IVF and Low AMH- next steps?

[KDwasJ]

Hi all, I’m wondering if anyone in similar shoes has some advice. I’m wondering whether to go into my sixth (and final) IVF round with my own eggs sticking to the same medication regime as before (high stim) or changing things up and going for a mild stimulation IVF protocol this time.
my previous history:
Started age 35, AMH 3

1st round, (Full stim 450 meriofert)
2 eggs
1 fertilised
1 day 3 embryo transfer
Failed to implant

2nd round (full stim 450 meriofert)
4 eggs
3 fertilised
Embryos deteriorated in Petri dish due to infection.

(Took around 6 months to apply for further funding from NHS Wales for third round in context of what happened to the embryos)

3rd round attempt 1 (full stim 450 meriofert)
Did not respond to stimulation and so did not proceed to egg collection.

3rd round attempt 2 (full stim 450 but split 225 Meriofert and 225 Gonal F)
6 eggs
3 fertilised
2 x good ( 8 cells 4 4; 4BA and a 4CA)
1 x average (5 cell 4 4) - later deteriorated

1 x Fresh embryo 4BA day 5 transfer failed to implant
1 x Frozen embryo 4CA day 5 transfer failed to implant

Now exhausted all NHS funding

Age 38, AMH 1.5

4th round attempt1 (full stim split across Meriofert and Gonal F again)

Did not respond to stimulation and so did not proceed to egg collection.

thanks :-)

You need to trial different medication and maybe test embryos or check uterus environment. It seems crazy to have had all those cycles and no real changes. Have you had other fertility testing besides blood work for amh and hormones? Are you now with a private clinic who can run more tests and trial new medications?

Hi @Miraclemuma03no not had any other types of fertility testing. Is there anything you’d recommend? My Understanding with uterine cavity assessments (like a hysteroscopy?) was that they don’t usually recommend one until there’s been recurrent embryo implantation failure (and I don’t think having had three counts as that yet?), however I am a paying customer now so perhaps I could ask for one. I have had a HSG before, both my tubes are clear.

I’m a private customer at the same clinic where I had my nhs treatment.

Hi, first of all, I’m sorry you’re going through this. Is the reason for the implantation failure the same each time? For example, if the issue is egg quality, you may continue to have difficulties until that underlying factor is addressed.

Hi @flippapthank you :-) The consultant has said that they think it’s likely due to the fact that I’m older, therefore my eggs are more likely to be chromosomally abnormal which can lead to implantation failure. If I was to go on to have more implantation failures they might then feel inclined to do further testing. I’m on lots of supplements to help with egg quality like DHEA, Impryl (now trying CoQ10 instead) Omega 3, Multivit, Vit D, and generally just trying to follow a Mediterranean diet x

I think if its embryo quality then its all about finding a good embryo. If you have no other underlying issued then maybe having eggs tested could be a possibility, its still not a guarantee but could save you unnecessary transfers with embryos that wont implant.