DOR and low AMH - advice please!

[Blacksheep33]

Hi everyone - looking for some advice/thoughts on my latest ivf cycle which I decided to abandon on day 6 stims

my situation is:

severe male factor infertility.

September 2019 - Age 33 - Amh 5pmol and large ovarian (fermion) cyst found and removed via laparoscopy

3 x scans on 3 cycles (cycle day 2) where afc (follicle number) is between 7 and 15

November NHS first round of icsi - 8 follicles, 6 eggs, 4 mature, day 3 transfer of 2 eggs - unsuccessful

February 2020 - private ivf - 21 follicles at beginning of cycle
10 eggs retrieved. 9 fertilised. 7 going well on day 3. Only 1 made it to blast - resulted in my daughter who is now 18 months

June 2022 - started a new round of ICsI. Clinic haven’t re-done my amh as decided my stim dose wouldn’t be changed (on high dose of 375 already)
day 2 cycle - 4 follicles
day 6 stims - only 2 growing. Opted to abandon cycle and hope my follicle count is higher next month

has anyone had such a huge drop in follicle count in 2 years (I.e. from 21 to 2, albeit my count has varied from 8-21)?

do you think the drop is just down to the fact that 2 years have passed and I am now 36?

would you have cancelled the round (at a cost of about £700 for wasted scans) in the hope that next months afc is better?

any views welcome!!

Anyone?

Hi @Blacksheep33, I can’t really answer your questions but just wanted to offer my support as I am in a similar position. I have low AMH and abandoned my first cycle due to poor response. It was an easy decision to make as it was my NHS funded round so it meant I didn’t lose any money and could have another funded cycle. I’m sure it was a more difficult decision for you. I changed protocol next time and responded better, although still not great. I’ve now had a further 3 cycles I was given the option of abandoning the second of them as I only had two decent sized follicles. I opted to go ahead because the way I saw it, I definitely wasn’t going to get pregnant if we didn’t continue so the small chance of success was worth more than the money we would have got refunded. Obviously that’s a very personal decision and depends on your own circumstances. I did slightly better the next time (although still not great by any stretch of the imagination!) so you might too but if I was you I’d ask your consultant what they will do differently to increase your chances of a better response rather than just doing the same again and hoping it will be different. Good luck x

Thanks so much for your message - and very sorry to hear you are in a similar position.

im a bit frustrated that after 2 years my clinic just suggested the same protocol without a scan to check my afc first, on the basis that it worked before. I did ask my clinic about changing protocol but they seem to just be ‘hoping’ that I will have a higher follicle count next month and reiterated that I had had a successful cycle on 375 Menopur (short) protocol before - of course that was many I had many many more follicles!!

likewise they advised me to try naturally this month which is really not an option for us as we have severe male factor and have always been told that the sperm count/motility is far too low to have a natural pregnancy.

all the best of luck with your treatment