Anyone had IVF success with high FSH?

[Pinkie3]

We are starting our first cycle of IVF next week after TTC for more than 2 years, my FSH last year was 11, I had it re-tested to decide the dosage of my medication and found out yesterday its now 14.4 I am feeling upset and confused today.

I know its good news that we are still allowed to go ahead with the treatment and i know it only takes one egg but I would love to hear of any success stories or advice from anyone with a high FSH to get me back into a positive frame of mind.

Thanks

 

[lexus15]

I hope there's plenty of success Pinkie as my FSH is 14 as well (uk)..Started my IVF last month and due to start stimming tomorrow..fx girl for us both

 

[Pinkie3]

Thanks Lexus, lets hope this is our time and we both get our BFP. I am itching to get started now.

Good luck i hope its all going well for you so far.

 

[KatherineA]

My FSH was 17 when tested away back last year, then 16 when tested in March this year. Had first cycle IVF in June which was sucessful!! The details are in my signature!

Good luck !!!

 

[Canagirl]

I have high FSH (has ranged from 8 to 15.1) along with low AMH (2.7). I was at a few fertility clinics and one doctor told me, based on my numbers, that I had a less than 5% chance of conceiving via IVF and strongly suggested donor eggs to me. Well...we went to another clinic and have found success.

I didn't have success on our first IVF cycle and it is true I didn't respond well to the meds, but we got 2 embryos and 1 of them took.

What worked for me was an estrogen priming protocol. I took estrace orally starting 7 days after ovulation until the day 1. Estrace (or other forms of estrogen) artificially lowers FSH (when your estrogen/E2 is high it suppresses FSH).

In one of my IVF cycles my day 2 FSH was 15.1 but on the estrogen priming protocol it was as low as a 2. I know it was an artificial suppression, but it worked and we're cautiously past 12 weeks now.

Best of luck!

 

[FlyFlorida]

Let me help you guys feel better... My FSH, a year ago, was 16.4 and my AMH was 0.93, AFC of 10 or 11. normal 28 day cycles for the last 27 yrs (since I was 12). Clear Tubes, 100% healthy, ovulation kits positive right on day 14. Apparently, I have poor quality and quantity. When I had these blood tests done after my good HSG (last July), the doc didn't mince words. She said by the time I was 39 (I was 38), I'd be looking at donor eggs. Talk about a shot to the heart. My eyes welled up, but all I could do was kind of laugh. Grieving process took a while, I thought I had gotten through it until this past week. Friends that didn't want kids (my age) decided to start trying and got pg 2nd month trying, another one just had her baby, 5 new babies at work, about another 5 pg, and my 38 yo friend that didn't want any more kids just had triplets without any fertility assistance. Choke me!

sorry!

 

[Pinkie3]

Thanks for the responses its great to hear some success stories and that there is still hope for people with anything going against them. I finally started my journey yesterday and feeling much more positive. Big Congratulations Katherine & Canagirl I hope both your pregnancies are going well?

FlyFlorida, sorry to hear your story, it seems very unfair that anyone should have to go through such a struggle and I am sure there are many women on here that feel the same as you. I am also currently surrounded by pregnant women with all sorts of unfair stories of how it happened but I'd never wish what we go through on anyone. I have to keep reminding myself of that.

Lets hope we all get our dream one day - Good Luck x

 

[Briss]

Canagirl, an estrogen priming protocol sounds interesting I am definitely going to ask about it.

KatherineA, can I ask what protocol were you on and the doses of the meds?

lexus, fantastic news. how is it going? I can see that you did long protocol with suppression? this is very interesting cos everywhere I read it says that high FSH ladies should use short protocol.

Pinkie, what was your response to stims?

My FSH was recently as high as 19 but my AMh is 6.7 and AFC 6-10. I know most clinics wont even offer IVF with such high FSH but some clinics do. I wonder if this is at all successful or a waste of time/money? I am on my second IVF which might be cancelled due to poor ovarian response i.e only two follicles have grown out of 10. My first IVf was natural/modified but it ended in chemical. This time they decided to stimulate me but it does not look very promising and I am really worried. We do not have any other option as we have male factor. I am considering going back to natural IVF as my cycle is regular and I ovulate every time, everything looks OK but high FSH. Just interested if anyone is in the same boat and what are your options/ protocols etc

 

[Canagirl]

Canagirl, an estrogen priming protocol sounds interesting I am definitely going to ask about it.

KatherineA, can I ask what protocol were you on and the doses of the meds?

lexus, fantastic news. how is it going? I can see that you did long protocol with suppression? this is very interesting cos everywhere I read it says that high FSH ladies should use short protocol.

Pinkie, what was your response to stims?

My FSH was recently as high as 19 but my AMh is 6.7 and AFC 6-10. I know most clinics wont even offer IVF with such high FSH but some clinics do. I wonder if this is at all successful or a waste of time/money? I am on my second IVF which might be cancelled due to poor ovarian response i.e only two follicles have grown out of 10. My first IVf was natural/modified but it ended in chemical. This time they decided to stimulate me but it does not look very promising and I am really worried. We do not have any other option as we have male factor. I am considering going back to natural IVF as my cycle is regular and I ovulate every time, everything looks OK but high FSH. Just interested if anyone is in the same boat and what are your options/ protocols etc

Hi Briss,

Regarding not responding well - I never responded well either. Oddly, I responded to Clomid just as well as injectables (3 follicles on 50 mg of Clomid).

I noticed you are on a low dose of Gonal F based on your signature (125). For my cycles I was on a much higher dose. Gonal F 300 & Menopur 150 each day.

There seem to be 2 schools of thought based on who your RE is. Some believe high stimulation with high doses of meds are best for poor responders to get the most follicles possible. Other REs believe that poor responders aren't going to develop lots of follicles anyway and put us on a low dose as they feel the high doses don't make any more follicles develop and actually reduce egg quality.

My first completed IVF cycle (that resulted in zero fertilization with ICSI) had me stimming for 15 long days on that high dose. I think it did damage my egg quality.

The successful cycle I was on the same dose, but triggered on night 11. We only had 1 mature egg (out of 6 retrieved) but 2 fertilized via ICSI (including 1 of the immature eggs). That was an estrogen priming protocol where I took estrace from 7 days past ovulation until my period started and then started stims on day 2.

The great thing about estrace or estrogen supplementation of any kind, is that it lowers FSH. It is an artificial drop (as high estrogen masks high FSH) but some doctors believe when your FSH is lower (even artificially) you will respond better to stims.

I know how difficult, frustrating and depressing it is. This CAN still work for you. I'm sorry you had a chemical pregnancy BUT the good thing about this is that it means you CAN get pregnant. You just have to find the right egg. For those of us with diminished reserve, it may take longer to find the golden egg, but it CAN happen.

You could try a cycle with higher stims and see if you develop more follicles. You could try an estrogen priming protocol (there are several variations). I also agree that, if you don't develop many follicles, a natural IVF cycle may be a good option so that you aren't pumping all those drugs into your body for nothing.

I wish you the best of luck and am happy to answer any questions you may have.

 

[Briss]

Canagirl, thank you very much for responding! I did hear about estrogen suppressing FSH. I tend to have functional cysts which produce lots of estrogen and on the cycles when I had those cysts my FSH went down to 8/9 but I did not think this could actually be used for IVF. This is definitely something to consider in the future because my FSH just goes up every year no matter what I do. My clinic advised me to increase Gonal F from 125 to 250 from today for the next two days and see what happens. I so hope some other follicles will catch up. stimming for 15 days is so much! I am supposed to be stimming for about 7-8 days so I basically have 2-3 more injections to make a difference. I hope my egg quality will not be affected by higher doses.

I've never tried Clomid, not sure why maybe because I have ovarian cysts. I did try 150 of menopur on my natural cycle for 5 days and we had 2 follicles but the second one could not be collected as it was next to my ovarian cyst. I did ovulate on its own after EC.

Gonal F 300 & Menopur 150 – seems like a very high dose. I think my current clinic is the second school i.e. that believes that poor responders aren't going to develop lots of follicles and put us on a low dose. That's why I was very surprised that they suggested 300 of Gonal F or cancelling the cycle. now they got it down to 250, I just hope it works.

 

[Pinkie3]

Canagirl, an estrogen priming protocol sounds interesting I am definitely going to ask about it.

KatherineA, can I ask what protocol were you on and the doses of the meds?

lexus, fantastic news. how is it going? I can see that you did long protocol with suppression? this is very interesting cos everywhere I read it says that high FSH ladies should use short protocol.

Pinkie, what was your response to stims?

My FSH was recently as high as 19 but my AMh is 6.7 and AFC 6-10. I know most clinics wont even offer IVF with such high FSH but some clinics do. I wonder if this is at all successful or a waste of time/money? I am on my second IVF which might be cancelled due to poor ovarian response i.e only two follicles have grown out of 10. My first IVf was natural/modified but it ended in chemical. This time they decided to stimulate me but it does not look very promising and I am really worried. We do not have any other option as we have male factor. I am considering going back to natural IVF as my cycle is regular and I ovulate every time, everything looks OK but high FSH. Just interested if anyone is in the same boat and what are your options/ protocols etc

Hi Briss,

Nice to speak to you again. My response to stims were a little slow and I was on the highest dose, I think I was on stims for 16 days in total. But I got 5 eggs collected and 4 of them fertilized, 2 were good enough to transfer.

We had our follow up appointment last week and we were told that our response was good and we were just unlucky it didn't work. We are going again in the New Year and he has advised two things. One, we do a protocol called 'Flare' which means I don't down reg, I go straight onto stimming, he thinks with my high FSH it will be better for me and I should get more eggs. We were also advised to use a new technology called Time Lapse which is suppose to detect the best egg very early for transfer.

I hope all is well with you, are you planning to have another cycle?

x

 

[Briss]

Pinkie, nice to hear from you. How are you doing?

thanks for responding! 5 eggs sounds great. high doses must have worked for you. what was your FSH?

I've started our second IVF. my protocol is called short antagonist. there is no down reg. I started stimming on CD2 with 125 Gonal F which was increased to 250 on CD7 cos there was only two follicles growing out of 10. I was told today that if we started with higher doses from the beginning I might have had more follicles. Increasing the dose mid way through did not have any noticeable effect. I still only have 2 collectable follicles. there is a 3rd one on the right side but it's close to the cyst and they wont be collecting it. It seems like everyone has a different opinion on what was supposed to work for me. some say I am only suitable for natural IVF (cos I also had 2 follicles on my natural/modified IVF with very little meds), others say I should do higher doses of stims. I am triggering tonight and EC is on Tuesday. Here I go again after all the drama of going through the chemical.

If I am correct Time Lapse is the same as embryoscope? we asked to place our embryos in this embryoscope so they could observe it more constantly and get more info. although i am not sure if it it worth it cos we wont have more than 2 eggs so not much choice.

 

[Pinkie3]

Hi Briss,

Wow I didn't realise you could go again so soon, good for you and wishing you all the luck.

As they say it only takes one, when you get no follicles is when you need to start worrying but you clearly still have some good eggs there. Yes I think the Time Lapse is embryoscope and I agree if we get fewer than 5 eggs the next time we wont use it but if we get a better response we will. My last FSH was 14.4 it was previously 11 so going up, id like to get it done again see if there is any change? I am trying to not get so hung up on the numbers I truly believe this will happen for us one day.

Good luck with your egg collection tomorrow, I will be thinking of you, let us know how you get on.

 

[Briss]

My first IVF was natural/modified and even though had a chemical my cycle went back to normal after a month so we could try again.

My EC was disappointing. Only one mature egg. I had a temp rise in the morning of EC and suspected I ovulated and turned out I was right. one of the two follicles on the left disappeared. Somehow, the doc managed to get one more egg from my right ovary without touching the cyst so we had 2 eggs collected but the lab later confirmed that only one egg was mature for ICSI. my only egg did not fertilise. they told me it was not good quality. I was very suspicious when they did not give me meds for the entire 2 weeks just for a few days. I guess they already knew that the chances of fertilisation were slim but did not tell me. strange after all this talk on how great my blood flow was and that I am to expect good quality eggs. The embryologist mentioned that the stim meds might have affected egg quality because my egg was of good quality on the previous natural cycle. maybe the one they missed was the only good one this cycle. The doc said there was no way to prevent early ovulation. My husband blames the clinic, 6K down the drain + me having to go through the stims and the result is worse than in a natural cycle. It's the end of the road for this cycle. this is going to be the hardest TWW ever with no hope whatsoever. I am in pieces and cant even think clearly where we go from here. totally devastating...

had a bit of a breakdown when we got home, after 2 failed cycles, DH does not want any more IVF until next summer. he said it's his turn to take the drugs (he struggled to see me going through stims) so finally agreed to see a urologist. I just cannot stop crying

 

[Canagirl]

My first IVF was natural/modified and even though had a chemical my cycle went back to normal after a month so we could try again.

My EC was disappointing. Only one mature egg. I had a temp rise in the morning of EC and suspected I ovulated and turned out I was right. one of the two follicles on the left disappeared. Somehow, the doc managed to get one more egg from my right ovary without touching the cyst so we had 2 eggs collected but the lab later confirmed that only one egg was mature for ICSI. my only egg did not fertilise. they told me it was not good quality. I was very suspicious when they did not give me meds for the entire 2 weeks just for a few days. I guess they already knew that the chances of fertilisation were slim but did not tell me. strange after all this talk on how great my blood flow was and that I am to expect good quality eggs. The embryologist mentioned that the stim meds might have affected egg quality because my egg was of good quality on the previous natural cycle. maybe the one they missed was the only good one this cycle. The doc said there was no way to prevent early ovulation. My husband blames the clinic, 6K down the drain + me having to go through the stims and the result is worse than in a natural cycle. It's the end of the road for this cycle. this is going to be the hardest TWW ever with no hope whatsoever. I am in pieces and cant even think clearly where we go from here. totally devastating...

had a bit of a breakdown when we got home, after 2 failed cycles, DH does not want any more IVF until next summer. he said it's his turn to take the drugs (he struggled to see me going through stims) so finally agreed to see a urologist. I just cannot stop crying

Hi Briss,

I'm so sorry to read your post. I know how difficult it is to go through a cycle and not be able to have a transfer because of no fertilization. Take some time for yourself before you decide on your next steps.

It makes me mad on your behalf when I read your post that your clinic told you there was no way to prevent early ovulation. For any IVF cycle that I've ever been aware of, things are done specifically to ensure that ovulation does not occur prior to egg retrieval. It is timed very specifically. When your E2 level reaches a certain level or your lead follicle is a certain size, an additional medication (here is usually Orgalutran (ganirelix) or cetrotide) is started to ensure you don't ovulate prior to retrieval. Then, usually about 36 hours prior to egg retrieval you give yourself an HCG injection to ensure the follicles are mature. This injection is the most important one and has to be timed exactly as your clinic tells you.

Did they have you on a medication to prevent ovulation? I could understand not doing so if it was an IUI cycle, but for IVF here they always prescribe an additional injection to prevent early ovulation. (I'm not sure about natural cycles, but for cycles using stims, this would be done)

I'm so sorry about your recent cycle and hope you can take time for yourself before deciding on your next step.

 

[Briss]

Canagirl, thank you very much for responding. I was on cetrotide for the last 4 days of stims, then my LH started to get up and reached 12 and my follicles were 20mm, 19 and 16, they told me to trigger that same day at 11.30 pm with 2 shots of ovitrelle which I did. I also did OPK before that at 6 pm and it was still negative so I was sure I wont get LH surge before the trigger. EC was scheduled 36 hours after the trigger but it looks like I ovulated the next day after the trigger and lost my most likely best egg. I am at a loss as to why this happened and what they could have done to prevent it. On my natural cycle I was taking Indometacin because my LH started a few hours before I was supposed to trigger and it was supposed to preserve my follicle until EC which luckily it did but this time they told ьу they do not prescribe Indometacin in stim cycles because they are controlling my cycle. It was also quite annoying cos the doc doing EC just said I only had one follicle on the left while I told him I was supposed to have 2 and he diв not seem to believe me. it was only after EC that he checked my file and confirmed that 1 egg most likely ovulated early and said I was lucky we did not loose all three. It was not lucky at all cos the remaining two were not suitable and I wish they would not proceed with EC cos at least my immature egg would take its time to mature before being released naturally and we would be entitled to a refund of most of the fees.

 

[Canagirl]

Hi Briss,

I'm glad to hear you were on cetrotide. I have read on the odd occasion that someone did ovulate while on it, but I really hope it is a one time thing. I'm not sure if they monitored your LH levels daily, but a friend of mine was on Orgalutran (same purpose as Cetrotide) and at her morning appointment, her blood work showed a dangerous LH rise so they called her and had her take a second Orgalutran injection immediately to prevent the premature ovulation.

I know how hard it is to think clearly after a difficult cycle. After my cycle with no fertilization of 4 eggs we took a few months off as we felt we needed to try a different clinic as we'd spent almost 2 years without success at the clinic we were at. Although I was nearing 37, the break was good for me as each cycle was stressful and it is difficult to plan your life around when you may be cycling.

My husband didn't want to do another cycle mainly because he felt it put me under a lot of stress and I was upset all the time, but after a bit of time passed he changed his mind.

Most importantly, take your time to pamper yourself and have time to yourself to get through this. I can completely relate to how hard it is and you aren't expected to bounce back to being cheery and happy right away as it just isn't possible.

I know it is said all the time, but you do just need to find that one good egg. Women that don't rely on treatment just have one egg to work with each month. For those us that suffer with DOR, it can take us a lot longer to find that good egg, but it isn't impossible. If you had good quality in the past, I would focus on that. Maybe this cycle just wasn't your month, or it was the fact that you weren't on stims the whole time or simply stims don't agree with you.

Once you've taken some time to recover, you can put together a plan as to what you want to do next. Best wishes.

 

[Briss]

Canagirl, so basically you cant prevent early ovulation as long as you were on cetrotide? once you trigger you just hope for the best? I wonder if i should just not proceed with EC next time if at least one egg is lost to early ovulation. the last time they checked my LH levels was on the morning of trigger which is basically 2 days before EC and it started rising. they did not monitor my LH after the trigger shot

no fertilization with 4 eggs!! did they explain the reason? is it possible that stim meds are affecting the quality of the eggs?

I have done two cycles with my clinic but not sure I will carry on with them, the last cycle just broke my heart and I was not happy with the protocol and how they managed it.

 

[Canagirl]

Canagirl, so basically you cant prevent early ovulation as long as you were on cetrotide? once you trigger you just hope for the best? I wonder if i should just not proceed with EC next time if at least one egg is lost to early ovulation. the last time they checked my LH levels was on the morning of trigger which is basically 2 days before EC and it started rising. they did not monitor my LH after the trigger shot

no fertilization with 4 eggs!! did they explain the reason? is it possible that stim meds are affecting the quality of the eggs?

I have done two cycles with my clinic but not sure I will carry on with them, the last cycle just broke my heart and I was not happy with the protocol and how they managed it.

The purpose of Cetrotide is to prevent ovulation. Most of the time it does work. Unfortunately there is the odd time when it doesn't work. I'm not sure if it is a one time thing or more likely to happen again if it has happened once, but that is definitely something I'd ask your doctors about. With the hcg/trigger shot it should cause the follicles to release exactly a certain number of hours after trigger which is why the timing is so important. The half life of Cetrotide is supposed to ensure that you don't ovulate prior to egg retrieval.

The cycle I had zero fertilization with ICSI of 4 eggs was an estrogen priming cycle but I believe the addition of Orgalutran prior to starting stims was oversuppressive for me and I was on stims for 15 long nights. I do believe the number of nights on stims did impact my egg quality. As to why there was no fertilization, all they told me was that it was probably an egg quality issue (which is what is usually told to women 35+ with high FSH/low AMH). I have no doubt my egg quality wasn't the best, but with less suppression next cycle and fewer nights on stims we did get 1 of our only 2 embryos to stick.

It doesn't hurt to get into another few clinics (if possible) to see who you fit with. You have to feel confident in your doctor and your clinic as that is very important.

 

[V2R]

Hi H4M how are the injections going? Are you feeling bloated or any side effects?
I start nose spray Sat for 2-3 weeks I will be scanned at some point but still no appointment through then I inject for 8-9 day's then scanned a Friday. I think working it all out I will be in Mon 6th Jan.Xx