# 3rd Failed cycle.Modified Natural cycle using ICSI. Low amh. WHAT NEXT?



## Tara2017 (Jul 8, 2016)

Hello

Thanks for reading. Bear with me with the long post. 
We are at a cross roads and not sure what would be the next ideal course to take.

Background story. TTC 6 years. 2013 saw first fertility consultant. Could not get any treatment on the NHS in our area because I was just over the threshold of 35 years.
Did have investigative laparoscopy in 2014. Had extensive tube damage with scarring from surgery many years ago. They tried to clear out the tubes. This was unsuccessful in that we didn't conceive naturally. Then had a gap in any treatments due to family bereavement and too much stress. 

In 2016 had tubal surgery. Started IVF/ICSI late 2016.
Opted for natural modified approach at Create because I have low AMH. Short protocol. Gonal-F and cetrotide and ovitrelle trigger with each egg collection cycle. We got 6 eggs in total. 100% fertilization. 

We were advised to have ICSI even though there are no male factor issue. Not sure if this was entirely necessary on reflection but we did get all fertilized. I think it was advised because of the lower chance of getting viable eggs.

The first transfer was fresh on same cycle as EC with top grade AA 5 day blastocyst. Got BFP But later miscarried at 10 weeks. Felt very hopeful even though it M/C

The second was a FET. Again another good 5 Day blastocyst. I think it was 5AB or similar. Can't remember right now but will be double checking for my own knowledge as well. This was a chemical pregnancy with low Hcg count.

The 3rd was FET. This was 6 day "expanding" 4AB. Failed to implant.  BFN. On this 3rd attempt we had additional Prednisolone and Clexane.

I get a bit confused with all the grading systems but have been told on each occasion the embryos were good or excellent.

Amidst all this I have used acupuncture, fertility mindfulness, supplements (Q10, fish oils, multi vits, Vitamin D) and good diet including no caffeine and alcohol.

We have one 5 day embryo frozen but is of lesser quality (4BB) compared to all the others. We just don't know what to do next. There has been no real explanation for the failures. They don't seem to know why or what else to do different. 
Considering getting another opinion in the meantime and trying another clinic but don't know where. We are in Oxfordshire/Wiltshire/Berks area. Really want to try stick to OE again.  
Not sure if should stick with the short protocol with less meds or something different.

Feedback, advice or shared experiences I am all ears and really appreciate it. Thanks


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## lemongrass (Sep 19, 2015)

Hi Tara

Would you consider a London clinic?  I was at CRGH in London - my consultant has since left but Dr Ozturk has an excellent reputation.  I had low AMH and did natural IVF, with eventual success.  

Good luck


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## miamiamo (Aug 9, 2015)

Hi, I am sorry you are going through this. In cases similar to yours I would recommend doing acupuncture (you had) and taking supplements (you did) What I can only add is considering doing karyotyping of both partners, and combining yr treatment with PGS NGS, as genetics might be the issue. xx


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