DOR at 31 - what now??

[MGee123]

We had initial investigations today (privately) and I was told I have a diminished ovarian reserve - more like that of a 39/40 year old (I am 31), with only a few follicles on each ovary. I have had an AMH blood test to confirm and should get the results tomorrow + results of my husbands sperm analysis. The Consultant suggested we should consider IVF ASAP.

It all felt very surreal and I am left wondering is there nothing else between receiving no fertility treatment and heading down the IVF route that could help us? I'd love to hear from anyone who has been (or is) in a similar position, and what you have been advised/what treatment you have received. I am not mistrusting the consultant at all, I am sure his advice is sound, but I would just like to hear others experiences. This all feels rather scary and was not how I thought our initial appointment would pan out!

Did they say how many follicles? I think a follicle count is meant to be a good indicator of fertility BUT they can fluctuate. For example, my first one a year ago I had around 15. Last month I had 34. I remember when I got my AMH result a year ago - 11.68 (I’m also 31) which from what I’d seen is what they’d expect of someone in their later 30s I felt sick!!! However none of the consultants have ever been particularly concerned and when we did our first round (due to MFI) we got 14 eggs on a standard protocol. Then this round they’ve put me on the lowest dose of stims as there were so many follicles. I’ve been doing acupuncture and take a supplement called impryl alongside pregnacare. No idea if the change is down to that but possibly...
Also remember that quality of your eggs is so much more important than quantity, you just need one good egg! And the chances are at 31 you will have lots of good eggs left. How long have you been trying? At 31 time is still on your side so I guess see what the next set of results bring back and then make a decision. Good luck. X

Thank you. I had 3 follicles on one ovary and 4 on the other. The Consultant said they would expect more like 7-10 on each for someone my age. We've been trying for just under a year without a hint of a positive test! He said exactly what you said re them fluctuating so wanted to speak tomorrow once my AMH tests are back. That's great to hear you got 14 eggs on your retrieval. It has all just blown my brain and I feel a bit overwhelmed. I'm sure I'll start getting my head round things in a few days. Just keen to learn as much as possible so I can understand what we're dealing with. Thank you for your quick reply and best of luck to you too 😊

Any other day experiences? Would love to hear from others 😊 thank you 🙏

As pp said it can fluctuate from month to month. During tests I had 11 follicles but I had 20 eggs collected during my ivf cycle. I do suspect some of these were immature as only 7 fertilised but it still shows the variation between cycles.

My AMH was on the low side of normal too (9.2 at 35). I was totally disheartened with all my results and thought it was the end of our baby dreams. However the clinic gave us a 30% chance with ivf so we went for it and DS is now sleeping in my arms.

Good luck!

Hi my sister had only 5 follicles at her baseline scan. She got 7 eggs and after two transfers one stuck. Almost all her eggs fertilised, and made it to blastocyst stage (she was early 30s). Her consultant said age is more important than the number.

Have you been TTCing long? If everything else looks normal and you've not been trying long you could carry on like that. If it's already been a year or so I'd go straight to IVF.

I had about 6 follicles in total and low ovarian reserve at 34. My amh was 2.8 which Is pretty terrible!

Like you I was in a panic and was told to go straight to ivf. I was also told that the ivf probably wouldn’t work as I was likely to respond really poorly.

However, then I got pregnant anyway - sadly it didn’t work out. So I went back to the ivf plan. I only had 2 eggs retrieved - however one of those became an embryo and 2 weeks later, a bfp. He’s now 5.5!

When he was 8 months old i decided that I’d better try again (naturally) if there was any chance at all for a sibling as it would probably take years.

2 weeks later I was looking at a bfp and I now have 2 boys with 16 months between them.

Moral is that low ovarian reserve is not a barrier in itself if that’s your only issue. Especially if you’re young- which you Absolutely are! It only takes one good egg and quality is far more important.

Recent studies you can look up have shown that low ovarian reserve in itself is not a barrier to natural conception.

Thank you everyone, it's so helpful to hear other people's stories. My AMH came back today as 6.3, so rather naff for my age! The Consultant was very clear though that in terms of IVF age is on my side. My husbands sperm sailed through the tests with gold stars (typical!) so no issues there. We've been trying for almost a year already so think we will look at starting the ball rolling with IVF. We are lucky we can afford a cycle privately without maxing out our savings, and will try and get an NHS referral going at the same time as well I think. It's lovely hearing your success stories and they have pulled me out of a rather gloomy place, thank you 😊

Good luck @MGee123. Def age that matters the most. I was told I was young in comparison to many, and I was 36/37. Had scary amh (2) and fsh 16 or thereabouts. Thought it was game over, but since then have had one baby via ivf and one baby naturally. Def true that these numbers are not a barrier to natural conception or indeed success with ivf.

@Autumnsun1985 - Thanks for the hope

I recently had a test result with an FSH of 15.9, which has really scared me. Having an AMH/AFC test in September, then will look at treatment options.

I'm 38 but everything else seems normal. I conceived my first child naturally at 35 - I don't know if I already had high FSH then and was just fortunate!

Hi. Im in quite a similar position to you in terms of numbers. I had an amh of 6.1 when I was 30 (last year) and a baseline follicle count of 9. We needed ivf for male factor. My follicle count pre my first cycle was 15 and I got 10 eggs. Only one made to to blast and it was a bfn. Just had egg collection for my second cycle and my follicle count pre cycle was 16 and I have just had 16 eggs collected.

Thank you all.

@Mseddy I'm really sorry your first cycle didn't work out. 16 sounds like a good number this time! All fingers crossed for you 🤞🤞🤞

I haven't had an FSH test. The consultant seemed happy that the AMH confirmed our situation.

I have booked our first cycle of IVF today. We have the consenting appt at the end of October with bloods and a repeat follicle scab the same week, then my IVF cycle should start the following week. I'm feeling a bit daunted by the prospect but pleased to have a plan with some dates in place. Psychological moving forwards and doing something about it is helpful for me I think.

Has anyone received any particular recommendations re supplements pre-IVF? I take a B vitamin complex, folic acid, iron and vitamin D. Plus ubiquinol since March after reading It Starts With The Egg. That book lists a lot of other stuff but I'm not sure how much to buy into it? I am going to email our Consultant for an opinion but would be interested to hear others too.

Hi,
I’m in the same boat as you. I have an AMH of 6.09 and I’m 29. I’ve also got shortening cycles and irregular bleeding which they think is indication of peri-menopause and they think I could potentially have some endo in places. When I had my scan I had 7 follicles in my left ovary and 2 in my right.
I have my protocol meeting, bloods and baseline scans on the 2nd of September then straight into our first cycle.
I’m petrified!

@MGee123 I took all of them that you've mentioned 2nd time around. I am also on levothyroxine because my TSH was on the higher end of normal and my clinic wanting to treat it to be sure. I also took a low dose of dhea although my clinic didn't tell me too. I had read good things about it helping with people facing premature ovarian failure. I read a paper from a trial in the UK. There where 15 women in the test group and 15 people in the placebo group. There where 7 live births from the dhea group compared with 1 in the placebo group. I decided that was enough evidence for me to give it a shot. Not sure if that is the reason why I have responded much better this cycle or not. I guess only time will tell over the next few weeks.

@Mseddy - That's really interesting. Where did you get the DHEA?

I got it online. I can't remember where as I bought it so long ago! I think it came from America. I only took a 1/3 of the recommended dose (1 tablet a day) and i was on it from around February until now

@Mseddy - Thanks - will do some research.

The DHEA sounds interesting @Mseddy - I have heard of it before so will do some reading and ask our Consultant. How are your 16 eggs getting along?

@Bobblehatwobble I'm sorry you're in the same situation but so pleased you've got things happening soon! I'm rather anxious too but trying to be logical and just do sensible amounts of reading + keep other areas of life busy so it doesn't all become about IVF! Will see how long that lasts!!

I have been reading a little this evening about nutritional advice for couples undertaking IVF. Has anyone had any consultations on this or done any diet modification? (Other than the obvious healthy lifestyle stuff!)

@MGee123 15 where mature and 11 have fertilised so I'm happy for now. The next few days is where egg quality comes into play though so got everything crossed! I saw a fertility nutritionist between cycles. She did lots of bloods looking at my vitamins and minerals and advised lots of supplements in things I was lacking (selenium, iodine, magnesium and zinc). She was supposed to do a nutrition plan for us to follow for 3 months prior, but covid happened and she went quiet and we didn't want to wait any longer so we went ahead with the cycle. Shes based in Leeds if thats local to you and you want any more info let me know

Wow that's great news @Mseddy. Have you had an update now?

I had a read about DHEA and asked our Consultant - he advised there isn't enough evidence to support its use at the moment so I think I will leave it for this cycle (might come back to it if needed!).

I also asked about supplements and diet and he advised as long as our diet is rich in vitamins and antioxidants, there is no need to adjust anything else. He also said the supplements I'm on are fine. I think I will just continue with what I'm doing and try not to worry for now.

Next thing to look into is exercise during IVF cycles, as I run 4-5 times per week. Has anyone had any advice around this?

I didn't want to read and run. I'm 31 too and I haven't been labelled as having DOR by the clinic. I had only 3 on my AFC scan (they could only see one ovary) but my AMH was 11 and my FSH was 'high for my age' but within normal range. We have been ttc 18 months and have unexplained infertility. We are starting IVF very soon. We were given the option of waiting six months so it might not be that dire. I know the scores aren't great though. I'm massively focussing on improving my egg quality. I think age is on our side and only by doing IVF will you know if it can work x

@MGee123 yeah I have a top quality blast on board now and 4 more in the freezer, 2 top quality and 2 good quality. We are in such a better position than last cycle it's incredible the difference!

Congrats on the embryos @Mseddy ! That's brilliant. Did you do anything different this round, or just luck of the draw do you think? All fingers crossed for you to have a successful outcome this time 🤞🤞🤞

Thank you @Rosieposy89 - it's nice to hear from someone in a similar boat. When is your IVF due to start? In a strange way I'm feeling more relaxed since our consultation, almost like the pressure is off until Oct! We are still TTC the natural way but with no expectation. I'm going to try and enjoy the next couple of months before we start the IVF route.

I am thinking of trying reflexology for relaxation. Any other suggestions of things to start in the months running up to IVF welcomed!

@MGee123 - I started a course of acupuncture, massage and reflexology this week (the Chinese doctor also gave me some herbs to make a horrid-tasting tea!!!).

It may be a placebo, but I've felt less stressed the last few days. Acupuncture seems widely recommended for fertility and stress, even by medical clinics, so I want to give it a good go.

In September we're having private tests (AMH/AFC/SA) and a consultation with a private clinic.

As mentioned earlier, I'm not optimistic because my GP test showed high FSH (15.9), which was a shock. Everything else appears to be normal.

So all my efforts are now focused on improving my general wellbeing and (hopefully) egg quality too.

Just thought I would post an update as when I've scrolled through huge numbers of these threads it is nice to know the outcome!

We had our first round of IVF in November with 6 eggs collected, 5 fertilised and a fresh transfer of a 5 day embryo which was early blastocyst stage (not able to grade). We didn't have any other viable embryos unfortunately. However, we were incredibly lucky and had a positive test on OTD. 7 week scan last week showed everything looking okay.

Good luck to anyone reading this post in the future 🤞

Congratulations! Lovely update. Wishing you all the best with your pregnancy.