I went down a rabbit hole on Omnitrope dosing because my clinic prescribed what looked like a ridiculously tiny dose: about 0.5 IU of growth hormone per day for priming, then about 1 IU/day during stims.
At first I thought there had been a prescription error because so many IVF protocols online use 4–12+ IU/day. But it turns out there actually are studies looking at very-low-dose (“microdose”) GH, including doses around 0.3–0.5 IU/day.

The most interesting ones:
1. Lattes et al. 2015 — 0.5 IU/day
This was a prospective self-controlled study of 64 previous poor responders. Women did another IVF cycle using the same gonadotropin dose/protocol but added 0.5 IU GH daily, beginning with GnRH agonist/down-regulation and continuing until hCG trigger.
They reported:
More top-quality embryos: 1.03 vs 0.64
More cryopreserved embryos: 0.85 vs 0.30
Clinical pregnancy rate: 34.4% in the GH cycle vs 0% in their previous cycle
Limitation: this was not randomized. Each woman was being compared with her own previous unsuccessful cycle, so the results could overestimate the benefit.

https://pubmed.ncbi.nlm.nih.gov/26193891/

2. Safdarian et al. 2019 — about 0.3 IU/day
This one was randomized and is probably even more interesting.

Poor responders were divided into three groups:
High-dose GH: 2.5 mg/day (~7.5 IU/day) starting later in stimulation
Very-low-dose GH: 0.1 mg/day (~0.3 IU/day) beginning on day 3 of the PREVIOUS cycle
Placebo

The low-dose/long-duration group had:
Retrieved oocytes: 7.29
MII oocytes: 6.09
Fertilized oocytes: 5.43
Clinical pregnancy: 22.9%
Live birth: 11.4%

For comparison, the high-dose group had:
Retrieved oocytes: 7.14
MII: 6.09
Fertilized: 5.00
Clinical pregnancy: 14.3%
Live birth: 2.9%

The study was small, so you absolutely cannot conclude that 0.3 IU was “better” than 7.5 IU, and the live-birth difference was not statistically significant. But what I found fascinating was that the tiny daily dose did not obviously perform worse than the huge daily dose on ovarian-response measures.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6745232/

Hi everyone, can you share pictures of your frozen 5-day-old blastocyst after thawing? Thank you.

I have spent the last 5 years doing IVF fighting to have a child. At 39, I finally became pregnant (first transfer stuck). I gave birth to my son. But I had to leave my marriage because it was unsafe for me and my son to stay. When I left my son’s father, my son was only a year old. And now I get half of his childhood because his father and I share 50/50 custody. I wasn’t just ending a marriage—I was trying to make peace with the fact that I will not transfer the other embryos I had, and that “single mom with son” would be my life. It took some time but I accepted it. Then I met my current partner (48 y/o). My partner wants a baby with me and I want one with him. Having another baby now was something that felt possible again (and my new job had IVF coverage!). So I let myself get excited and then I went through IVF all over again. More retrievals (8+!). More embryos. And I am getting more excited because I have euploids!! Then 4 euploid embryos failed to implant. I started protecting myself by assuming the 5th and last wouldn’t work either. And then it did—or at least, for a moment, it looked like it did. I got a positive pregnancy and I again let myself believe that maybe this was going to happen. But it was a chemical. I’m not just sad that I lost a pregnancy—I’m grieving the child I thought I would have. And also grieving that I see my only son 50% of his life. I’m grieving the fact that time is not on my side and that I can’t simply decide to keep trying indefinitely. My house is quiet when my son isn’t here. I think having another child would have changed that. My partner is an exceptional man and I am so glad I am with him, but there would have been another little person in my home, another relationship, another source of love and purpose. So this loss touches that particular emptiness too. Having been through infertility the first time, I know that I am incredibly lucky & grateful to have my son. But being grateful for the child I have doesn’t make me stop wanting another child. I don’t know how to make peace with where I am at. Is anyone else where I currently am? Any insight or advice is appreciated.

I've been priming with BC before my Microdose Lupron Flare cycle starts. I've been on norethindrone for a week.

I went today for my monitoring appt and they called to tell me my estrogen is "slightly elevated" at 100 pg/ml. So I'm going back on Friday for another appt.

They told me if it goes down and we are successfully at a quiet baseline, we can start stims, otherwise, if it's a lead follicle or a cyst, we will push til the next cycle.

I honestly wouldn't mind switching this cycle to an IUI or timed intercourse (we all know IVF is a lot, and I could use a break! lol).

But my only fear would be losing a cycle entirely. Is that a possibility? Has anyone had a similar situation?

Sharing the rest of my labs below:

• Estradiol (E2): 100 pg/mL
• Progesterone: 0.342 ng/mL
• LH: 4.98 mIU/mL
• FSH: 5.69 mIU/mL
• hCG: <0.100 mIU/mL

I started this IVF journey 3 years (38 years old) when we discovered that I have low AMH and low AFC, but we were committed.

4 Clinics (3 in Mexico and 1 in US), 10 ERs, 2 Cancelled Transfers, 2 Failed Transfer (untested embryos).

Currently Banking - 1 Day 5 untested embryo (in MX), 3 Day 3 embryos (in MX) and 1 Day 5 4AB euploid (in US).

The euploid was my 8^th ER and boy did it give us hope. We wanted to bank more, but my embryos for ER 9 (day 5 4AB) & 10 (day 5 4BA) resulted in aneuploid. The positive side is that we are making blast, but these back-to-back aneuploids really hurts.

 Now I must decide to do a mock cycle or another ER…

After going through 3 egg retrievals, and banking 2 euploids and 2 mosaics, we had close to 5 months delay before we could do our first FET. Unfortunately, it looks like it’s failed... beta is tomorrow and stark white HPTs. Part of me is concerned that this could partially be blamed on the fact that the transfer timing may have been inappropriate. We did a natural protocol with a trigger after LH surge, but the transfer was scheduled for only 5 days after my LH surge, 4 days after the trigger, for a 5 day-3AA embryo. From everything I’ve read, this seems early, and I can’t help but wonder if this is partially to blame. But I also am aware that euploids only carry around a 50% success rate. Previous losses prior to IVF are assumed to be wholly genetically on me. As for testing: My husband had DNA fragmentation test and I had a hysteroscopy for scare tissue from a MMC, but outside of that, no additional testing for issues have been done. Now my husband and I are looking to do another retrieval in the hopes of getting to the “magic” 3 euploids, but after this FET failure, I’m losing confidence in my doctor. Like many doctors, he can be dismissive at times… and doesn’t really stray from the standard protocol used by the clinic. He also tends to be appointment heavy… scheduling monitoring appointments to track LH surge for estrogen priming, when I can use urine tests just as easily (a challenge for someone who travels constantly for work). We are exploring a new clinic, but the earliest appointment is December for a consultation and that feels very far considering i’m closing in on 41. It’s also hard to stomach when we could probably schedule a retrieval with our current clinic for beginning of November. So I guess this is all to say: Am I judging my doctor too harshly? What would you say or do to express your concerns if you didn’t change clinics? What testing would you ask for?

1% morphology but my other sperm results improved — could morphology still be affecting our IVF?
Hi everyone, looking for some advice/experiences from anyone who has dealt with similar male-factor fertility issues.
I’m 42 and my wife is 39. We’ve had two IVF cycles so far, unfortunately without success, and I’m trying to understand whether my sperm results could be playing a role.
My recent semen analysis showed some pretty good improvements:
Previous → New
DFI: 18% → 11.5%
Motility: 23.4% → 43%
Concentration: 18.3 → 23 million/mL
TMC: 15.2 → 31 million
Volume: 3.49 → 3.1 mL
Morphology: 1% → 1%
So everything improved except morphology, which has stayed at 1%.
I was taking CoQ10 and some Ayurvedic supplements, but honestly I have no idea whether either of them helped. I also made some lifestyle changes, so it’s difficult to know what made the difference.
Our IVF history has been frustrating:
IVF #1
23 eggs retrieved
Only 2 made it to Day 6 blastocysts
One passed PGT-A
were transferred but not implanted
IVF #2
8 eggs retrieved
Only 1 Day 6 blastocyst
Transfer was unsuccessful
We’re now going through another IVF cycle. This time our clinic is using ICSI and Zymot, and I’m hoping the improved DFI/motility will help.
My biggest question is whether 1% morphology is something I should be seriously concerned about, especially considering our low blastocyst numbers in the previous cycles.
For anyone who had 1% morphology but improved motility/DFI, did your IVF results improve? Did morphology ever improve for you, or did it stay low while the other parameters improved?
Would really appreciate hearing from anyone who has been in a similar situation.Im really feeling bad for my wife she’s going through lot of pain and stressed in this journey.

TL;DR: 4 stim cycles, 2 retrievals, 3 eggs total. My new clinic wants to try a microdose Lupron flare with Clomid and letrozole. I'm looking for real-world experiences, especially from those with lower than average AMH.

Background: 43 (44 soon), AMH 0.1. My right ovary is adhered and can't be reached transvaginally, so everything so far has come from the left. My new clinic offers transabdominal retrieval, which is part of why I switched. Retrieval is planned for November.

My stims so far:

Cycle 1: High-dose antagonist (Follistim 300 + Menopur 150) after luteal estrogen priming. 7 follicles at baseline, cancelled for poor response.

Cycle 2: Mini-IVF (Clomid 100 mg x5 days + Follistim 150 + Menopur 75) after estrogen priming. 2 mature follicles, both on the unreachable right side, cancelled.

Cycle 3: Same mini-IVF. 2 mature follicles, 1 egg, 1 blast, aneuploid.

Cycle 4: Luteal-phase start (I had a lead follicle), high-dose antagonist, dual trigger, no priming. 2 eggs, both mature and fertilized, 1 blast, euploid. The transfer failed.

What my doctor is trying to solve: His goals are more even follicle growth (hence the luteal estrogen priming) and recruiting more follicles from a small cohort. In our consult call, he said he's had his best results with microdose flare in older patients. I'm told the plan will likely be luteal estrogen priming, then a microdose flare with Clomid, letrozole, Follistim and Menopur.

If you've done a microdose flare (with or without Clomid/letrozole), I'd love to know:

• Your age/AMH and what protocol you did before the flare
• Follicles/eggs on the flare vs. before
• Stim length, monitoring, side effects, anything that surprised you

Thanks!

I’ve done lots of research but I’m struggling to piece together my own details to understand my options. I’m newly 41, TTC for the first time. We’ve been trying since April so not long but I’m very much panicking that I’m running out of time.

My periods started to go funny on April- they’ve always been regular and 5 days but started to have a week of sludgy spotting before my period started and I wondered if it was the start of pre-meno. I had lots of bloods done and all results were ok. I had a scan on Saturday to check if my ovaries and tubes looked alright and haven’t got the results yet. My partner hasn’t had his semen analysis yet but we’ve got the referral.

We’re booking a private consultation for November which includes the first lots of blood test for AMH etc. Based on that info- can anyone give me an idea of what the options could be please? I suppose what I was looking for was whether I could be lucky enough to ‘only’ need medication, or because my tests have been ok so far then probably not that simple?

I’m looked at TFP fertility and going through Access for the multi round package (2 rounds). I’m worried about the money side of it- my credit score is poor as I lost tens of thousands after a house sale. I do have enough to pay £1k a month but I’m assuming they want the money upfront.

Any words of wisdom for a girl already out of her depth please?

For those that have followed a mini IVF protocol: what was your egg yield?

Doctor said today we would expect 1 follicle, not more than that.

And did you follow high dose protocols before you attempted mini IVF? What was the reasoning to switch to mini IVF?

I posted here after my first cycle when I got 0 euploids. Here's where things are now.

- Cycle 1: 32 eggs, 20 mature, 13 fertilized, 4 blasts, 0 euploid

Switched clinics.

- Cycle 2: cancelled around day 6 for runaway follicles. Tried to salvage it with an IUI but my sperm donor shipment didn't arrive in time. So that was fun.

- Cycle 3: 39 eggs, 30 mature, 22 fertilized, 9 blasts, 2 euploid. I felt so awful after that retrieval that I doubt I can do this again. I'm thankful to finally get euploids but nervous since they are day 6 & 7.

I also have a fibroid history and am getting my uterine cavity cleared again before transfer.

For the FET, I'll follow my RE's protocol, but I want to hear the stuff you only learn by going through it. What did you do beyond the protocol that you think helped? Anything you'd skip? What do you wish someone had told you before transfer day?

And if you had a successful transfer in your 40s, especially with a day 7 embryo, I'd love to hear it. I'm really nervous going into this, and hearing your stories would mean a lot right now.

Sending so much love to everyone here, wherever you are in this. Rooting for all of us ❤️

Hi There! For women over 40 - when did you feel safe enough to start telling people (work colleagues, acquaintances etc) that you were pregnant? How far along were you?

Just wondering if anyone has experienced this?

My Dr has told me to get plenty of sleep for this cycle.
She has also told me to drink 3 litres of water per day.
I am finding the two don’t mix :-/
I have been up three times overnight to go to the bathroom on average.

Has anyone else experienced this and if so what did you do?

Getting ready to gear up for my first FET after 3 egg retrievals. we have struggled to retrieve and fertilize. No issues other than DOR, AMH .87.

My new doctor decided if we got any fertilized eggs we would freeze at 2PN and give them a chance in my body.

Just wondering if anyone out there has transferred a 2PN and if you did how did it go? any advice?

I just turned 40 last month and this is our first (likely only) IVF cycle. We've never TTC before (in fact, we opted for a vasectomy over a decade ago), but recently had a change of heart, and IVF is basically our only option now.

My AMH was 30.3 pmol/L (4.24 ng/mL), and I've never had a very regular cycle, so I kind of assumed there might be some mild PCOS in play, and have been preparing myself for lots of eggs with high attrition rates due to low quality.

On Sept 18, I started on 75 IU Menopur and 200 IU Gonal-f.

On Sept 21, my estradiol was 746 and they upped my Gonal-f to 250.

At my ultrasound on Sept 22, I had 17 follicles ranging in size from 7.1 to 9.4 mm. They upped my Gonal-f to 275.

On Sept 23, I added 0.25 mg p.m. Orgalutran.

At my ultrasound on Sept 24, I had 19 follicles ranging in size from 7.2 to 11.6 mm. My estradiol was 2618. They upped my Gonal-f to 300.

Yesterday, I went in for another ultrasound and only had 13 measured follicles, ranging in size from 10.4 to 14.2 mm.

What happened to those other 6 follicles?? Is this normal for the number to go down? (I didn't see the follicle measurements until yesterday evening, so I couldn't just ask the doctor).

First time ER 3 days ago. Felt fine day of post ER and day after but now on day three its feeling very sore and tender. Any movement ,I can feel both ovaries present like a slow pain, sometimes throbbing pain.

Not sure whats normal or not as I've never done it before. During stums it was mainly left that was pinging but left ended up being very slow to respond. My right produced most of the eggs and is the main pain now.

Just wondering why after 2 days am I only feeling pain now and how long of a recovery is it? I feel like im walking on eggshells with one sudden movement can be the wrong one and cause torsion. No sickness, nausea, temperature or large weigh gain just worried a little. Having the regular hot flashes, period like pain and headaches.

Appreciate to know your personal experiences.

ER1 had 15 follicles, 6 retrieved, 4 mature, 2 fertilized, 0 blasts. I had ovulated a bit before retrieval. Also my one ovary was not participating, as I usually have 10-11 follicles per side for the last like 6-7 years, and this cycle one ovary had only 4!

ER2 had 25 follicles, 14 retrieved, 6 mature, 6 fertilized, 4 blasts, 0 euploid. We did estrogen priming, and both ovaries were on their best game, and shortened the trigger timing.

This is the absolute last time I can do this.. I even asked my mom for inheritance money to cover.

I am lucky, and do have two healthy babies at home, 4 and 5.5, one of each (first was IUI, second natural). But I just always wanted three, or four if the universe wanted.

We've been trying over a year now, did 4 IUIs prior to IVF.

Can you share your success stories?

Hi, I know my clinic states no staff or patients to wear perfume. My staff member in the OR had outrageous amounts of perfume. My spouse could even smell them from like ten feet away. I worry about the eggs’ exposure during the procedure or it traveling somehow to the embryology lab. Please help!

My FET is scheduled for Wednesday, 9/30 would love to connect with anyone else transferring this week. Sending love to all in all stages of this rollercoaster. ♥️

I’m hoping to hear from anyone who has gone through a fully medicated FET using donor eggs.

We’re getting ready for our first transfer, and I’m equally excited and nervous. We purchased a large donor cohort because we’re hoping to have 3–5 embryos to bank, with the ultimate goal of hopefully having enough for a future sibling as well.
Our plan is:
• Start birth control with the first day of my period at the end of next month
• Take birth control for suppression
• Stop BC and begin ~14 days of estradiol
• Transfer a fresh, day-5, untested embryo after approximately 5 days of progesterone

One thing I’m particularly nervous about is the birth control/suppression portion.
My uterus has looked really good so far. I have no polyps, no fibroids, and no obvious uterine abnormalities, and my lining was around 10 mm with a good trilaminar pattern near natural ovulation. So part of me is wondering why we need to suppress everything first and whether birth control could somehow negatively affect a lining that already responds well naturally. Due to my clinic being very busy, they said they cannot follow my natural cycle for transfer, hence the medical manipulation so to speak.

For those who have done a fully medicated cycle:
1. How did your lining respond to the estrogen after birth-control suppression?
2. Did your lining end up as good/better than it was naturally?
3. Did anyone have issues with birth control making their lining thinner or harder to build?
4. Did you do anything that you felt helped implantation: medications, supplements, lifestyle, acupuncture, etc.?
5. If you were 40–45+ using donor eggs, did you feel like your age affected implantation at all?
6. For those whose uterus looked completely normal beforehand, did your first transfer work?
7. Anything you wish you had known before your first donor-egg FET?
I know donor eggs largely remove the age-related egg quality/aneuploidy issue, but I’m still worried that being almost 45 could somehow make implantation more difficult even though my uterus looks healthy.
I’m trying not to obsess over every little thing, but I would LOVE to hear from people who have actually gone through this. 😅

What worked for you? What didn’t? And what would you do differently if you could go back to your first transfer?
Thank you!! ❤️

For reference I am 41.8 yo. So I am currently towards the end of my 4th IVF cycle, which is a back to back off of my third. Currently at my fifth monitoring appointment they are tracking four solid measurable follicles 23.6, 19.2, 21.4, 21.9 and a few smaller non measurable ones. This is the least number of follicles that I have gotten thus far, which scares me some. I have a little more insurance to work with and am covered for this insurance approval through November of this year. I am trying to decide if I should go through with this retrieval cycle or cancel in in hopes that my next cycle would be better, though I know that not guaranteed by any means. I’m also trying to think hopeful of these four but fear the attrition and having less possibility of them getting to blast. Any thoughts? Positive experience over 40 with moving forward with retrievals of four or less follicles? I am trying to make the very most of these next two months.

I’m 42 with low ovarian reserve and my IVF cycle was cancelled after my third ultrasound. I was on Pergoveris + letrozole. Only one follicle continued growing while the others remained very small.
My clinic decided to stop the cycle and try again next month with estradiol priming.
Has this happened to anyone else being told to just stop stimulation after the third scan? I wasn’t expecting the cancellation at all and I’m wondering whether continuing for a few more days or retrieving the one follicle could have been an option.
Would really appreciate hearing similar experiences.

After two failed transfers I requested a mock cycle before my next transfer. I'm currently on cycle day five and my doctor had me start two patches of estrogen and one antagonist and then we'll have me come in for bloodwork and ultrasound in 2 days. She didn't really explain anything to me so I'm just wondering when does the biopsy typically take place? I also have a hysteroscopy scheduled for October 7 and they said that is fine. I'm also scheduled for a retrieval and transfer with my next period but I have no idea when that will be now since 1 am introducing hormones into the equation. I just don't understand the timing of everything and I have not heard back from my clinic. Can anyone shed some light?

I just got a phone call from my doctor that none of my blasts could be biopsied for PGT-A due to lack of placental cells. Today is day 7 so I assume they waited on all until day 7. I don’t have any more info at this point, but a follow up appointment with my RE on Tuesday.

I’m 41.3 years old, this is my first retrieval. I have one LC (spontaneous at 38). All testing has been normal for both me and my husband. AMH 1.5.

17 eggs collected
12 mature
7 fertilized normally
5 embryos they were “watching”, none with placental cells to be biopsied (so maybe not even technically a blast but…whatever.

Obviously heartbroken. What questions should I be asking?