QuestionI am 29 years old and have an amh of .36 and fsh of 9. In my first ivf cycle I only produced one dominant follicle. My doctor used the flare protocol with 450 follistim 225 menopur and 10 units of Lupron nightly from day 4 of cycle. The month prior i was on bcp, estrogen, and testosterone patches. That cycle was converted to an iui and was unsuccessful. The same protocol was followed for my second cycle, but this time I had 2 follicles that were around 20mm each and one around 12mm. We went for the retrieval and the doctor found no eggs. Why were the follicles empty? Is there anything that can be done to besides turning to donor eggs at this point?
AnswerHello Julie from the U.S. (Illinois),
I cannot tell you why no eggs were retrieved. There are many possibilities. You are considered "poor responder" meaning your ovaries do not respond to stimulation well. In addition, your decreased amh and elevated FSH levels indicate this as well and we call that "decreased ovarian reserve". The one good thing is that you are young so most of your eggs should be good quality, and it only takes one good egg to have a successful pregnancy. So, at this point, you have two options, you can continue with trying IVF using your own eggs and expecting that it may be difficult because so few follicles are produced, or you can proceed to donor eggs which will increase your chances because there will be more eggs to choose from.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf. Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate
