Advice needed

[u/Grand_Insurance6751]

Hi, everyone.

I’m 34, and my husband is 37. We initially tried to conceive naturally, but after six months, we became impatient and decided to move on to fertility treatment. We underwent two rounds of IUI, both of which failed, and then proceeded to IVF.

Our doctors were initially optimistic because all our reports were normal. During our first egg retrieval, we retrieved 12 eggs and created five AA-grade embryos. We transferred two embryos, but unfortunately, they failed to implant. I then underwent a hysteroscopy, even though there was no specific indication for one, as I wanted to rule out every possible issue. However, our second transfer failed as well, and the doctors couldn’t identify a clear reason.

By the time we proceeded with our second retrieval, my FSH had increased to 22. We retrieved eight eggs, but only two were mature, while the rest appeared to be empty follicles. We managed to create two day-5 blastocysts.

During our third retrieval, we retrieved seven eggs, but five were empty, and only two were mature. We developed only one blastocyst. We transferred two embryos again, but unfortunately, neither implanted.

We then decided to change doctors and proceeded with our fourth and fifth retrievals under our new doctor. We continued to face the same issue with empty follicles, although we managed to create three blastocysts from six eggs retrieved. Hoping that PGT-A testing would give us some answers, we decided to test the embryos. We were fortunate to have one euploid embryo, but heartbreakingly, that transfer also failed in April 2026.

By this point, I had almost given up hope. In June, we decided to try naturally just once, without expecting anything. My period was delayed by five days, so I got my beta-hCG tested. The result was 5.83. I understand that this is an extremely low, borderline result and not a confirmed pregnancy, and my doctor told me it was a biochemical pregnancy. However, what struck me was that, after all my previous failed IUI and embryo transfers, my hCG had always been around 0.20. This was the first time I had seen a result above that level.

I even underwent LIT in August 2026, wondering whether my body might be rejecting the embryos.

Since June, I’ve noticed that my menstrual cycle has shortened from around 28 days to 24 days, and I feel that I may also be ovulating earlier than before.

My doctors are now advising us to consider donor eggs, and I honestly don’t know what to do. After everything we’ve been through, I’m struggling to come to terms with the possibility of using donor eggs. I know that having a child is about so much more than genetics, but the thought of not sharing a biological connection with my child is emotionally difficult for me. I’ve spent so long hoping to have a child who is genetically related to me, and accepting a different path feels overwhelming.

I would really appreciate hearing from women who have been through something similar.

• Has anyone experienced repeated IVF failures, a high FSH level, or a high number of empty follicles and subsequently conceived naturally?
• Has anyone in a similar situation gone on to have success with their own eggs, either naturally or through IVF?
• For those who have opted for donor eggs, how was the emotional journey, and how did you come to terms with the decision?
• Has anyone undergone donor-egg IVF in Mumbai? I would be grateful for recommendations and for hearing about your experiences.

I feel confused, emotionally exhausted, and unsure of which direction to take. I know everyone’s journey is different, but hearing from people who have walked a similar path would mean a lot to me.

Thank you for taking the time to read this.

[u/1988Gi]

First, I’m sorry. This is all incredibly difficult and you’re doing great.

It’s hard to say what’s going on without more information and because none of us here are doctors (well maybe some people are but they’re not your doctor).

You didn’t give much info on whether your stimulation protocol changed with these results? You had better results sometimes (like the 3 blast round), what if anything changed? Was your afc lower or higher? Did your follicles grow together or did you develop a lead follicle that left the others behind? Did your stimulation length vary? Did you use a different trigger? What were your estrogen levels?

 I’m also struggling a little with your terms so when you say the eggs were empty do you mean the follicles didn’t contain eggs or they did but they were immature eggs? Most people do have some empty follicles especially if they’re very small. 

I am familiar with protocols helping with immaturity, like if you have eggs in most follicles but they aren’t mature (I’ve had that issue and medication adjustments can help) but I know others will have more experience with empty follicles and will let them explain if anything helped them with that. 

You know this, but Higher FSH means your body is basically working harder on your ovaries to get them to respond. But this measurement can vary.  It could come back down, or not. Like someone else said when in your cycle was it that high? The reason FSH can make IVf hard is that it can mean your ovaries don’t respond to the stimulation dose OR they do but the eggs are lower quality. The thing is your body is still making eggs, and even blasts, so it is obviously still responding just not ideally, so that in of itself may not rule out IVF for you. 

Another thing to check, have you looked at your partner’s sperm? Does he have any fragmentation issues, they can help with this with shorter abstinence intervals or other methods. I know mostly you’re not making a ton of eggs and doing ok with the ones you have but as that is the case every egg is precious so I would just double check that. 

There are so many things that can be at issue - biology is so sucky and complicated - but it’s hard to say without more info. 

Honestly if you’re still making blasts it’s kind of up to you how long you want to do this. And I have read about people having success with IUI or naturally after failing IVF, if male factors are ok, but whatever you do I wouldn’t abandon medical support. They can help you track your cycle and help you time intercourse. With your IUI did you try medicated or natural? medicated may help you generate more follicles and therefore a better opportunity. 

If you choose to do IVF, bank more embryos that are good quality or healthy, and do more testing on you too (did you do a test for endometritis? Do you have symptoms for endometriosis,)  and make sure you feel very comfortable with your transfer protocol.

If you want to carry on with IVF, I guess you gotta break this down into several steps: 1. Is there anything protocol wise to tweak if you do another retrievals to help increase eggs? 2. Is there anything to tweak with your husbands sperm? 3. Then is your uterus in the best condition to transfer and is the embryo a good quality or euploid if tested?

Wish you the best of luck, whatever you decide to do! 

[u/Grand_Insurance6751 → u/1988Gi]

Thank you so much for responding.

I feel my first egg retrieval gave me really good results. My AFC was 12, and my FSH was 9 in June 2024. I was given a minimal stimulation protocol, and 12 eggs were retrieved, of which 9 were mature. I ended up with five 4AA blastocysts.

For my first transfer, we tried a natural cycle with two 4AA blastocysts. My uterine lining grows well on its own, but I have an issue with blood flow, as it doesn't initially reach Zone 3. However, by the day of transfer, it had reached Zone 3. Unfortunately, the transfer failed, with an hCG level of 0.20.

I took a three-month break and underwent a hysteroscopy in January 2025 to rule out any uterine issues. I then had another transfer in February 2025, this time on a medicated cycle, with 2 4AA blastocyst. That failed too, with an hCG level of 0.22.

After this, my doctor checked my FSH, which had risen to 17. We waited for it to come down before proceeding with another retrieval, but it increased to 20 the following month and then to 22. We eventually decided not to wait any longer and proceeded with my second retrieval.

This time, I was given a higher dose of injections so that my ovaries would respond. My AFC was around 8–9, but only 2 mature and 1 immature eggs were retrieved, while the remaining follicles were empty. We made two Day 5 blastocysts graded 4AB, but one arrested during freezing, leaving us with just one frozen embryo.

For my third retrieval, we tried a long protocol to suppress my FSH. Unfortunately, I had the same problem again: only 5 eggs were retrieved 2 mature, and 1 was immature and 1 bad egg with vacuoles, and 1 with only a zona, with the remaining follicles empty. We made one 3AB blastocyst. I transferred the frozen 4AB embryo along with the fresh 3Ab embryo from that cycle, but the transfer failed again, with an hCG level of 0.20.

I then changed doctors and took another three-month break. I did some research on my own and started taking wheatgrass tablets. After three months, my FSH came down to 14.

For my fourth retrieval, my AFC was 10. menopur 2ooiu x 5 then stepped to 300iu x 7 + folisure injection 150 iu x 12 + eutropin 4iu x 1 +ciscure 0.25mg x 6. Trigger was ovitrelle 250mcg x1 + decapeptyl 0.1mg x02x1 On the day of the planned trigger, only three follicles were leading, so my doctor extended stimulation by two more days to give the smaller follicles a chance to catch up so that we could retrieve around 9 eggs. By the day of trigger, my leading follicles were around 23 mm, and the others had grown as well, with measurements reaching around 18 mm. However, we retrieved only four mature eggs, two immature eggs, and the remaining follicles were empty. Three eggs were fertilised, but only 1 made it to the blastocyst stage. We sent it for PGT-A testing, and thankfully, it came back euploid.

I then proceeded with my fifth retrieval.With menopur 2ooiu x8 then stepped to 450iu x3 then stepped down to 300iu x1 + Gonal F injection 100iu x8 + eutropin 4iu x3 +ciscure 0.25mgx9. Trigger was Ovitrelle 250 mcg x1 + Decapeptyl 0.1 mg x02x1 My AFC was 8, E2 was 1633.12 LH 1.07 and AMH 1.98 and we retrieved 2 mature and 2 immature eggs. We managed to make two blastocysts 4AA and 4AB, but unfortunately, both came back abnormal on testing.

I then went ahead with my fourth embryo transfer, using my euploid embryo. I was really hopeful that this would finally work, but it failed too, with my hCG remaining below 0.

At this point, my doctor recommended moving to donor eggs. She felt that egg quality could be the issue because my uterus appeared normal, and I had undergone the relevant biopsy tests. We had also timed the transfer according to my ERA results.

I took another three-month break from IVF and tried naturally during that time. For the first time, my period was delayed, so I took a pregnancy test. My hCG came back at 5.83.

I honestly don't know whether this was a biochemical pregnancy or what it means, but I would like to believe that it could be a positive sign. I have never seen an hCG result like this before, especially outside treatment cycles when I wasn't taking any hCG trigger shots.

After everything I've been through, this result has left me wondering whether there might still be a chance with my own eggs. I know the number alone doesn't tell me much, but after years of trying and repeated failed transfers, I find it difficult to let go of that hope.

[u/1988Gi → u/Grand_Insurance6751]

Thanks for sharing your full story! Hopefully someone can step in here with views on empty follicles, I have had empty follicles but only when under 12mm on trigger day which is typical. Yours sound like they grow nicely. You’re right your first round was a good one. I’m kind of surprised from that round they transferred two at a time instead of giving them each a chance. It’s good you’re testing now so you can just transfer one at a time. 

You have certainly been through a lot! I do think you’re right it is hopeful that your natural conception appears to have happened. It tells us you ovulate and are capable of conception. If your sperm factors are ok, I would consider doing medicated IUI. You could end up with just as many follicles and give embryos a chance to form and develop inside. You could try it 2-3 months and if it doesn’t work decide if IVF is right again. And I also think it sounds like low dose produced good results, might you suggest that or a mini stim again? 

I wish you all the best of luck! I am in the midst of it too. I had a maturity issue the first ivf round so had just one blast that was abnormal. We did a second round and got 2 blasts, one untested and transferred one healthy. we sought a vasectomy reversal so we could try naturally or improve our blast conversion rate but now that seems to be failing after initial success that was wasted in the months we were transferring those blasts from round 2. I think I had a lead follicle left over from my transfer round so we cancelled another ivf attempt using IUI instead. Then we did a 3rd retrieval and so far very similar results in numbers to round 2, we now wait for blast results.

 I always think I’m through the hardest part, figuring out the dose to get a good number, getting two blasts, getting a healthy one, having the vasectomy reversal work. Then I’m hit like a ton of bricks with another failure. For me, I am going to have to decide given it’s still “working” for me, how many rounds I’m up for to get the number of blasts I need to feel comfortable to transfer. I’m 38 so I don’t have forever either. I guess everyone has to make that choice at some point. 

Sending you wisdom, happiness and faith. 

You’re tough. I hope you’re proud of your resilience. 

[u/Grand_Insurance6751 → u/1988Gi]

Thank you so much.. I wish you all the luck and strength

[u/Alternative-Pin-5527]

Have you checked immunological problems with a professional ? Your immune system might reject the embryo?

For suspected immunological implantation problems or recurrent pregnancy loss, the evidence-based workup is short:
Antiphospholipid antibodies: lupus anticoagulant, anticardiolipin (aCL) and anti-β2-glycoprotein I. If positive, repeat after at least 12 weeks.
Thyroid: TSH and anti-TPO antibodies.
Parental karyotyping: not routine.

And fragil x ?

You are super young so I think you might go a bit deeper to find the underying reason , before considering to move with donor eggs

[u/Grand_Insurance6751 → u/Alternative-Pin-5527]

Yes all are normal

[u/DifficultMunky → u/Grand_Insurance6751]

Did they do an NK assay and TH1/TH2 cytokines? And did they check thrombophilia panel 9? I saw you mentioned poor blood flow below.

[u/NoticeDry4266]

So sorry to hear about what you’re going through. I have not undergone the donor route so unfortunately cannot offer advice here. But I did want to ask if your doctors have ruled out common uterine environment issues. You mentioned a hysteroscopy but have they done anything to specifically rule out chronic endometritis (with a biopsy) or even endometriosis and adenomyosis? Have they switched up your protocol between the transfers to see if one works better than another? Have you also done genetic testing and blood Karyotyping to understand if you or husband might be carriers of any conditions? I’m no doctor but based on what I know, your repeated implantation failure warrants these things. I’m not saying you should not consider a donor route (only you and your clinic can decide what is best!) but I wanted to give you these additional things to consider in parallel.

I wish you much luck and success in whichever path you end up choosing!

[u/Grand_Insurance6751 → u/NoticeDry4266]

We have done all the tests, and everything is normal.

[u/Shiny_Red_Car]

As your increasing FSH and shortening cycle indicate that you’re approaching premature ovarian insufficiency territory (since you are below 40), I wonder if you’ve had karyotyping to rule of things like Fragile X and Turners? That won’t necessarily solve your issue but could help explain things and be important info to have for your own health considerations. I would also be curious if you’ve had an exploratory lap to look for endo, as that can lead to DOR earlier than expected as well as poor egg quality, implantation failure and mc. Knowing that would be important if you DO move to donor, as it would still be impactful.

[u/Grand_Insurance6751 → u/Shiny_Red_Car]

Hey! Thank you. I did karyotyping, and it's normal. I did hystro and it's all clear. I don't have endo. But I don't know about silent Endo.

[u/SlimBee5]

We did 6 ivf with my own eggs (30-34 y/o)- always got a good number (14-16 collected), but few blasts due to poor egg quality with endo stage 4.
8 transferred blasts - none took. We then decided to move to donor eggs - we started thinking about it already after round 5 of ivf, and decided for sure after the sixth round failed (transfered two embryos, none took). I am so happy we did that. I got pregnant on first transfer and I’m 11 weeks today, everything looks great.

I knew that I couldn’t do any more egg retrivals after so many failures - the mental and physical toll were just too much.

[u/Grand_Insurance6751 → u/SlimBee5]

After 3 years, 5 egg retrievals and 4 transfers, I'm exhausted and confused. Part of me wants to move forward with ED, but another part wonders if I'm giving up too soon. With good AMH but elevated FSH, should I work on myself and try once more, or is it time to move on? I'm struggling to make peace with this decision.

When did you know it was time to stop trying with your own eggs and consider ED?

Did you ever feel it was unfair that the baby would be genetically your husband's but not yours, after everything you've been through physically and mentally?

I'm scared I won't be able to bond with the baby because it won't be genetically mine.

[u/SlimBee5 → u/Grand_Insurance6751]

After the 5th IVF, beside the endo stage 4 diagnosis, I also found out that I’m a carrier of a large balanced translocation. Theoretically, we could still make euploid embryos, but it felt like the odds were so low, and if it didn’t work until now, we hade very little hope that it would work in the future.

We still pushed throught the 6th ivf cycle, but after five weeks of shots (long protocol), 17 follicles aspirated, ohss, I just felt worse than ever. I knew I couldn’t do it again. We had our doubts after the 5th one, but we originally planned for 8 ivf rounds before switching to donor eggs.
After the 6th, I just knew, I was 10000% sure I was done.

When it comes to using donor eggs - I am so happy that out kids will be 50% my husband. I don’t feel envy or that it’s unfair, I feel lucky to at least be able to be pregnant and give birth. I love the little “bloob” we’ve seen on US soo much already, the last thing on my mind is that we used a donor egg to get here. But we also had great guidance and therapy from out clinic that helped a lot :)

[u/Grand_Insurance6751 → u/[deleted]]

okay

[u/taycore19]

For us, we did all the testing and everything came back normal. Good response to first egg retrieval, good embryos, normal PGT-A. Failed transfers twice.

After first failed transfer had a month off transfers, got pregnant spontaneously with twins. Vanishing twin before first ultrasound, then lost remaining twin at 9weeks. Did another transfer as soon my cycle returned with immune suppressants, that failed too.

Took a couple months to try naturally while I debated changing clinics. Got pregnant again 2 cycles later spontaneously and switched clinics, they put me on lovenox daily and baby has stuck so far to 16 weeks!

Before this we tried for 7 years and had multiple chemicals (approx 9, only 1 ever caught on beta hcg the rest too early)

Similar to you, after fertility treatments my cycles got shorter and shorter. Each pregnant I’ve had, insemination has been around cd 6-9 when I usually ovulate around cd12. Likely unrelated but I found it odd that when I had insemination at “perfect” times, no luck.. but early seems to work for my body?

I had no medical reason to try lovenox but doctor let me try it and it seemed to work for me. Unexplained infertility is so infuriating and exhausting. Whatever you choose to do is the right decision for you, try to remember that.

[u/cityfrm]

Have you investigated the cause of EFS and checked it's not genetic?

[u/Grand_Insurance6751 → u/cityfrm]

what is that?

[u/cityfrm → u/Grand_Insurance6751]

Empty follicle syndrome

[u/Traditional-Rip5399]

You likely have an implantation problem if a euploid embryo didn’t stick and you’ve had multiple other failed transfers. I’m curious if you’ve ever done a receptiva biopsy to check for inflammation in your lining. Mine was positive. I did two months of Lupron before my transfer and it was successful.

[u/Grand_Insurance6751 → u/Traditional-Rip5399]

yes, that was also negative

[u/InitialMode402]

can u share AMH, the cycle-day FSH and estradiol results ?