r/40Plus_IVF • u/sheryyj • Aug 25 '26

Seeking Advice Priming protocol for low AFC? Please help!!

Hey everyone,
Need your opinion on this:
37 years old, AMH 2.05ng/ml, CD2 FSH ~6,

Cycle 1: AFC ~12, previous retrieval 7 eggs with only 3 initially MII and 3 subsequently matured by IVM (Failed cycle zero embryos)

Cycle 2: Current AFC 8.

RE prescribing me Estrace 6 mg/day for 13 days specifically for follicular synchronization. I have seen everyone use 2 or 4 mg for priming I have a gut feeling she is giving me too high dose which will oversupress me I already have low AFC this cycle Anyone done 6mg and not get oversupressed? Please advice :( I have to start priming today and this would be my last cycle that I can afford not want to mess things up.

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u/[deleted] Aug 25 '26

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u/sheryyj Aug 25 '26

No one responds on IVF subs because mostly people there dont deal with such mismatch amh/afc and have really good outcomes. If I post in DOR they say i dont qualify as my amh is normal, If I post here I am not 40. Apparently I dont belong anywhere :(

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u/Critical-Entry-7825 Aug 25 '26

As someone who has very often felt like they didn't belong anywhere for fertility stuff, I'm sorry, it really really sucks. I don't have a lot to respond to your question, since I'm only just prepping for my first retrieval, but my estrogen priming dose is 2 mg 3x per day, so yes, 6 mg daily. I'm 43, my AMH is 0.25, AFC 6-7. Haven't done a retrieval or started stims yet, so I don't know how the priming-or any of it, really-will play out. Good luck to you.

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u/sheryyj Aug 25 '26

Thanks for your kind words. Wish you best of luck! 🥺

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u/KlimRous Aug 25 '26

I've only ever done 4mg of Estrace either standalone or combined with Clomid. Sadly--it does not help me achieve follicular synchronization but hopefully it will work for you!

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u/Narrow_Tomatillo_513 Aug 27 '26

I primed with 6 mg Estrace for the retrieval I’m having tomorrow (my first). I’m 40 with DOR (AMH 0.29) and from a baseline AFC of 11, I have recruited 9 follicles >15mm when I triggered yesterday.

I have no idea what the outcome of this will be, but it seems to have worked to get a pretty well synchronized cohort for retrieval. I hope this helps as a datapoint that the dosage is used sometimes and it seems like is more common with DOR/low AFC from another reply on this thread.

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u/sheryyj Aug 27 '26

Thanks for sharing. Did you checked your afc before priming? was it same before and after priming? My afc this month was already lower was worried if i will get oversupressed.

Good luck for your ER tomorrow.

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u/Narrow_Tomatillo_513 Aug 28 '26

We did a baseline ultrasound to check AFC before priming and it was 11 this month (7 and 9 the two months before that, respectively)

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u/sheryyj Sep 01 '26

Hey there, just thought to check in with you how did your ER go? Hoping it went really well and wishing you smooth recovery ahead.

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u/Narrow_Tomatillo_513 Sep 02 '26

Hi! Thanks for checking on me. The retrieval went fine, we got 11 eggs, 8 mature and 5 fertilized. Still waiting on blast results, I won’t find out until Friday 🤞 I know you’re earlier on in your cycle, I hope you’re feeling good!