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Dr. Roseff,
I'd love another opinion. I'm 41 years old, with a prior history of infertility 11 years ago when trying to conceive my son. My problem then was irregular cycles ("most likely PCOS" according to my RE, but testing didn't meet all the criteria). So, I had one cycle prior to seeing an RE. We then did four clomid cycles and only ovulated once at 150 mg. We then moved onto injectibles and IUI. We did five of those cycles with no luck. They were all "perfect" cycles, according to the RE with anywhere from 3-6 follicles. Then, the next month, I actually ovulated on my own (didn't realize it) and got pregnant on my own...didn't even try to time things correctly. So, in all, I conceived on the 8th ovulatory cycle that I tried. However, my RE could never explain why the inj/IUI cycles were all bust, even though numbers, lining, follicles, sperm and everything seemed good. Subsequently, my husband and I divorced, and I didn't try to conceive again until this past November with a new partner.
At this point, my cycles are still irregular, but more frequent than they were 11 years ago. We saw the RE to start testing right away (different RE as my old one has since retired). My partner's (age 38) semen analysis was normal, though volume slightly below 2 ml. However, everything else was very good and total count was 117 mil. with two days abstinance. My 3 day tests showed FSH of 5.5, LH of 4.7, AMH of 8.3 (high) and estr. of 27. RE was very pleased with these numbers at age 41. So, we tried naturally in November for the first time and got a negative. Then the second time we tried naturally in January, we had a positive, but lost the pregnancy at 5 weeks. I'd had my progesterone tested at 7 dpo and it was 16.7 that cycle. The RE said it's common to have early miscarriages and chem. pregnancies, especially at my age. The RE then started me on femara since I had no luck with clomid earlier, and we diid an hcg trigger and timed intercourse. The first cycle of femera produced 3 follicles, but no pregnancy. My progesterone that cycle was 12.5, so they also had me do PIO starting on 7dpo. I'm on femara again this cycle and CD 13 today. I go for an u/s tomorrow.
My question is this. So far I've tried to conceive a total 11 times in my life. 7 of those cycles were medicated and I have had NO luck. Only 4 of those cycles were natural cycles and I've conceived twice, once resulting in my DS and once resulting in the early loss. But, I have to wonder if during the medicated cycle they are missing something, triggering too early for me, timing the intercourse or IUIs too late or early, or something else? I would continue trying naturally but given my infrequent ovulation and my age, I simply don't have the time. My lining always looks good. I want to say it was 11 or 12 when I triggered last month. It was always good last time around, as well. Progesterone was lowish, but not terrible... but we supplemented it during medicated cycles. The two times I got pregnant, I was on no supplements and it tested fine both times.
Our plan now is to do this cycle with timed intercourse. If it's a negative, move onto femara/IUI or femara/injectibles/IUI and try that for a couple months. If still no luck, we'll regroup and probably talk about IVF.
Any thoughts?? Is there something they could be missing? Thanks for your time.
Val
I'd love another opinion. I'm 41 years old, with a prior history of infertility 11 years ago when trying to conceive my son. My problem then was irregular cycles ("most likely PCOS" according to my RE, but testing didn't meet all the criteria). So, I had one cycle prior to seeing an RE. We then did four clomid cycles and only ovulated once at 150 mg. We then moved onto injectibles and IUI. We did five of those cycles with no luck. They were all "perfect" cycles, according to the RE with anywhere from 3-6 follicles. Then, the next month, I actually ovulated on my own (didn't realize it) and got pregnant on my own...didn't even try to time things correctly. So, in all, I conceived on the 8th ovulatory cycle that I tried. However, my RE could never explain why the inj/IUI cycles were all bust, even though numbers, lining, follicles, sperm and everything seemed good. Subsequently, my husband and I divorced, and I didn't try to conceive again until this past November with a new partner.
At this point, my cycles are still irregular, but more frequent than they were 11 years ago. We saw the RE to start testing right away (different RE as my old one has since retired). My partner's (age 38) semen analysis was normal, though volume slightly below 2 ml. However, everything else was very good and total count was 117 mil. with two days abstinance. My 3 day tests showed FSH of 5.5, LH of 4.7, AMH of 8.3 (high) and estr. of 27. RE was very pleased with these numbers at age 41. So, we tried naturally in November for the first time and got a negative. Then the second time we tried naturally in January, we had a positive, but lost the pregnancy at 5 weeks. I'd had my progesterone tested at 7 dpo and it was 16.7 that cycle. The RE said it's common to have early miscarriages and chem. pregnancies, especially at my age. The RE then started me on femara since I had no luck with clomid earlier, and we diid an hcg trigger and timed intercourse. The first cycle of femera produced 3 follicles, but no pregnancy. My progesterone that cycle was 12.5, so they also had me do PIO starting on 7dpo. I'm on femara again this cycle and CD 13 today. I go for an u/s tomorrow.
My question is this. So far I've tried to conceive a total 11 times in my life. 7 of those cycles were medicated and I have had NO luck. Only 4 of those cycles were natural cycles and I've conceived twice, once resulting in my DS and once resulting in the early loss. But, I have to wonder if during the medicated cycle they are missing something, triggering too early for me, timing the intercourse or IUIs too late or early, or something else? I would continue trying naturally but given my infrequent ovulation and my age, I simply don't have the time. My lining always looks good. I want to say it was 11 or 12 when I triggered last month. It was always good last time around, as well. Progesterone was lowish, but not terrible... but we supplemented it during medicated cycles. The two times I got pregnant, I was on no supplements and it tested fine both times.
Our plan now is to do this cycle with timed intercourse. If it's a negative, move onto femara/IUI or femara/injectibles/IUI and try that for a couple months. If still no luck, we'll regroup and probably talk about IVF.
Any thoughts?? Is there something they could be missing? Thanks for your time.
Val
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