Drastically different responses to ovarian stimulation
2 Replies
jmr767 - August 26

I did IVF w/ ICSI in Feb of this year and I had a chemical pregnancy then had a medical miscarriage (never heard heartbeat, did not miscarry after stopping progesterone for 3 weeks - took cytotec) in April. My response to stimulation was good. 14 eggs retrieved, 11 mature, 11 fertilized. I tried another cycle in July and shockingly it was cancelled due to low response of medication. I had 8 follicles but only 3-5 measurable, growing slower than average and thin endometrial lining. My question/concern is, what is the likelihood of me having a good response to stimulation if I try again? I just turned 39. Is it possible that this last cycle was too soon after a miscarriage? Does a low response ever happen just as a fluke? I also discovered I had developed a sinus infection just as I was starting the stimulation shots. Could that have had anything to do with it? I'm looking for some hope! Thank you.


Dr Smith - August 28

As you get older, there can be considerable fluctuation in the number of follicles that begin to grow each cycle. The medications do not affect the number of follicles that start growing, just their rate of growth after they do start growing. So it wasn't a medication or protocol issue. Since how many follicles that begin to grow on a given cycle is age-related, but more or less random, it is impossible to predict what could happen on the next cycle. It was the right move to cancel the second cycle, particularly in view of the first IVF cycle being better. All I can say is "Try again and see what happens". Sorry I can't be more helpful, but mother nature has a tendency to be unpredictable - especially during hurricane season.

I don't know how long you should wait after a miscarriage, but the wait would have more to do with getting the endometrium in shape than ovaries. The sinus infection had nothing to do with the ovarian response. It was just miserable to go through.


jmr767 - August 28

Ha!!! Thanks so much Dr. Smith........and considering I live in North Carolina........this "Hurricane" season has been crazy....both on the ice and predicted to be in the ocean!



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