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diminished ovarian reserve
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diminished ovarian reserve

I am 30 years old. I have diminished ovarian reserve. My FSH on day 3 was 8.6, so we did the clomid challenge test, which my FSH on day 10 was 14. My dr. said there are still many people who get pregnant with diminished reserve and that my age is a big facto. She said we need to be very aggressive and waste no time. I have read everywhere that with diminished reserve your chances of pregnancy are 5% or less. Now, the round of clomid I was on for the test gave me a perfect follicle, 24 mm and another smaller one. But it thinned my lining too much. So I am on Femara, I have two mature follicles, one is 26 mm and the other 18 mm. My question is: since I am showing I am stimulating well to the fertility meds, does my chances of having a baby go up past 5%? Everything I read with diminished reserve says that it is very hard to stimulate the ovaries to get them to produce follicles.
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Avatar_n_tn
babysomeday,
ovarian reserve testing better reflects the number of eggs left in the ovaries than how viable those eggs are. in women over 35 depleted ovarian reserve does tend to correlate pretty well with egg viability. in younger women, however, this does not always hold true.  younger women may respond less well to ovarian stimulation for reasons other than ovaries depleted of eggs.  
for women under age 35, therefore, age is a better predictor of egg viability than ovarian reserve testing.  and you are nice and young.  combined with the fair response to femara, i would predict a higher success rate, perhaps closer to 15% per month. this still may sound quite low, however, recall that the fertility rate per month of young, recently married couples with no fertility problems, trying to conceive is only 20%. so go for it.  
there are caveats to this-  some young women may undergo premature ovarian aging from smoking cigarettes, prior chemotherapy or genetic conditions.  one genetic condition you may want to consider is fragile x syndrome.  a carrier of fragile x syndrome can experience early loss of eggs, and in this case, a baby born to a mother with this condition would be predisposed to mental retardation, particularly if the baby was a boy. fragile x testing can be done on your blood.  
i hope this helps.  
david
11 Comments
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Avatar_n_tn
I was told in my early 20"s about my premature ovarian faiure. I just turned 39 in December. To my suprise after 18 years of marriage I became pregnant. Sometime in September I conceived. I did not know I was pregnant due to no regular cycle. No morning sickness. Was on birthcontrol at the time so the idea never crossed my mind.  I found out in Januray I was expecting then the next week he was gone. I had him the last week in Janurary. Cause of stillborn is unknown. At my age I do not know if I will every have a chance to conceive again. So it is possiable I am proof.
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183933_tn?1290220562
I don't know where you live, but I am currently doing IVF at an fertility center in San Francisco and they deal with a lot of low ovarian reserve ladies. I think it's a specialty of theirs. Like I said, I don't know where you live, but you may want to look into it. It is called Pacific Fertility Center. I will be starting the injections for my first ivf cycle in about two weeks. I can't wait.

Carisa
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Avatar_f_tn
Thanks :) I live in Michigan, so a bit of a hike!! But I hope I do not need it since I did stimulate well to Femara...she said I have a good chance :) and had to give me the twins speech and told me I now have a 10% chance for twins since both ovaries had matured follicles and that my dh sperm is good to go...prayer is what I am holding on to :)

Good luck with your IVF...:0) I hope you have great success!!!
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Avatar_f_tn
Thank you Dr. Keefe!
I am not a smoker and have not undergone any chemo. I will ask my Dr. about the fragile x syndrome and testing for it.

Thank you!
Lora
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Avatar_n_tn
Hi, this is first time posting. Just wanted possibly another physicans opinion or maybe someone who has gone through something similar. I'm 36 TTC 3 1/2 yrs. Born with one ovary. RE thinks my reproductive age is higher than chronological age due to this. Clomid challenge FSH 7.5 on day 3 and 15.5 on day 10. Conceived after 10 mths on our own. Ended M/C at 10 weeks. Tried for 1 1/2 naturally, no luck. HSG one clear tube, sperm analysis fine. Tried Clomid, Femara, injectables and currently on 3rd IUI (last Monday)with injectables. Had 5 nice size follicles, but I usually have 2 or 3 and it has not worked before. RE thinks quality of eggs are the reason. If this IUI is unsuccessful he wants to try Clomid challenge again, because it was so borderline. If that one was to come back higher, I think he would conclude that what we're doing with the iui's and injectables may be a long shot and move on to donor eggs (which I do not think I want to do) Who knows maybe this one took. I'm now on the 2 week wait.....
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Avatar_f_tn
wanted to let you all know you can still conceive with High FSH , or in other words, "Diminished Ovarian Reserve".

I tried to conceive for 16 months when I was 33 years old. I conceived the next month, which was the 17th month of TTC. It ended in miscarriage at 8 weeks.

We then tried a while longer before going to a Fertility Center. The RE did a cycle day 3 FSH test and it came back at 17.6! We did a high stim cycle. At the beginning of the cycle, we did a baseline u/s and I had only 3 antral follicles. I was 36 years old. I needed 8 amps of Gonal-F per day. (4 amps in morning/ 4 at night) just to produce 4-5 mature follicles. We did a double IUI and it failed.

We accepted that we would probably not have children and we moved on to our next dream. We were happily married and knew that we would have a good life, no matter what, so we started with the plans of building a house. I recall vividly a feeling I had not had much previously the week or so before ovulation---sore breasts. I laughed to myself thinking it was a longshot, but I woke up hubby anyway, two nights in a row to take advantage of it. Well, one month into our house being built, that action resulted in a PREGNANCY!A natural pregnancy! I tested on my birthday and it was positive!

I gave birth to a beautiful, healthy baby girl in August of 2005. She is the love of our lives.

Don't let the doctors make you think it's a lost cause. It's always a possibility to conceive. It takes a lot longer, yes. And, if your level is 20 or higher, it's much worrisome.

I was just tested again at age 39 and it came back at 10.. So, the numbers do bounce around. And, I was told that it's still possible for me to conceive again as long as the numbers are not 20 or higher.

I may try again. If the good Lord wants it to happen, He'll let it. Meanwhile, I'm still the happiest I've ever been!

Good luck!
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99627_tn?1301274552
Hello Carisa. I live in Mountain View CA. I am looking into doing my 3rd IVF. Which clinic are you usinf in San Fransisco? You can email me if you want. ***@****

Thanks
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Avatar_n_tn
Just wanted to thank you for your story and positive words of encouragement. Still on the two week wait..
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Avatar_n_tn
Babysomeday,

I have DOR but so far my fsh is ok. I am a Fragile X carrier. I have been trying to concieve (conceive) for 3 years now. Its a long hard road. We started with IVF 3 years ago to genetic test for fragile x. I was hard to stimulate. One time they got 3 eggs from me, another time they got 5 eggs from what looked like 12 mature follicles. Doc said she thought I had DOR.

We gave up on ivf. Finally decided I had a fertility problem we tried clomid 3 times. It thinned my lining.

I've now done 3 rounds of injectable only cycles. Plus another 2 IUI injectable cycles. No pregnancies. This last time I had 4 mature follies. My prog was 7.05 so on cycle day 18 they finally gave me progesterone instead of when I asked the day of the IUI. I only made it to CD 20.

I'm gonna do another IUI cycle at the end of this month.
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Avatar_f_tn
you are welcome. I'll help in any way I can.

In fact, I will give you even more encouragement:

READY???

I am now pregnant again. It's early... 5 weeks, 2 days. But I just found out and am happy just to know it's possible still! Even with High FSH and diminished ovarian reserve.

I know the chances of miscarriage are high... as many as 1 in 3 pregnancies end in it, according to literature, but I'm hopeful.
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