IVF / low ovarian reserve success rate

[Iggilypiggily]

Hi everyone,

I am looking for a bit of reassurance and a virtual hug.

Husband and I (38, 37) have been off contraception for 7 years. I’ve never been pregnant that I know of. There was a ?chemical pregnancy once but I don’t know if I have line eyes. Recently there was a sac on an unrelated ultrasound and thick lining which turned out to not be pregnancy, so I guess there is perhaps a slight chance that I have conceived a few times but not realised it.

We haven’t been trying actively for 7 years, we were leaving it up to fate really for the first few years as we were renting, tough jobs etc. We did get tested several years ago as we thought it was odd we hadn’t even had a scare and they identified low ovarian reserve with no known cause. AMH 3.3 with 5 follicles identified when I was aged 35.

I had decided IVF wasn’t for me and life went on. We were buying a house and moving and changing jobs so it went to the back of our minds for a little bit but we still were leaving it up to fate some months. I’ve been testing ovulation and I do ovulate regularly. We have been TTC now roughly a year, but again not every month (husband works away at times so we can’t always and sometimes life has got in the way).
We just got retested and thankfully my results haven’t changed much, AMH 3.1 and 4 follicles which is a little reassuring. But I am just feeling like it is never going to happen.

We are going to do IVF now but I am dreading it. I’m already feeling overwhelmed just trying to negotiate appointments with work and I strongly fear the side effects. I have ADHD so life is a bit of a struggle at the best of times, but PMS hits me hard. The doctor was also quite negative re chances, or perhaps I just see it that way. She was probably just realistic.

I have always had super light periods and a quick google search suggests that my lining is perhaps too thin for an egg to implant. My eggs are few and far between and suspected to be low quality, so doctor is already preempting several cycles for success. And top it all off I have a shortened cervix from a history of two abnormal smears which I was told back then would heighten my risk for miscarriage. My understanding is that they will typically see how it holds up because the management of this is risky in itself and then if you have had several miscarries they will consider stitching it during the pregnancy to help it hold the weight.

I can’t help but feel that the odds are massively against me and that I am going to put myself through hell for a negative outcome or for success in terms of conception but a high risk I could miscarry and it just feels a little like I’m setting myself up for failure and heartache. Im not someone who was put on this earth to be a mother (husband feels the same), so it’s not exactly a situation of me being unable to cope with not having children as we know we would be okay if it was just the two of us, but I can’t help but feel like starting this process will also kick start a hope and an excitement that will lead to enormous disappointment that isn’t there already, if you get me. My other worry is that I start early menopause because of IVF thus reducing the changes of natural conception even further.
Has anyone experienced such odds stacked against them and had success? Can anyone offer advice or a virtual shoulder to lean on? It would be very much appreciated.

I believe you will be just fine. You are 38.
I am 41 with extremely low AMH and male factor.

So do it. And do it quick!

PRP would help with lining.

Thank you. Are you also doing IVF? It is so overwhelming

Yes.
I failed 2 IVF cycles.
It's hard before you start. After you start, you get used.
But, yes, I feel the same desperation and guilt for not doing it earlier.

Okay that’s good to know. It just feels like a lot that I’m looking forward to. We sortve feel like it is quite rushed as well so I’m not quite mentally prepared. I know what it entails but I hadn’t actually really thought of me going through the motions of it if you get me, even though I knew it lay ahead. It’s all feeling very real

When is your next cycle?

Don't do the mistake I have done. I have waited to be "mentally prepared" and now I regret it. Some of us are never fully ready. Some of us are perfectionists. Some of us are too stressed. Some of us feel incapable.
You are already 37.
Those who have children have a reason to wake up and do the hard things in life. When I met my nephew is when I discovered the love of a child/for a child. The connection!
Freezing the embryo is an option if not ready. But after the age of 40, the egg quality becomes very poor.

I wanted to do this cycle, but I only had a bad looking follicle and I had to postpone. Hopefully this is because I am post egg collection and this can happen after egg collection.
Next month hopefully!

Hi @Iggilypiggily I was ttc for 4 years never got a bfp on a test, I found out my amh was 3, started ivf I naively thought it would happen quickly because I was 31, my 1st round collected 4 eggs all failed to fertilized, 2nd round we done icsi collected 2 eggs 2 fertilized but Deteriorated day 4, clinic told me my eggs were terrible quality I should look into donor, changed clinics had ovarian PRP lower dose stims 3rd round amazingly collected 8 eggs had a 3 day transfer, now currently half way through my pregnancy, ivf will be so mentally exhausting, make sure you're clinic is experienced in low amh and is willing to try different protocols! Best of luck x

I am 39, have low amh (3.8 last time tested) and had two maximum dose NHS rounds, first round 3 eggs, all fertilised, one transferred and failed. Second round 1 egg, 1 embryo, but a failed transfer. We were due to start at a clinic with experience in treating women with low ovarian reserve as from what I've read on the internet, it truly does seem to yeild better results for those who respond poorly to maximum stims, so do look into it. The fertility doctor was actually quite positive about potential outcome, and said it's just about getting the right combination of egg and sperm. I've heard of PRP and would totally have been game, but I've had a deeply unexpected positive test last week. I'm keeping my head firmly screwed on and know I very likely will be back on the ivf train shortly. But do keep trying naturally, and do track ovulation if you aren't already.

I was scared about what the IVF meds would do to me, I get very very spaced out PMS, and the only hormonal contraceptive I've used gave me severe mood swings, hyperactivity and depression (and broke up my lovely relationship) so I was worried. Honestly, I couldn't tell you I felt anything from the meds at all, other than I got sleepy in the evening (which felt nice). I actually felt more calm and positive and level headed than I normally do, and reflect on the IVF process as a fairly positive experience despite receiving bad news in batches.

Are you taking any supplements? F Doctor also told me to take myoinsitol as it supports egg health and ovulation (it's intended for pcos but I don't have that, doctor said the benifits are true for any woman). I've been taking ubiquinol for mitochondrial improvement for three months too. Doctor wasn't very interested in Ubiquinol but said there's no harm. It apparently takes three months to positively affect the eggs you're storing, so any chages in health stuff you're planning to make, make them now. Sorry my post is so long. Just telling you the things I'd like to have been told before starting IVF (or even starting ttc).

Thank you all so much, I really appreciate that. It’s good to hear some positive news and also some less terrible experiences of the side effects! I really appreciate it. It is also so helpful to know what to try as none of those drugs were even remotely addressed for me. We are doing it privately through health insurance so I will ask.

I have told myself I’ll try twice and if it isn’t successful I will accept my fate and just go back to trying naturally so we will see. If it’s not meant to be then it’s not meant to be for me and that is okay I guess. Good luck with all of your tries too! And with your BFP @Clocloxx!! so exciting and I really wish you all the best.

Oh apologies! I mixed that up - good luck with your BFP @Nosejug and huge congrats on your pregnancy @Clocloxx !

At 35 my AMH was 2.3 and I had 5 follicles. We also had male factor and a genetic issue to contend with which meant any blastocysts needed testing to see if viable. Doctors quite negative. I felt like we were almost told off for wanting to try with our own egg/sperm and not going straight to donor! The doctors made me feel like it was hopeless. Anyway, I made some lifestyles changes - lost weight, limited alcohol, took DHEA and CoQ10 supplements. Had acupuncture weekly during just before start of egg stims. Thought should have started earlier really.
After a month of egg stims (my follicles took ages to respond) we had 4 eggs collected, 1 fertilised and was healthy. Months later I had a frozen embryo transplant, continued acupuncture throughout the process, got a positive pregnancy test. Now have a baby girl!
It did seem hopeless and impossible and I got there. I hope my story can give you some light and encouragement. Wishing you all the luck in the world!

Update for everyone, we got 5 eggs with 2 fertilised and none made it blastocyst stage. So my feeling at the beginning was correct.

But I am doing okay, I was very disappointed when we heard this morning en route to our transfer but that was at 9 am and it’s now 11 and I’ve just moved on. It is what it is. We can leave it at that. It wasn’t meant to be.

I’m sorry to hear that. 5 eggs was a really good result, especially with your previous 4 follicle count, you must have had more this time. I’ve never got more than 3 eggs despite more follicles.

My recent pregnancy failed, it was between ectopic (most likely) but officially recorded as a pregnancy of unknown location. It’s taken this long to get my period and begin trying again (waiting for ovulation and also gearing uk for ivf). I now have very very low expectations for the very expensive ivf, but feel that I don’t want to live with regret, and since this our first self funded round, it’ll serve as our last ditch attempt. After that I’ll ttc naturally still, and consider donor egg ivf but I’m still conflicted on the matter.

are you going to continue to ttc naturally? You’re still relatively young. I understand wanting to stop, especially with assisted conception. You were worried about doing ivf right? Was it ok at least in that respect? You’ll at least know you properly tried x

Thanks for your response and I am so sorry to hear about your loss. That must’ve been very difficult. That sounds like a good plan for you guys, if you have it in you for one more attempt.

Well I had 14 follicles during sticks so 5 eggs was lower than expected on day of egg collection. Drs kept praising how responsive I had been to treatment and were very excited about it so it was a bit of a blow. I really didn’t expect to get that many and then they kept saying the numbers 11-14 so I was hopeful we stood a chance of having some back up embryos in the freezer and then nothing.

And I actually found it really straightforward! I wasn’t suffering to many side effects. It’s just the constant ever changing nature. You get one piece of good news and then you are just walloped in the face with some disappointing news. It’s just too much that way. I also really wasn’t expecting it to work and everyone was so encouraging it started to make me think perhaps it would, so I am feeling really stupid and annoyed at myself for not listening to my gut. Plus I know that once we actually would get to transfer stage there’s too much potentially that can go wrong beyond that. I don’t think I can take it. I’ve been doing a shit job at work because I’m so distracted with it and I can’t sustain that. With regards to naturally, I have thin lining and issues with cervix and all sorts so I just think it isn’t an option. I’ve been off contraception for 7 years and have never had even the faintest of a positive test.

You are so strong to keep going on, it is such a tough journey. I really admire your strength and I am so hopeful you get your baby at the end of it all. Send lots of luck and love your way. Let me know how you go with it all xxx

Sorry you are having such a hard time @Iggilypiggily it’s such a difficult process to go through, you are doing amazingly! One question to consider - has your partners sperm been checked with DNA fragmentation, not just standard sperm test? It’s not just the number of eggs collected but also the sperm. Something to ask at your follow up. Xxx

Thank you, that is useful to know. I certainly will ask that. We also missed out on our final dose of stims medication which was supposed to help my smaller follicles get over the edge and grow enough to be collected because the pharmacy delivered us an empty box which was frustrating and did make us feel a lot like we had messed it up. We opened a seal medication box to find it had two boxes of pen tips and no vial of medication. So we can’t help feel a bit let down. Even though that is likely not to have made a difference, it will always feel like it might’ve.

Gosh I’m so sorry the pharmacy let you down like that @Iggilypiggily i’d be fuming! Can you take it up with them surely some compensation should be offered. They more than let you down and they have a duty of care to ensure correct medication is delivered particularly something as important as this. Also if get all your questions together for your follow up. I’d be asking in more detail about the sperm quality, the embryo development (when did they start failing? / what were they like day 3 (how many cells?) sperm takes over from day 3 to day 5, so if the embryos slowed down from day 3 it points towards a sperm issue. All these questions will provide you with more insights into what is going on. The more info you have and understand the better informed decisions you can make. I hope you have a positive follow up and can make your next steps after xxxx

Thanks for such a sweet reply, I’ve been off Mumsnet a wee while and forgot how kind ppl are! My jaw dropped when I read that about the empty box… that’s terrible! I dunno how you feel about it (this was self funded right?) but I’d be making a complaint, as that was a prescribed part of your treatment, it’s not ok that they messed up regardless of it being a third party.

I also have cervix issues actually! I had to have mine dilated as it had closed over after a rather severe lletz, and that in itself is a pregnancy risk but I’m not capable of spending worry on that yet. I’m wondering if your issues are similar. I had 0 risk factors for ectopic so that was a blow, 100% a normal early mc over that any day.

if it’s any comfort or encouragement to you, my only two positives both came just after failed ivfs. First was immediately after, second two cycles after. I sometimes wonder if the poking around my poor cervix helped. I’m a bit older (39) and if I could have a few months break from trying I would, so I wouldn’t say I’m being strong, I just don’t have an option. Been spending a lot of time fantasising about running away recently…!

on the dna frag testing, I was asking for my DP to be tested by our clinic (low morphology), but they said it’s not a very solid science, that fragmentation changes test to test and is more a reaction to oxidative stress (I think that’s the term?) a lot of the treatment is lifestyle and supplements which hopefully your dp is taking on anyway (mine took a lot of gentle guidance!!!) I’ll add that our only two pregnancies have also been after stopping drinking (we both love to drink). If I end up not having children I will def be filling my boots at leisure.

Thank you so much. That’s really helpful, I will certainly take that advice on board.

I know, we will bring up the medication error at our follow up. My husband was so furious, I’ve never seen him so angry. I’m more angry in retrospect! But I’m already feeling better and am just leaving it in the past now. What’s done is done.

@Nosejug apologies, I somehow missed your reply and only seen Laura’s above it! Thank you for that, that is also really helpful to know.

We were private but Bupa funded which is a luxury I know, and I think has helped as we would’ve been even more fuming re the medications error if we had been paying ourselves. But I do think they are worried as they have gone to great lengths to show that they are investigating it with the pharmacy (which is an external company). We will bring it up at our review, my husband is not likely to let it rest! He will fight that corner to the end.

That is so useful to know, I have heard a few people say re post IVF positives. I’ve been off contraception 7 years and not even a whiff of a positive test even though we haven’t been actively trying that whole time. Re cervical stuff, I had two cell removals so a LEEP and another one I can’t remember the name of so they did tell me I was high risk due to significantly shortened cervix. I did think even if I did get that far it wasn’t likely to last but like you I hadn’t thought that far ahead really.

I am 37 myself so haven’t got much choice either. It’s either five up and accept defeat or keep on going with it. But we are the same - we don’t drink weekly or anything but we do love a cocktail or a wine and we have given it all up. Perhaps not as long as we should’ve, as we sortve decided to do the IVF quite quickly. But I just can reconcile all my healthy eating and giving things up and supplements with the fact that I have a friend who has gotten pregnant accidentally 3 times and once didn’t even know she was pregnant for 6 months and was at my hen party sloshed at what would’ve been 5 months. I’ve also got another friend who has had two abortions because she missed a pill and got pregnant both times… she then decided to try and was pregnant first go. Another friend got pregnant on her honeymoon first go. Another who has ovulation from one side only and got pregnant in 2 months both times, and all of the above are smokers, party heavily, some of them are drug takers and not one of them exercises or has been as healthy as we are. My husband and I are at baseline very active and aside from cutting out alcohol I just increased a few fertility friendly foods in terms of how regularly I eat them but they were all things I ate weekly anyway. So how on earth are all these desperately unhealthy people just getting pregnant by accident?? Half of them weren’t even trying. And we can’t even make 1 blastocyst?

I have low AMH but my husbands tests were all above average. Like I said, my lining is ‘on the thin side’ and cervix was closed during a rather horrendous saline sonogram which makes me think it’s quite closed often. So it’s all me it seems.

Keep me posted on how you are going. When is your next IVF run? I have no idea how I could manage another run with work as I work for the NHS and they don’t allow for fertility leave so I’ve had to pretend I was having some surgery. I also had stims for 14 days so in terms of scans etc I couldn’t just do it via a fortnight off. The most stressful part of the experience was navigating work during it.

Oh god I know what you mean in so much of what you’ve said! The partying friends living it up and simultaneously having their families. I’ve a friend who wasn’t even trying and had operations for fibroids and is 40 and accidentally got pregnant, she just gave birth recently to her beautiful first baby. I mean if ppl addicted to drugs or who drink heavily don’t exercise and eat nothing nutritious can produce offspring, there’s def something different here isn’t there. I very much wish we had couple friends going through it as it’s lonely, very lonely. We’re also a baseline healthy couple but who like to share crisps and wine! I’ve given up running in case that had an impact and have soft-given up my career which was just starting to blossom, but was using a lot of chemicals and paints and is impossible to take time off from once your on a job. That part has been v hard (I’m now doing random online work just so I don’t dip into savings which, let’s face it, are all going on baby making.)

wow the bupa thing is cool! If I wasn’t end of the line I’d be considering getting health insurance! Unfathomable that the nhs don’t allow for time off for ivf?! But I’m with your DP, hold them to account. It’s not just about money, but emotional toll and hugely about trust. I can’t let it go that the builders used cement when they told me they’d use lime mortar, I can’t imagine the fury I’d feel with someone impacting my ivf treatment. (Like you say though, it likely wouldn’t have made a massive difference, but that’s not the point at all.)

next ivf will start in my next cycle, so pretty soon. 3 back to back low stim cycles freezing all then implanting anything that has survived. Honestly I pretty much think it’s a massive waste of money and unlike my other cycles I’m kind of dreading it but I guess I can’t live with regret I might end up feeling. I worry too that if I decide to go for donor ivf I will regret not having done it asap.

so much to think about all the time, it gets kind of dull being sad!

It is good to know that someone else is around the same age, also likes crisps and wine and has been going through the same with similar enough issues! I do run, swim, cycle and do yoga and Pilates (I prefer them both hot) so I’ve given up all that as the consultant told me I could walk really and that is all which doesn’t help. The yoga / Pilates was more risk of torsion which I get and running / cycling due to the effect on ovaries but also apparently it can help shed lining. I want to start up again but I am also wondering but what am I doing to my eggs etc. And my husband is at least getting that outlet which I’m not, as once he has done his samples he could return to the gym. I see no point in going when I can’t do any of the things I enjoy. So I’m also feeling just a bit unhappy about my body generally - not only has it failed us both but I don’t like the way it looks right now either or the way clothes feel on me.

I found a podcast I was listening to where they were going through IVF while they were recording and one got pregnant first time, one on second FET transfer and they are still recording and are determined to not make it a pregnancy podcast but I’m like give it up! No one wants to listen now you’re on the other side. And they were complaining about being disappointed with like 10 eggs retrieved because they thought they would get 16 and I was just like oh shut up!! You’re so whiny and you’re entitled to be sad but there are so many people in a worse off situation who would never stand a chance of getting those numbers so perhaps be grateful!

A friend of a friend is also going through it at the same time as us, which as been helpful in a way, but she got 3 embryos and they are going to do transfer in a few weeks. So now it’s not particularly helpful to have that happening in parallel to us also.

The Bupa thing is through my hubbys work. He has paid for 7 years out of his salary to have my health cover and it is quite rare to have IVF but he’s probably paid more than the IVF costs if you work it out so it’s one and the same really! But we wouldn’t have done this run without it. I think we might have enough for another or at least the bulk of another run if we add to it a bit.

Sorry to hear about your career. I’m interested to know what you do? It sounds creative. It so tough we sacrifice so much, when all those mad one’s around us give up nothing and then often don’t even treat their kids well when they get them! And we are over here making all the sacrifices for what feels like nothing.

We did this run because of our age and also because we thought we would regret it we didn’t try, but today I am regretting trying as I preferred being in the ‘it will happen when it happens space!’ At least there was still some hope there.

@Iggilypiggily hope you don’t mind me jumping on this thread but was going to say I have lower AMH for my age and have had some success but I suppose each person is different. If you go in for a second round they have more information on what did and did not work but totally get it if you are done with one.

I know EXACTLY which podcast you are referring to. The lady who had the failed transfer kept on talking as if her entire cycle had failed but she had three embryos in the freezer. This was at the time I had had a totally failed cycle and nothing to freeze so it really grated on me. My second cycle from April was much better (I took human growth hormone which I think made the difference).

As a side note, I was an angel for my first round in Jan/Feb. My second round April/May I drank all the way until my transfer and ate like shit. Work was also way more stressful. First round was pants second round much much better so it really is all about the meds you are on in my opinion.

I hope you are ok! The pharmacy muck up sounds insane but I have heard of people going to do their trigger and their meds not being in the box!!!!!!!

No, please do join! Omg that is horrendous re the trigger. Our meds was our final dose on trigger morning, so we originally were meant to go pick up some and take it and then the consultant was worried it would cause me to ovulate so in the end we had to do without. We have learnt our lesson though and checked every single box from then on when checking stock. What happened to the poor trigger people? Did the whole round fail?

This is true, thank you. I’ve heard of people saying they drank and did all sorts in their final round, hot yoga and running and everything and they were the most successful that time round. Whether it’s to do with you being a bit more relaxed or something I don’t know. We have taken the day to think about it and I think we will go again, but plan to stay on this healthy diet until the next go. It can’t hurt to avoid alcohol and cut down on sugary foods for another month or two. Where did you get your hands on the human growth hormone? So many people keep mentioning hormones and supplements on here that I haven’t a clue about and I don’t even know where to start.

Ugh the podcast infuriates me! Glad someone else felt the same. It was useful when I was just about to start IVF as I listened to it to know what lay ahead but it has served its purpose, no one wants to listen to two pregnant women interview IVF specialists. And they were obviously entitled to their own feelings but they were so negative and doing waay better than I knew I ever would. And then when the second one announced her pregnancy at the beginning of the episode she said something like ‘yeah, move along if you can’t cope with a positive pregnancy announcement’ but it was the giddy way it was said which I do think came from nerves but it felt so rude. I didn’t even find it hard to listen to a positive pregnancy announcement but I switched off there and then.

and I am doing okay! I just let myself be sad yesterday (you can see the anger and resentment in my earlier posts, ha!) but I am feeling better today. My husband is worse off today. But we will be fine!

Yep it meant they couldn’t do their egg collection. Awful!

Ask your clinic about whether it would work for you as they would need to prescribe. I got it through Stork and was on norditropin.

I listened to that ep and it was a very weird one tbh - still quite negative. It was very useful at the start and then yes when the second lady didn’t get pregnant on her very first go (honestly hardly anyone does) it just changed .. or maybe I had changed because I was like whelp yep me too but I’ve got to go through another round of stims again 😆.

Glad you are doing ok. It really is a rollercoaster!