u/Fit-Jeweler-2055

Almost 40, DOR, trying to decide back-to-back vs break, looking for input

I’m turning 40 next month and trying to bank embryos.

History:

• AMH ~0.7
• AFC ~9
• Possible adenomyosis, small fibroids
• Heterozygous prothrombin mutation

IVF cycles so far:

Cycle 1 (August 2025):

• 6 eggs retrieved
• 5 mature
• 3 blasts
• 0 euploid

Cycle 2 (March 2026):

• 6 eggs retrieved
• 1 required IVM
• 2 blasts
• PGT-A pending

Cycle 3 (current April 2026 cycle):

• Started stim April 11 (currently stim day ~12)
• Did estrogen + Cetrotide priming before stim
• Started Cetrotide early during stim
• Had an ~11 mm follicle at baseline before starting stims
• Early E2: 46 → 199 → 368
• Today’s labs:
  • Estradiol: 444.10
  • LH: <1.00
  • Progesterone: 0.504
• Today’s follicle sizes:
  • 17 mm, 17 mm, 16 mm
  • 12.5 mm
  • 7 mm, 7 mm
• Doctor estimating ~3 to 4 eggs

Observations:

• I consistently make blasts (1 to 3 per cycle)
• Euploid rate unknown so far (0 out of 3, waiting on March)

Current dilemma:
Trying to decide whether to:

1. Do another back-to-back retrieval immediately
2. Or wait a cycle for a cleaner baseline and possibly adjust protocol

Questions:

• Has anyone had better response after skipping a cycle vs going back-to-back?
• For those around 39 to 41 with similar numbers, did protocol tweaks help more than just doing more cycles?
• Would you prioritize speed (back-to-back) or optimization (waiting/reset)?

Would really appreciate any similar experiences or advice 🙏