Follow Up Appointment Update: Feeling Optimistic

Well, we went for our follow up appointment on Thursday, the 19^th.  It was a really good appointment.  Dr. Amols began by apologizing for not getting us in sooner.  His mom died and he went away for her funeral. 

He was disappointed and discouraged that I was not pregnant.  He was surprised that I didn’t respond better to the protocol I was on, especially since it was a very aggressive approach.  He allowed us to ask questions.  The following are questions I asked were:

Are my chances of IVF being successful in the range of a 28 year old or 40 year old since that is how my body responds?

My chances of it being successful are not that of a 28 year old because I am a poor responder, however my eggs are young.

Will my egg quality always be a C grade, or can it be different next time?

Egg quality can vary cycle to cycle.  If I had 30 or more eggs removed and they were all C quality, then it might be fair to say that my quality is poor.  However, we only retrieved 7 therefore we can’t accurately say my eggs are poor quality.  We just got a small sample. 

Can Lupron suppress or affect egg quality?

        Yes, it can.  However, no research proves it.

Should I take DHEA?

It is not proven that it works to improve egg quality.  Hs wife took it and her quality was really good however, there is no proof it was from the DHEA.  He explained that he took his wife in every day 3 of her cycle.  If it looked like it might be a good cycle, they began with meds towards IVF.  They always turned it into an IUI because she didn’t respond well.  This past time, her egg count was the best (3), so they proceeded. 

Should I take DHEA now and then if this cycle doesn’t work, it’s in my system for next time since it should be in your system for 3 months?

If I took DHEA, I would need to stop after the transfer because if I have a girl, I cannot be taking a male hormone because it could transfer to the baby.  So, it’s not worth taking for 2 or so weeks.

Will my AMH level change and how quickly?

There is no known answer to this.  My levels will only get lower as time goes on, but no idea how quickly or what a .95 and .75 means.  Doctors just know that above 1 is good and below 1 is bad.  The lower you go under 1, is worse and worse but still unsure what those numbers mean.  My situation is time sensitive so we need to act now and not let time pass.  I shared with Dr. Amols this is why I don’t want to sit and wait around.  He is fine with us pursuing.

Our plan for next time is to do a different protocol, MLE.  This protocol is used for poor responders in hopes of getting one more egg.  For my age, it only takes one egg.  This protocol eliminates birth control and Lupron and replaces it with estrogen and ganirelix.  I have to call when I ovulate and have my blood taken 7 days later to check my progesterone and clarify that I did ovulate.  I will then begin taking estrogen.  Then, I will being meds on either Day 1 or 3 of my cycle.  I will still take menopur and follistm but will add in ganirelix towards the end of my cycle to ensure that I don’t ovulate early. 

So, we are currently waiting for me to ovulate.  I am on day 6 and have to start testing on day 9. 

We both left feeling very optimistic.  I read some negative things about Lupron so I’m glad we are trying a different approach without it.  I feel this could be the timeJ