Ovarian reserves
1 Replies
jparrish - April 24

Dr. Jacobs,

I am 39. I have not had a problem becoming pregnant naturally. In the past 4 1/2 years I have had 6 pregnancies: #1 early miscarriage, #2 live birth, #3 and #4 early miscarriage, #5 tubal pregnancy and #6 early miscarriage (trisomy 12). I have only one ovary, the other had a wedge removed 10 years ago. I am attempting IVF with PGD because I am a Duchenne Muscular Dystrophy carrier (my son has DMD).

My Day 3 FSH is 6.4 and estrogen is 19.

My first protocol was birth control pill / Lupron overlap. I started with Gonal-F = 300 and was increased to 225 twice a day. I started with 3 follicles and only 2 grew. My estrogen got up to 153 on stim day 7. Cycle was cancelled.

My second protocol was Lupron microdose flare. My Gonal-F = 300 twice a day. I got up to 6 follicles, but only 2 continued growing. My estrogen got up to 737 on stim day 11. Cycle was cancelled.

My third protocol will be Gonal-F = 300 twice a day with no Lupron.

My Day 3 numbers do not indicate a low ovarian reserve. According to my IVF nurse, my clinic does not routinely count and record an antral follicle count, but she said they look at ovary and would have noted if it looked small. It seems like the follicle count is standard practice, so I plan on asking my RE why it is not done.

In your experience, do you often see good Day 3 numbers along with a poor follicle count?

Thank you.

 

B. Jacobs, M. D. - April 24

There is a great deal of variability, but antral follicle count seems to be a more sensitive determinant of ovarian reserve.
Good luck.

 

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