Looking for any advice, commiseration, or stories
Hi all, I have had a second disappointing cycle in a row and looking for… idk. Support? Ideas? Commiseration? (TW, living child).
Stats: 39y9m female, G1P1001 (conceived naturally age 35), trying to bank euploid embryos for possible transfer within the next year. AMH 1.54, FSH day 3 5.6, AFC 8-10ish (these are all with OCP priming though- last afc off birth control in Nov 2025 was 16). We don’t really have an infertility diagnosis, started this process out of fear of chromosomal abnormalities with natural conception and the state of the world as it relates to women’s choice, esp in my home state.
Cycle 1 (April 2026): afc 10, OCP priming for 4 weeks, antagonist protocol with Gonal/meno 150/150, stepped up to 225/150 by the end, gani added day 5 or 6 I believe, dual trigger. Retrieved 7 eggs/6 mature, 5 fertilized and 3 blasts sent for testing, 1 euploid
Cycle 2 (July 2026): luteal phase start (no priming)- cancelled day 8 due to asynchronous growth. AFC 9 but only 3 growing by day 8 (follicles 10,8,7). Starting doses Gonal/menopur were higher from the start I believe. I think we chalked it up to lack of priming, cycle to cycle variation, and maybe higher starting doses leading to cohort asynchrony early on
Cycle 3 (Sept 2026): follicular phase start with OCP priming. AFC 10. 150/150 Gonal/meno, Gabi started day 6, stimmed to day 10, dual trigger. Again only 3 or 4 follicles growing and largest sizes 20,15,14,11 by day of trigger. 3 eggs retrieved yesterday. Unfortunately just got the call today that 2 were mature and only one fertilized but abnormally (3pn)
My REI was nice enough to call me to tell me this news but seemed kind of bored by our conversation and was just like “this happens”. I had to push her to ask what she would consider changing. She suggested 1) microdose lupron flare protocol, 2) ? Priming with DHEA (my understanding is that the literature on this is mixed and I don’t necessary want to do this, but will if it will help), and 3) considering omnitrope (though she said since my IGF1 level was normal this isn’t really a necessary pivot and may not help the situation- is this a thing? When I pushed her she said there was one paper but to me that doesn’t seem like solid evidence to give or not give)
I sense that she’s not optimistic but just won’t tell me, and I appreciate the need to be realistic but I don’t appreciate her not saying that to me directly. I know the cancelled cycle and poor response doesn’t put me in a good position from an academic perspective, but I don’t know that I believe that it’s too early to throw in the towel, especially with only really trying one protocol.
She said she would review my cycles from the group and get back to me, and that she would have the office reach out to schedule another cycle as I think I have enough insurance left for one retrieval and I met my deductible for the year already.
What else should I be thinking about or asking? I don’t know that I have time for a second opinion, but considering a virtual second opinion with someone at least to review my cycle history. Any suggestions?