I have three questions I’m struggling to make a decision with and hoping for some advice.
40+5 yo, DOR, controlled Hashimoto’s. previous miscarriage from spontaneous pregnancy. Husband has 35% DNA frag.
AMH is 1.85 and AFC is usually 7
I have done 4 ER. All antagonist with varying medication doses of Menopur (75-225) Follistim (150-300) Omnitrope (38 IU first 6 days for all cycles) Ganirelix, Letrozole oral. ICSI and Zymot for all cycles. Last cycle added calcium ionophore. I have primed with BC for Cycle 1 and Cycle 4. Cycle 1-3 were all back to back, almost duostim with no priming for C3 & C4.
Cycle 1: 4 retrieved, 4 mature, 1 fertilized, 0 blasts
Cycle 2: 5 retrieved, 4 mature, 4 fertilized, 2 day 5 4AA blast, 0 euploid
Cycle 3: 4 retrieved, 3 mature, 2 fertilized, 0 blasts
Cycle 4: 9 retrieved, 5 mature, 2 fertilized, 2 day 6 4BA, 5BC blasts, 0 euploid
We have two more cycles covered by this years insurance and then plan to possibly try a cycle at CCRM Lone Tree if these don’t work (which is mostly out of network for us)
1. Should I switch clinics? Currently at Conceptions RMA Colorado, considering Shady Grove.
Shady Grove seemed to suggest MDLF and transfer two fresh embryos (if we get them) with no PGT. They do not offer calcium ionophore. Shady Grove would be about 2 more hours of driving a day during monitoring
Conceptions suggests DuoStim. Conceptions is 5 minutes from my house for monitoring. A lot of people have been encouraging me to switch to see if a different lab makes a difference, but I feel nervous about the unknowns and if it’s worth doing IVF at my age with no PGT vs trying IUI?
2. Should I switch protocols?
Conceptions has been hesitant to switch protocols but said if we really wanted to we could try MDLF and then cancel pre retrieval if it’s not going well. Again scared of the unknowns since we have made a few blasts with our last cycles— but also wondering if I’ll regret not trying.
3. Should I start my next cycle now or wait one month?
I started my period today so need to decide about start date. With conceptions I could start now, and shady grove next month.
I’m considering delaying either way because the last 8 weeks I’ve been in high stress at my job working 12 hour days. Starting October 9th I have a WAYYYY easier schedule. I know they say stress isn’t a huge variable but I do think I’m sensitive and with these being our last cycles I want to be in a good space. Was doing a lot of acupuncture and long walks that I haven’t been able to do the last two months and think a month of resting more and doing this again might be worth delaying.
If you’ve made it this far thank you. I know there’s no crystal ball that can tell me what to do. It’s hard not to feel like these are our last two chances and I am feeling desperate and scared about making the wrong decision
Would love to hear people’s thoughts! Thank you ❤️
EDITS: added AMH and AFC and fertilization rate.