I'm not sure if this belongs here or under TTC, if it should be moved please do so.
When we first started trying for #2 we had been delayed by some health issues with DH so we were about 6-8 months later than we had planned. I knew that with my AMA (38 about to be 39) that if we had any issues that we’d be referred pretty quickly to a specialist. I always heard to wait 6 months if you are older and TTC doesn’t work and 12 months if you are of younger age. Well, I had my yearly visit with the lady dr and I mentioned we’d been trying for a few months with no luck. She asked how long it had taken for LO#1 and I told it was the first month.. (wow, looking back what a lucky deal that was!!!) Anyway, at my yearly we had been trying for 5 months. Dr immediately referred me to the local, well known fertility specialists. I was nervous and discussed it with DH and he was on board bc I was worried. I remember crying to him on the phone after I left the Dr and saying I was soo worried I wouldn’t be having another baby ever, so I made the appointment.
In November we met with our RE specialist. He explained that nothing could really be done or discussed until we had the initial battery of tests that most everyone who walks into an RE office has.. Blood work for both myself and DH, HSG for myself and ultrasound for me. Nov 17, my ultrasound showed endo thickness of 4.5 and 9 follicles over 10 mm (23.2, 17.7, 14.4 on the left and 28.5, 19.9 and 11.5 on the right). I was told this was good and sent on my way. Of course I checked dr google and I was somewhat pleasantly happy with the 9 follicles, not too bad but also not the greatest either. Nov 23, I arrived for my HSG. My blood pressure was sky high (I have chronic borderline high bp and take daily meds) and they almost didn’t do the procedure but I did some deep breathing and was able to get my bp down enough for them to do it. It was very similar to a pap, I felt some pressure from the fluid they pump into your uterus and then they showed me the fluid as it spread through my uterus and into my tubes and out to me ovaries. All was clear, no blockages and then it was over. Took approximately 2-3 mins. I was sent home. My blood work had also been drawn back on Nov 17. I got the phone call that my labs all looked normal, except my FSH was slightly high, but the nurse said all was a go for beginning treatment. Like a dummy I didn’t even ask what my FSH was. I had to call back and she told me it was 12.3, they like it to be below 9. She never mentioned my low AMH or anything else but I have since found out my AMH was .021, which is very low. It should be .42 - 8.34 for woman ages 36-40. DH’s sperm analysis came back normal.
We had a meeting with the RE where he told us our results. He suggested we do a few rounds of Timed Intercourse (TI) with clomid and a trigger shot. I was cd4 at that apt so he asked when we wanted to start. DH and I said asap and that meant THAT DAY!!! We probably should have taken a month to think it over but we jumped right in. We went from the RE to the nurse and went over our instructions and how I could pick up my meds for that night at CVS but that I had to order the rest from the freedom pharmacy and they’d deliver them to me. I got instruction videos on how to inject myself (what?!?!?!). I took clomid cd4-cd8. I took 150 injection of gonal f on cd7 and again on cd9. I had a monitoring apt on cd11, endo was 6.5 mm, and I had 2 follicles, 16.5 and 12.7. I was told to trigger that night, so I gave myself the ovidrel shot and TI that night cd11 and then again in the am of cd13. After we had our TI I had to start inserting progesterone suppositories vaginally until my beta. I waited the TWW and went for my beta, naively excited, it was negative.
Cycle 2 same protocol. Clomid cd3-cd7. Gonal F cd7, cd 9. Monitor on cd11 and I had 5 follicles. (12.2, 6.5 on lft and 11.5, 11.1 and 7.3 on the right). I was instructed to do another shot of gonal f that night cd11 and monitor again on cd12. On cd12 they measured 3 follicles (? Not sure what happened to the other 2, guess they fell short) 12.2 on lft and 14.5 and 12.9 on right ovary. I was instructed to do another injection of gonal f on cd13 and monitor on cd15. Cd15 I had 8 measurable follicles (?—these records seem confusing) but only 4 were measured….. left ovary had 18.8 and 11.4 and right 12.5 and 22.4, endo was 8.2mm. I triggered that night with TI cd15 and cd17. My tracking app also gave me cross hairs on cd18 and I was excited bc I thought we had timed this cycle perfectly!! As before I started the progesterone suppositories. Beta on Feb 11, negative.
Cycle 3. Clomid cd3-cd7. Gonal F cd7, cd9. Monitor cd11 and I again had 5 follicles, Left ovary 16.4, 13.4 and 12.2 and right ovary 21.3 and 15.4 but my endo was only 5.0, not so good. Clomid can cause your lining to suffer. I was told to start estrace vaginally twice a day to help my lining, gonal F cd11, monitor cd12. On cd12 my endo had gone up to 7.3mm! That was great news. My follicles were left 19.8, 12.8, 13.6 and 11.3 and right 24.4 and 17.6. I triggered that night with my shot of ovidrel and TI that night cd12 and cd14 in the am. Again my tracking app gave me cross hairs on cd14 so I was again very hopeful bc we had again had great timing. Progesterone suppositories. I took a pregnancy test on cd27 (13 dpo) and I saw a faint line! I texted my two friends who had been my support system and they both saw it too!! I was cautiously optimistic. I decided to test again in the morning with a first response. And… it was stark white. Beta on cd30 was also negative. Not sure what that line was, maybe an evap or maybe a chemical?? Not sure.
We were told to meet with the RE at this point to go over future treatment. He printed out my percentages of success with IVF and gave us the costs. It was very dismal. The percentage was less than 10% success rate for one round I think it went up to about 35% with three rounds of IVF. My projected egg retrieval was about 1-2 eggs per cycle. The RE did however say he thought I’d do better than that bc thus far I had been responding well with an average of at least 5 good follicles each time. But the cost he quoted us was what sealed the deal. He said for one round it would be $14k-$17k plus about $6k for meds. That’s $20k for a 10% success rate??? Wow, we couldn’t wrap our heads around it. He did offer a two round IVF package for $18k plus meds for each cycle ($12k) or approx. $30k for two rounds. We were not offered any type of refund program, like if it didn’t work we’d get a percentage back or other options. He said we could continue on though and try IUI. However, with no male factor it really wasn’t too much different than TI. Although it would cut out a few things such as the sperm having to navigate through the cervical mucus and it would guarantee the spermies were there to meet the egg. But if there was some issue with fertilization or something IUI won’t help with that.
Because I hadn’t been able to accept us quitting we moved on to IUI. RE suggested 3 rounds at most and then revisit.
Cycle 4. Clomid cd3-cd7. Gonal F cd5, cd7, cd9 monitor cd11. I had 5 follicles, left 15.5, 12.5, 9.5 and 9.0, right 5.8, endo was 5.7mm. I was instructed to do another shot of gonal F that night cd11 and monitor on cd13. On cd13 my endo was 6.7mm and 5 follicles on the left (not sure what happened to the one on the right).. 16.5, 21.8, 11.9, 10.9 and 10.7. Took gonal F that night again and started estrace vaginally twice a day again to help with my lining. Monitored again on cd14 and my follicles had grown to 18.6, 24.3, 11.6, 13.7 and 14.4. My lining was only 6mm though. I triggered on cd14 and my IUI was set for cd16 (my birthday!! Has to be lucky right??). That morning DH collected his sperm sample and I dropped it off to be washed. My IUI was set for 1.5 hours later. I was feeling sick so I went to the store and got some meds. The IUI process was quick and painless. Took about 2 mins and then I was told to lay there until the clock dinged (5 mins). I went home and napped the rest of the day bc of my being sick. Progesterone suppositories. Beta on April 15 was negative.
Cycle 5. Clomid cd3-cd7. Gonal F cd5, cd7, cd9, monitor on cd11. I had 4 follicles only one measurable (it seems to be getting worse, not better for me). My follicle was on my left ovary and was 12.6mm, endo was 3mm I was told to do gonal F cd11, cd12 and monitor cd13. On cd13 I had 3 follicles, left 15.7 and 8.2 and right 8.9. My endo was 5.1. Monitor on cd14, follicles 8.8 and 16.6, endo 4.6mm. Monitor on cd15 follicles were 18.2 and 9.7 endo was only 3.8mm. I was told to trigger that night. I was worried my lining wasn’t thick enough, I was pretty over this cycle. I had been to the dr 3 out of the 4 past days and I was over it. IUI was done on cd17. Same as before, no pain, very quick. The nurse commented on how great DH’s sperm count was. And I replied that I knew, the issue is with me not him…. Smh. Progesterone and estrace suppositories. Beta on May 17 was negative.
That week we traveled out of town for a funeral and I really started to do some soul searching and praying. I realized how blessed I am to have LO#1 and that maybe I was trying to control this issue too much and I just needed to let it go. But I couldn’t. I asked DH if he was ok with me to get a second opinion and he said whatever I needed to do. So I sought out some recommendations and found a great place nearby my work. I set up the apt and requested my records from my RE. The apt came and I went in. I explained my situation and the dr was great. She listened and she basically told me it was up to us how far we wanted to pursue this and what we would be comfortable doing. She didn’t push me in a certain direction and she gave me their options. At their clinic I could do a mini IVF for only $8k plus meds which would be about $3k. This was way more affordable and I’ll be honest when I walked out I was pretty sure we’d do it! They also had other packages and I could do any of them. There were no money back packages though. Well I left that apt and then days past. Yes, days before I really talked to DH about it. I don’t know why or how it happened but for some reason I think I was still working through accepting we were done with only one child. I finally brought it up to DH and we talked about it. And as before he was willing to do whatever I wanted. He was fine being done and was happy with LO#1 and our family as is but if it was important to me then he’d be ok with it. I of course ended up in tears telling him how hard it was to give up that “plan” of two kids. I finally started to tell friends that it looked like we were done. And it happened while talking to one of my coworkers/friends who is very pro more than 1 kid in a family. I told her our struggles and she flat blank told me to stop treatments and be happy with what we had. For some reason it was like a light went off and suddenly I just felt ok. Maybe it was bc all my other friends and family who were aware were “supportive” of the treatments (my mom even went so far as to offer to pay for treatment) and this friend said exactly what I needed to hear.
That weekend I went to the beach with a friend and she inquired about us having more kids and I told her we were done and when I told her I felt good about it, like no remorse or sadness! I ordered a book from amazon about having and being an only child. I told DH I was good with our happy family of three. We were done treating. After five cycles and thousands of dollars, injections, blood work and meds we were done.
The very next cycle I expected to be wonky bc I’d been medicating myself for 5- 6 months. So I just waited for AF to arrive. On cd34 right before I went to bed I decided to poas.. just bc I had plenty of cheapies left over and well bc it was cd34. I fully expected it to be negative and that I was just having a really long cycle… holy moly! It was positive right away! I started shaking and I swear almost passed out. I took another one in the morning and I called the RE to have blood work taken. That afternoon at 130 pm it was confirmed I was pregnant!! I am currently 9w1d. We have a long way to go but here we are.
I wanted to write this long drawn out post because when I got my results, the high FSH and low AMH I searched and searched for people like me and their stories. It was very few and far between that they actually turned out happy. I found maybe 3-4 happy endings with numbers like mine. It was hard to find people with similar numbers so just in case someone out there is looking I wanted to share this! It is possible. Even with my bad “numbers” I still did respond fairly well to treatment. And somehow got pregnant 100% naturally so even if you have DOR there could be a few good eggs in there still! I want everyone to know that this is in no way a pro “stop treatment” post. I believe that everyone has to do what they feel is necessary.
This whole experience has opened my eyes to so many things about infertility. I give my hugest kudos to those who have dealt with, are dealing with it or will deal with it in the future. It’s an emotional, physical and financial roller coaster. All my best.