Help needed - bad responder to Stims and don’t know why?

[Maestro7]

Hi all. I’m mid way through Stims for my second cycle. First cycle was long protocol with 150 of gonal f and I only retrieved 5 eggs. Second current cycle is short protocol and 225 of gonal f plus 75 of menopur. Had my scan today and looking like only 5 follicles again.

I don’t understand why I’m not responding - especially as supposedly my AMH and AFC are normal - I‘ve just turned 34 and I have an AMH of 17.4 and AFC of 15. All my bloods have always been normal and show I ovulate fine and I have a normal cycle and normal levels of prolactin, oestrogen FSH etc. The reason we are supposed to be doing IVF is for male factor issues.

Last time all 5 eggs were mature and all fertilised but they started dropping off and by Day 5 we only had one morula.

Does anyone have any experience of only getting a low number of eggs and success? Or any idea why I respond so badly regardless of protocol and meds and if there’s anything else we can do?

Feeling very down today about it all I have been taking lots of good supplements (zita west ivf prep plus ubiquinol and vitamin c) and eating healthily - off caffeine and alcohol Lots of salmon and avocado etc - chocolate is a bit of a downfall.

Anyone any ideas?

I have switched to natural modified IVF so target very few follicles and it has actually increased the quality hugely - on short protocol last year I was getting 14 eggs each time (which is line with my AFC) but less than 30% fertilised even with ICSI and blastocysts weren't great quantity. Now we target between 2 and 7 and fertilisation is now 100% with top quality so I wouldn't worry about the numbers of follicles. Although it is odd that you have a good AFC and AMH but just not converting them to actual collectible follicles but I'm a firm believer that the body knows its own limits and if it's saying to you I can only get you 5 then don't push for more as they'll just be crap quality?

Thanks for the information. I don’t understand what the missing link either is between my supposed good AMH etc and how I respond. Hoping the doctors might have some answers after this. However if they do another round after this and no better I will definitely be looking into natural as it does sound like it may be a better fit.

I’m not in the UK but we are both work from home until January 2021 so I wouldn’t rule out moving over for 3 months to do it somewhere well regarded.

The good thing about natural modified is it's over very quickly - start stims around cycle day 4 - injections sometimes only every other day and then egg collection usually cycle day 13 so with the transfer you'd only need a couple of weeks in the U.K.

I'm with Create - there are hardly any clinics in the U.K. offering natural modified as lots of other clinics turn their noses up at it as they prefer to place the emphasis on pumping you full of drugs to get as many follicles as possible

Thanks for all the information. I would wonder though if I’m only getting 5 on loads of drugs would I even get 2 on natural. Hopefully it will all work out.

You aren't on very high doses... I was on 175 of gonal f because of my polycystic ovaries. Even with that I did get possible mild ohss... but they had increased me to 225 for the final three days of stims to help some follies 'catch up'.

I don't understand why you're on such a low dose if you didn't respond splendidly last time (btw I think it's totally average to get 5-8 eggs),..

And always remember, quality, not quantity matter!

I was on about 225 on my first cycle because I’m 28 with an amh of 15 so it was considered borderline for my age. Got 13 eggs maybe your dose needs to be tweaked a little?
As for the drop off, it’s actually quite normal, I had 13 10 mature 5 fertilised with icsi ( mfi too) and were all good by day 3 then had one top quality by day 5. I’ve read sperm takes over after day 3 so it could be your husbands sperm quality?
I was very lucky to have that one and for it to work first go though. It’s best to go to your clinic when you can and discuss what can be changed x

Sorry I misread your post.
I have no more advice but I’d get onto your husbands quality and try to up that if you can. All I took for my cycle was coq10 folic acid and a multivitamin x