r/DOR

TW euploids, spontaneous pregnancy, loss

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We just finished 5 rounds of egg retrievals (in the US), with a range of outcomes, so sharing what we learned in the process. I understand that the PPOS protocol is newer, but I think it achieved something similar to a luteal phase stim for us, and could also be something to look into!
This group has been really generous in sharing support and perspectives, so I hope some of this is helpful and helps you advocate with your RE team!

My age during most of the retrievals was 34-35, AFC 3-7, AMH 0.45-0.67; suspected endometriosis.

Round 1: Did mini-IVF with a different clinic, with no blasts (also ovulated early on one side). Had Mirena IUD in for this round. AMH was 0.84 ng/mL, age 33.

Switched clinics, removed IUD, and AMH measured at 0.49 ng/mL, then had 1 spontaneously conceived missed miscarriage (which turned out to be euploid), and 2 chemical pregnancies before and between IVF cycles.

Round 2-4: Microdose Lupron Flare (MDLF) was quite good the first time, so we repeated it, but it was a long protocol that was hard on my body, and we started getting less good results. All were with 1-2 weeks of estrogen priming, and with both Follistim + Menopur, and ICSI+Zymot.

* Round 2: 6 eggs retrieved, 4 mature, 3 fertilized, 2 blasts (both euploid) - stimmed 12 days

* Round 3: 7 eggs retrieved, 5 mature and fertilized, 2 blasts, 1 euploid - stimmed 14 days, slightly higher gonadotropin doses

* Round 4: 7 eggs retrieved, only 2 mature and fertilized, 1 blast (aneuploid) - we had some cysts at baseline this round, and stimmed for 15 days with very high dose, so it was all kind of off.

Took 2 months of rapamycin (5mg/week) in between Round 4 and Round 5. AMH tested at 0.67 ng/mL before Round 5. I stopped rapamycin before starting the PPOS protocol since it may work against the ovarian stimulation.

Round 5: Progestin-primed ovarian stimulation (PPOS), with Menopur only, 9(!) eggs retrieved, 8 mature, 6 fertilized, 3 blasts, of which 1 was euploid, 1 was aneuploid, and 1 was a "no result" due to insufficient sample. We kept ICSI+Zymot because my partner had slightly elevated sperm DNA fragmentation.

Supplements that I think helped: CoQ10 - 600mg / day, Vitamin D 2000 IU/day since it was <50 ng/mL during Rounds 2-5, Acai 1g/ day, NAC 500mg /day started around Round 4/5, fish oil 690 mg/day.

Partner also took CoQ10 and Vitamin D.

I also got a positive Receptiva (1.6) after Round 3 that we are hoping to address with a lap next week.

I tried to find a thread on this topic but have not had any luck. I am wondering whether anyone with diminished reserve in their 20s or early 30s has a close female relative with the same, and whether you discovered the cause behind it? So far I know that most studies have been unable to pinpoint specific genetic causes, but I am curious about sisters undergoing IVF etc. thank you.

TW: Live birth

My first FET worked years ago. Since then, subsequent transfers all failed and I wasn't able to make blasts in my last ER. I don't think it's worth it to put myself at risk of repeated anesthesia and surgery so I'm thinking of now trying IUI or timed intercourse. I went straight to IVF because I had unexplained infertility and never had a positive pregnancy test on my own. But for every cycle we tried on our own, my period was often delayed (3-5 days), but I either didn't try an at-home test or it was negative. IUI and timed intercourse seems a lot less risky than IVF so I was wondering if I should try that now.
Has anyone does this before and had success?

I don’t have many people to talk to about this, and I already broke down to my husband last night, so I hope it’s ok if I share here.

I was both nervous and excited going into my appointment because I was just looking forward to having some answers, but the thought of them sticking a catheter into my uterus did not sound fun. 😅 Overall the experience wasn’t terrible. The doctor was super kind and walked me through every step and everything she was doing. The speculum was ICE cold which I did not love, and the insertion of the catheter was kinda painful, but no worse than period cramps. The nurse assisting had the screen angled to where I could see it as the machine was taking the x ray images, so that helped me keep my mind off the discomfort. The procedure was pretty quick, and the feeling of relief as everything came out was great lol.

I could tell immediately just from watching the progression of the dye on the images that there was something up with my left tube. Once it was over, the doctor went over the images and gave me her initial thoughts (she wasn’t my primary doctor, so I’ll get my doc’s thoughts at a follow up appointment). She pointed out some areas of dye pooling in my uterus, which may indicate some irregular tissue (already anticipated that based on previous ultrasounds). My right fallopian tube looked pretty good, although it was kinda cramped in there. My left tube on the other hand had a lot of dye pooling before it eventually did spill out. She said that could mean scar tissue or a dilated tube. She didn’t give me much info on what that could indicate (although now I’m concerned about hydrosalpinx), but did say that my doctor will probably order more imaging or we’ll go to surgery. The office called me yesterday to confirm that she does want to do a follow up appointment with us “within the next month”. I’m hoping we can get in sooner rather than later because I really want to get the ball rolling, especially if surgery is the likely outcome. She didn’t outright say I have endo, but it feels like that might be the case. My doc diagnosed me with DOR at our last appointment, so it’s all been kind of overwhelming and I still feel like I hadn’t really processed it, until last night. I broke down to my husband over the fact that I could lose one of my tubes. I also just really have a bad feeling that I have endometriosis. It’s all just been a lot.

I did a round of clomid this month and have my mid-cycle ultrasound today. If it looks good, we have a trigger shot ready to go. But I’m not even sure it’s worth using the shot if the likelihood of getting pregnant in my uterus’s current state is not super high, but I guess we’ll see what they say. I also feel like if the follicle is showing on the left side, then in would be a waste of a shot. Our insurance doesn’t cover any of the meds, so we’ve been paying out of pocket. I would love to be able to save this trigger shot for another time and not waste the $80, but we’ll see.

I’m just really sad. We’ve been trying since November 2024 and started seeing a RE last month and so far it just feels like a lot of bad news and more waiting as we do more tests, possible surgery, etc.

Hi everyone,

I’ve been lurking here for a while as I’ve been getting a better understanding of my baseline fertility, and I’m now starting next steps. Really appreciate this community and would love any advice or insight.

Background:

- AMH: 0.53 at 29, 0.32 now at 32

- Thin uterine lining (getting an updated ultrasound soon)

- HSG was normal

- Fragile X carrier — planning to test any embryos

- Partner’s sperm analysis came back normal

What I’m doing now:

- Prenatal vitamins for 4+ months, CoQ10 for a few weeks

- Acupuncture 2x/month for ~4 months

Next steps:

My doctor wants to focus on thickening my lining with an estrogen protocol, then move into IVF.

Has anyone had success with increasing uterine lining? Anything that helped you prepare for egg retrieval?

Thank you💕

After 12 attempts with an antagonist cycle I’m trying MDL flare and my Dr has me starting Lup CD2 (10U 2x/day) and then adding in 300 Gon/Foll and 150 Men. For my antagonist cycles I did anywhere from 125IU of just Foll to 150/150 Foll/Men. So around 300IU TOTAL.

300/150 seems very high to me and I’m concerned I’ll waste meds. I typically get 0-2 eggs per cycle. My afc though is 6-7. Chat said higher doses might be needed for MDL because of the Lup suppression?

Any insights around what doses worked best for you would be great. I’m leaning towards starting at 200/75 and then going up if needed

I’m a little bummed. I’m 40 with low AMH and low AFC but not otherwise traditionally infertile (though I do have endometriosis). I’ve had one child conceived naturally, just waited too late to decide on a second I guess.

I’m on day 6 of stims and only 4 follicles are growing. I think there’s probably little hope of success and this was my only shot financially. I’m accepting whatever answer the universe gives but it’s still hard to not be disappointed.

Hi all,

Hi everyone,

I’m feeling really upset and overwhelmed at the moment. I will turn 40 this year, with very low AMH and me and my husband have shared gene that can be inherited and we only knew this while going via IVF.

I have done IVF and it failed ( transfer failed after collecting multiple embryos and doing PGTM testing), so here we start again today was my pre procedure scan and they only saw 2 follicles (11 mm and 5 mm), i see no hope i have been trying for so long….

I feel like I’ve failed my husband. I know my case is very complicated

I would really appreciate hearing real stories from anyone who has been through something similar — what worked, what didn’t, and how you coped.

i started stims on Saturday after taking yasmin to control my period. i have been for my day 5 scan today and my folicles are not responding how they should. Biggest is 4.8mm and i have a large cyst on my right ovary measuring 4.6mm. I thought the cycle was cancelled then my clinic rang and said i can take letrozole then have a scan on Friday and see if they have responded and that we might get 4 folicles. I dont know what to do please advise anyone who has been in a similar situation. i am 41 today and have DOR if this cycle is canceled i will move onto donor embryos.

Hi! So for my IUI, I did follistim and Menopur. I used Pregnyl for my trigger shot but also used .5 cc of it as booster shots on 3 DPIUI and 6 DPIUI. I have low AMH. This is my first medicated cycle. I am 27.

I am 11 DPIUI today. I am not spotting when I typically would about 2-3 days before my period. I’ve been trying to test out the trigger shot but it’s still in my system. The past three days, they have been super faint.

With anyone with this protocol, how long did it take for it to get negative? It hasn’t gotten darker.

I am doing luteal phase estrace priming for the first time. going into my second cycle. First was a bust- no blasts.

How did estrace make you feel? Also I am concerned that my suppression check will look even 'worse' than last time? will they still clear me to go ahead with stims if they see very few on supporession check? what is my e2 supposed to look like with estrace priming vs without?

(last time they saw 4 follicles at suppression, and i ended up getting 4 eggs, 2 mature, despite several other follicles showing themselves later, but they never caught up in size)

we're trying estrace to fix the asynchrony. my 1st and only cycle i had 2 follicles at 16mm on my day 6 scan. Any help on what to expect is appreciated.

Hiya, had my first scan yesterday, started stims on Friday (tonight will be day 6 of stims). Last cycle was cancelled as only 1 follicle developed after 8 days on puregon. Changed to rekovelle this cycle.

Right Ovary: 3 x <2mm, 12mm, 15mm

Left Ovary: 6 x <2mm, 8mm, 12mm

Lining at 7.3mm. Reckon the 9 follicles might start developing in time or are my hopes on those 4??

Hi there, this is my first post. I am writing from New Zealand, where i have accessed privately funded fertility care. I haven’t been very successful in my first IVF cycle and am trying to prepare for a doctors review. I am here to seek advice what improvements/changes might be worthy of inquiring about, as i am finding it very overwhelming to read through all the data myself. Some of you are such experts!

- what supplements improve egg quality?

- what medications could i try instead of what i had?

- any other suggestions?

Here are my details:

- no male factor to infertility

- one spontaneously conceived baby in 2021, 7 months of trying

- one spontaneously conceived pregnancy this year, ended in a biological pregnancy unfortunately.

- secondary infertility, have been trying for 1.5 years and since done 1 IUI and 1 IVF cycle

- 38 yo, AMH 0.69ng/ml (4.9pmol/l)

- IVF stim with 300mg gonal-f for 14 days, no response on day 6, then 4 follicles on day 9. 2 days of Orgalutran and then HCG triggered with Ovridel.

- 4 eggs retrieved, 3 fertilised, 1 day 3 fresh transfer with 6 cells, the other fertilised eggs did not grow from day 2. I haven’t finished the 2WW yet but am anxious and trying to plan for the worst case scenario.

I would appreciate advice on how to improve the quality of my eggs. From what i understand i had 3 embryos, all had level 3 DNA fragmentation. Only one made it to 6 cells and was transferred at that point. The others were 2 and 4 cells, level 3 (the levels go 1-5 here with 1 being best and 5 being most fragmented).

I live a healthy live however have not cut out all alcohol pre implantation, and i do have a BMi of 36. I have very mild Crohns which is managed with medication and i am in remission, so no active inflammation.

I otherwise take folic acid and iodine but not currently any other supplements. My Vit B and D levels are solid.

I appreciate your help! And i will keep myself occupied for the remainder of the waiting time of this cycle, trying not to spiral!

I just opened my AMH blood test results. I’m 33 year old female and my results for AMH were 0.589 ng/mL. No children yet, getting married in November. Found out my future husband also has a low sperm count. We have spoken about him seeing a urologist a starting on comid then freezing his sperm. I’m so concerned. I’m honestly having such anxiety about being able to convince. How bad is a 0.589 AHM level really? 😭 is IVF a possibility? I’m getting mixed answers.

I know I need to get an ultrasound to see about my follicles right?

I’d also like to mention I have Ehlers-Danlos syndrome which can cause increased risk of miscarriage, pregnancy risks and increased infertility.

I’m so confused and scared.

I’m 38 with DOR (AMH 0.5 in May 2025 and 0.03 in Feb 2026) and 4 failed IVF cycles. My last IVF cycle was converted to IUI due to only 1 follicle growing but it wasn’t successful. I started my period on 3/19 and it was extremely light and very short, but the nurse said it was like due to being on progesterone suppositories the 2 weeks right before (for the IUI). Now I’m cycle day 20 and OPKs have been negative since cycle day 10. The clinic had me do labs and yesterday E2 was 120 and P4 was <0.2. I’m freaking out that I’m now well into perimenopause. I’ve always had consistent periods (every 25-26 days, 6 days long) leading up to IVF which I started in Oct 2025. I know IVF doesn’t cause perimenopause but could this be a temporary anovulatory/abnormal cycle post-IVF or am I definitely in perimenopause? I don’t have other symptoms like hot flashes or insomnia. I’m sorry also if this is the wrong subreddit to post this but I’m just freaking out. 😭