Yesterday was our second appointment with my fertility doctor, Dr. M.
I got my Fertilome test results back. I have two genetic variants that are associated with a moderate risk for disorders associated with infertility – one for premature ovarian failure, and one for endometriosis. I don’t have the latter (as far as we know) but oh yes my ovaries are prematurely something. Dr. M says they are functioning like a 40 year old woman’s ovaries (I’m 34.)
The test results are good as far as we’re concerned because we already know I have diminished ovarian reserve (DOR) and now I know it’s not my fault. Now I know it’s not because I’m fat or because I used to smoke cigarettes.
We also reviewed my latest lab results. Dr. M says that my FSH (follicle stimulating hormone) of 2.2 is probably suppressed by my elevated estrogen, and that my true FSH is probably closer to an 8 or 9, which is actually good, and from what I’ve read, not the norm for people with AMH as low as mine. But since my AMH is so low now (<.03) Dr. M recommended IVF with preimplantation genetic screening (PGS). Great! But I’m too fat for IVF at the moment, which I already knew, which is why I am working on my weight.
So the treatment plan is to do IUIs starting with my next cycle in two weeks, until I either get pregnant or lose the weight to do IVF. My IUIs will be with Follistim, HCG trigger, and progesterone suppositories.
The upside: we have a treatment plan, my DOR is being taken seriously, I’ve only got 18 pounds to lose before I am eligible for IVF (though ideally I will lose more than that), we are going to get to see how my ovaries respond to stimulation, and we’re not wasting any cycles while I lose the weight. Also, I’ve only been taking DHEA for a month, and only been doing acupuncture and wheat grass/antioxidant smoothies for a month, so my eggs need this extra time to get into better shape, too.
The downside: My AMH is so low that the best time for IVF was probably two years ago. I have serious pressure to lose weight and I feel angry with myself that my weight was never too high for IVF until the last year or so really. Also, I know that our chances of success with IUIs is slim. I know that our chances with IVF are slim, too. While I feel like I have some resolution because I have a diagnosis and a treatment plan, this is far from being resolved and while I feel like we have the solution, we’re actually just starting the next chapter in our infertility journey. We may need to eventually move on to chapter three: donor eggs, and my husband and I both need to make some peace with that along the way in order to be able to stomach my own eggs failing us, in case that possibility becomes a reality. I also know that if we do conceive with either IUI or IVF I have a history of miscarriage and I don’t know at what point during a pregnancy will I ever feel safe from that again. My husband is confident that we will get pregnant with IUI. He is always the optimist and I tried to talk to him about our chances of conceiving and he just has complete faith this will work. I am worried he will end up feeling very let down again.
Infertile Eggs 
I am sorry you are going through this. It’s not an easy thing to go through.
I have the same diagnosis, diminished ovarian reserve, and I am the same age. I’m curious if the doctor said what your chances are of conceiving? My doctor gave us a 10% of ever conceiving.
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She didn’t give me odds, and I was too afraid to ask though I should have. I also don’t know if she could even say since I have conceived naturally four times and just lost them all. I keep reading about women with DOR being unable to conceive, so she thinks my eggs just suck.
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I’m always curious what different doctors say for women with our condition. From reading online it appears there is a wide range of opinions, and sometimes a lack of knowledge.
I am hoping for the best for both of us!!
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I have DOR and we went straight from IUIs to donor egg IVF, as we want to have the best odds. Just think of it as adopting an egg and still getting the opportunity to be pregnant… then read up about epigenetics, which is what was the turning point for me. Yes there is grief and letting go of the dream of using your own eggs, I have been there myself, but for me in the ultimate scheme of things this had the better odds.
As a side note they should not be refusing to treat you based on your weight. Telling a patient they have to lose 18 pounds in order to treat them as absolute discrimination and has no scientific basis – weight is an issue in less than 10% of all infertility cases and BMI is an antiquated measurement that does not actually measure health. Along with that, if you go to donor eggs the risk is almost non-existent because you’re not using your own and your only goal is to make sure you develop a good healthy endometrial lining.
My AMH by the way was .002 and FSH 18… a crappy formula…
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I have read about epigenetics which was also something that made me more willing to use donor eggs. My husband is not sold on it yet. My insurance covers IVF but if it didn’t I might not be willing to give my own eggs more than one try.
I do believe that you can be healthy at every size, but my insurance only allows me to use this clinic (university provided insurance to use university hospitals, doctors, etc) and a friend of mine who also goes here has the same issue (with another doctor) and I know I won’t get them to change policy. I looked up a lot of research on BMI and IVF outcomes and it doesn’t seem to correlate with less successful outcomes so I’m not sure where these decisions come from.
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I hate that they use weight to blame on everything! I’m slightly over weight and I had my first IVF appointment three months ago. I was shitting it, I really thought they’d blame me and my slightly over weight status. It turns out its not me! Yes we’re still in the same boat but I can’t stop blaming myself for our problems!
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