?
5. If we add CGH to the mix, what is the likelihood of finding a good egg to transfer? (If there is one, the live birth rate is close to 70%.)
Okay, your turn. Add questions, speculate on answers… Thanks!
I really am useless on all of those but I am intrigued by the Day-3-test-was-really-Day-5 theory. Let us know what the Dr. says on that one! And good luck with all of it … no fun, but one step at a time…
1. Interesting, but I have no idea.
2. It usually doesn’t mean good things for natural conception, but that doesn’t seem to have stopped you in Juanuary–an ectopic has nothing to do with any of that stuff, so maybe your chances of natural conception are pretty good. On the otherhand, My numbers are really low (in the 4 to 5 range), and I can’t get pregnant at all, so I think it is really hard to predict.
3.An antral follicle count may have been what your doc did in June–there are lots of antral follicles at the beginning of the cycle, and then one becomes the dominant follicle. In an IVF cycle that process of letting one become dominant is subverted and teh other follicles are given chance to grow.
4. The chances of success are much lower with a single embryo transfer–not sure why, but they just are. Also, I’d make sure that your doctors embryology lab has good statitics of getting embryo’s to the blastocyst stage, because if they do you will likley transfer few, but better embryos. If they don’t, you will be more likely to have a day three transfer, where they have to transfer more because they have less data about which ones are truly the good ones.
5. I don’t know much about CGH, but if you can afford it, do it. I think, but may be wrong about this, that you have to get your embryos to the blastocyst stage before they can preform cgh.
1. I would think the same thing. If doc agrees you’ll probably retest.
2. No idea.
3. Ditto to what Sarah said.
4. Both my successful IVF cycles (live babies) were single embryo transfers. And after having twins with one of those, I wouldn’t suggest to anyone to attempt any more than that in one cycle, but that’s just me, after the fact. Time and money are factors which need to be considered.
5. I can only speak for PGD…day 3 embryos were fine to use. Out of upwards of 7 of those, only one would show up genetically sound. But I started at 37. Genetic screening really bumps up success rates- for someone your age the take-home baby rates are really high, almost like a sure thing. Sorry, I’ve no numbers to share- just recalling a recent IF Clinic newsletter article I received in the mail.
I think you have a great list here already.
1) No idea. Great question for a RE.
2) This makes total sense to me. And given that it seems we’re on opposite ends of the spectrum of a (potential, for you) DOR diagnosis, it seems logical that you could get pregnant again naturally. “Poor responder” in IVF can mean lots of things. In your case, maybe you’d only produce a few mature eggs … but it is better to have only a few *good quality* eggs than almost two dozen *poor quality* eggs.
3) Again, in your case an antral follicle count makes sense to me. Ask Dr. T.
4) We were quoted 63% transferring two … I would think one may lower that a bit, but not by much. Our chances of twins was ~35-40%. FET is lower than fresh, that’s all I know.
5) No clue. But I certainly like the 70% take home baby statistic!
Keep us posted!
I don’t know the answer to the vast majority of the questions but I do want to say that we both started thinking about #1 at the same time. I have been on prometrium twice after unsuccessful IUIs. Both times my period has been delayed by 3 days and both subsequent cycles I have ovulated earlier. I just figured this out this weekend when I ovulated on day 11 and we totally missed our chance. What I think happens is that our bodies start the cycle when it SHOULD happen, not when it actually does because it’s delayed by the prometrium.
So, that might have some bearing on the FSH levels- you probably really were day 5. That being said, I don’t know if that starting early is a function of diminished reresve as well. I have borderline FSH and I’m 37, so it’s entirely possible.
Anyway, just wanted to offer my thoughts…Good luck. I have posted before and it’s amazing how many similarities we have. Even FSH issues now.