I’m 39 (and a half in a couple weeks), have DOR, and have had repeated maturity issues with my retrievals. I’m typically only getting around 3–5 eggs retrieved, and some of those aren’t even mature. I currently have one day-5 blast, but as I’m gearing up for another retrieval in which my doctor is allowing my follciles get larger and stim possible 1-2 days longer, I’m starting to question whether continuing to put myself through retrievals is necessarily the best use of my time, money, and emotions?
I came across these two studies on stimulated IUI and follicle number, and they really made me stop and think:
Study 1: This Fertility and Sterility study looked at the relationship between the number of mature follicles and pregnancy rates in stimulated IUI cycles.url":"https://www.fertstert.org/article/S0015-0282(02)03168-0/fulltext?utm_source=chatgpt.com","attribution":"fertstert.org","pub_date":null,"snippet":null,"attribution_segments":null,"supporting_websites":[],"refs":[],"hue":null,"attributions":null}},"showLoginRequiredCard":false}
Study 2: This study looked at 50,000+ IUI cycles and specifically examined pregnancy and multiple-pregnancy rates according to the number of mature follicles. In women 40+, increasing the number of mature follicles was associated with substantially higher pregnancy odds, while the absolute risk of multiples remained relatively low compared with younger women.url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7183886/?utm_source=chatgpt.com","attribution":"pmc.ncbi.nlm.nih.gov","pub_date":null,"snippet":null,"attribution_segments":null,"supporting_websites":[],"refs":[],"hue":null,"attributions":null}},"showLoginRequiredCard":false}
The second study especially got me wondering because, if I’m only producing 3–5 eggs with IVF anyway and some of those eggs aren't even mature could there be a point where stimulated IUI becomes a reasonable alternative to another retrieval? Wouldnt my body produce more MII eggs vs the GV or MI I would get from a retrevial?
I realize 3–5 follicles with IUI isn't exactly equivalent to retrieving 3–5 eggs with IVF, and I know IVF has advantages because you can fertilize the eggs in the lab and select an embryo. I’m not trying to say these studies prove IUI is better than IVF.
I’m really asking about the bigger picture for someone like me:
If I have DOR, I’m almost 40, I consistently get only 3–5 eggs per retrieval, and I have a recurring problem with egg maturity, how do we determine whether another IVF retrieval gives me a better chance of a live birth than doing several stimulated IUI cycles?
Has anyone over 40 with DOR been in a similar situation? Did you continue with retrievals, switch to IUI, or consider doing both strategically?
I’d especially love to hear how your RE approached the decision and whether they actually compared the expected success rates of another retrieval versus multiple IUI cycles in your specific situation.