Poor response to stims - so confused !!

[Raleighx]

Can someone help me out here because I’m extremely confused.

So a bit of backstory... I’m 32 years old - AMH of 21.4. All pre-treatment investigations looked fine.

Started ivf on the long protocol at the beginning of June. Down-regged on buserelin and had a scan last week after 3 weeks injecting to make sure everything was looking fine. At this scan they found 2 cysts on my ovaries at 5 x 3 cm. I’ve never had cysts before but the nurse said it was likely down to the hormones and it can happen sometimes as a result of the medication. She said they might be gone by my next scan but they would take bloods to see if they were releasing hormones. If they were then it would likely be a cancelled cycle and restarting again.

They called me the next day to say good news they weren’t producing hormones so I was fine to start stims. I asked if it would have an effect on the treatment. They said no.

Fast forward to my scan today to see how I’m responding to stims. Cysts are still there (shrunk slightly) and I only have 2 follicles on my right ovary over 10mm, one under 10mm and 2 tiny ones on my left.

When I questioned it the nurse said sometimes this can happen with cysts. This was not explained to me at all as if I knew it was the case I probably would have chosen to abandon the cycle as we are already stretched to our limit financially. If the cycle had of been cancelled when they spotted the cysts it would only have incurred a cost of £150 + drugs. If it gets cancelled before egg collection now I’m looking at a cost of £2300 + drugs and we will never be able to afford another round.

I was told the doctor would review my notes and they would call with a plan this afternoon. The nurse has just called there and asked me to go on for a scan on Tuesday with a view or doing egg collection Thursday !!! I am so confused because my egg collection was meant to be friday so why would they bring it forward if I am responding so poorly??? It doesn’t make sense to me. Surely it would make more sense to up my dose of ovaleap or extend how long I’m on it ?

I told her how upset I was and all of my concerns and she said it would have to be a doctor I discussed it with. I’ve now been booked in for a scan on Monday with a doctor and to discuss.

I’m so upset. I feel sick with stress! I feel completely failed by the clinic and like this round is a complete write off.

If your follicles are very large and the other ones very small then they will aim to get the mature eggs from the large ones as it is likely the smaller follicles won't have mature eggs. So bring egg collection forward to prevent losing out on mature eggs?

I was the same age and similar amh but didn't respond well and they kept me on low dose as they thought I'd have ohss. I didn't and haven't had cysts so I cannot comment but I believe they can suck up some of the meds preventing it from getting to the follicles.

I think I would feel similar if I was in your situation. I am unsure what your clinic policy is but I know with nhs if they were to get 3 or less eggs from a retrieval they won't do any further ivf. I would ask to defer this cycle but ultimately you only need 1 embryo to have a success.

Hmm I don’t think they are very large so I have no idea what they are thinking! all she said was I would need at least 3 follicles to be able to go to egg collection.

I have heard that as well about cysts and everything I have read says they will have a negative impact so I’m really annoyed I wasn’t informed that by the clinic so I could make an informed decision. I feel like I’ve been completely mislead.

At this point it will cost 2.3k to abandon the cycle and 3.3k to go all the way to egg collection so I don’t know if I should give it a shot for the difference.. if I have that option of course.

I'd say it's your money and body and you should control it more? I would have thought most clinics have a policy where if they won't get 3 eggs due to poor stims then they cancel and it is not that much more for another cycle. I am not sure on private as not there quite yet. I definitely will not be using UK though

Really sorry to hear what you are going through. Can't offer much help but from my limited experience ask all the questions and press for answers. Sometimes I think they stop seeing us as human beings going through a really trying process.

When you meet the dr on Monday, would you still be able to change and continue stims or will you have no real option to continue the cycle as originally envisaged?

Aww thank you! That’s how I’ve felt the whole way through no one has explained anything to me.

I felt a little better at my appointment today after a conversation about things but they still say the cysts have nothing to do with the poor response. I’m just confused really as I don’t know why else I would have responded so badly. I have a decent amh, eat healthy, am a healthy weight, other scans have been fine and I’m in my early 30s. I don’t know why things have gone so wrong.

at my scan today I still only have 4 follicles but they are about the right size for collection. I’m worried the odds are not in my favour but because there’s more than 3 they have persuaded me to go to egg collection. I just feel hopeless 😔