# Endometriosis, sperm problems and not enough eggs



## Joeline (Nov 14, 2007)

Hi all

I'm new to this forum - completely new to forums in general actually, so please bear with me! I don't even understand some of the jargon e.g. BNF.

My partner and I have had one round of ICSI which failed. We're both 33. I have endometriosis (had a laparoscopy to remove 2 endometrioma last year) and he has higher than normal abnormalities and anitbodies though motility and volume said to be ok. 

I was looking forward to the ICSI but didn't respond to the drugs well enough. I started on 250 of Gonal F but had so few follicles they boosted me to 450. I thought we might have to abandon and was devastated. We ended up with 6 eggs from 7 follicles (though he had to dig!) only one of which fertilised - grade 1/2 6 cells. It didn't work and I am finding if difficult to understand why I didn't respond to the drugs. Also, doesn't injecting the egg damage it potentially? Could this lower chances with ICSI?

Next time (private), the doctor says he's going to use LH instead of Gonal F (any thoughts) and will start me off on 450. Is this high? Am I in trouble here? I'm concerned that endo plus bad drug response plus sperm problems = years of trying and it not working.

It would be lovely to hear from someone who's been in a similar situation or anyone with views. You all seem to be so good with the detail - I need to gen up more. I could dig out the sperm analysis data if that's worth looking at in more detail??

Thanks in anticipation!
J x


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## caline (Nov 12, 2006)

Joeline,

Welcome to FF. I joined FF a year ago and was also completely new to forums. Don't worry about not understanding the jargon as all of us don't at first.

Go to this link and you will get a list of Common Abbreviations and general info for the site.

http://www.fertilityfriends.co.uk/forum/index.php?topic=101841.0

http://www.fertilityfriends.co.uk/index.php?option=com_glossary&Itemid=120

BFN = Big Fat Negative.
Tx = treatment

My first IVF only gave 3 follies, 1 of which fertilised. However my last Tx gave 8 follies. (2 embies transferred) Unfortunately still a BFN but at least it has given us hope for the next Tx. I have moved from 75 Gonal F to 375. I was also on Menopur but didn't respond so well. I just think infertility Tx is not an exact science and we all respond differently to different protocols. Unfortunately, sometimes it can take a while to work out which one suites us best. 
I don't have endo but have another condition which reduces greatly the chance of implantation so I can understand the frustration of feeling you have hit the 'jackpot' with all the problems. 
Wishing you all the best for your next tx.

Sending you some lucky 
Caline x


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## Joeline (Nov 14, 2007)

Hi Caline

Thanks so much for your reply! It really helps to know there are people out there who do not respond to the drugs with loads of eggs. It's one thing having friends going through IVF at the same time, but when they get double figure eggs it makes me feel rubbish!

Thanks for sharing your story with me. Fingers crossed we'll both get there one day. I go to Canterbury BMI for my treatment - what about you?

Joeline x


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## MillyFlower (Apr 6, 2007)

Joeline,

We are in very similar positions. I'm 30, have endo and have had a lap, my DP has poor numbers, morphology and mobility! 

First ICSI I have 150 of menopur, 9 follicles, 5 eggs, 5 fertilised, 2 grade 1 8 cell embryos transfered on day 3 and BFN (Big Fat Negative). The other 3 eggs were not good enough for freezing.

Second ICSI. They decided to up my drugs and follow the short protocol (no down regulation). This time I was on 225 menopur. They grow quicker but there was less . 8 Follies, 4 eggs, 3 fertilised and 1 grade 1 7 cell and 1 grade 2 8 cell transfered on day 3. I am now on my 2WW (two week wait).


If we have to go again I am going to ask for more test to try to find out why I don't respond very well. I have a BMI of 19, have never smoked, don't drink, eat well, LH and FHS were low so I am as confused as you.

I know that I didn't answer you question but I thought it may help you to know that you are not alone. Sorry your first cycle. I know how heart breaking it is .

LOL,

Milly


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## Miranda7 (Feb 12, 2007)

Hi Joeline!

It sounds a bit as if you might be a poor responder, but six eggs is pretty good for one of those!

I am a PR - my AMH level makes me menopausal. My husband has been snipped for 16 years and they couldn't reverse it. My last cycle I got just four eggs, but two fertilised with sperm they aspirated from him and I'm now nearly eight weeks pregnant - it can be done! With a huge range of issues, it still can be done.

I think you should have your AMH checked, so you know if that's going to always be your response to the drugs or whether it's a blip. It's been known for people to have a bad cycle then be fine on subsequent goes.

AMH is anti mullerian hormone and tells you what time you have left, fertility-wise adn how you're likely to respond to the drugs. PRs tend to do better with Menopur, which is the stuff with the LH, but it's dear - you'll most likely get a better deal by getting a prescription and ringing up Fazely Pharmacy or somewhere that offers it cheaper - I would have saved hundreds on my last cycle if I'd done that.

Hope that helps

xx


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## buster24 (Jul 11, 2005)

i am like miranda i asked for a AMH check as my fsh was fine and it turned out to be total crap, at i think around 1.5, so i used donor from my sister this time, unfortunalty still a BFN    . but we have 8 frosties.
i wish i had mine checked a few years ago.
good luck on your tx journey and wish yous all the best.
K xxxx


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## emsy25 (Mar 18, 2005)

Hi,

Just wanted to say hello and welcome.

Emma
x x x x


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## Joeline (Nov 14, 2007)

Thank you all SO MUCH!!!  I was shocked to come back and see so many replies and it is WONDERFUL to know I'm not the only one sitting around wondering why it's all so vague.

My mind is boggling right now. 

Milly - at last someone in the same position . We should definitely stay in touch. I really hope your 2WW (ha ha - getting the jargon now!) works out in a BFP! I am very similar to you on BMI etc so we really can compare notes  

Miranda - oh my god, can you come and give me a lecture on this please! Right - AMH. I know you explained it but this is a test you can do to find out how many eggs you have left in your body, yes? How does it tell you how well you'll respond to the drugs? Where can I get an AMH? At my clinic? What is a PH? My consultant said LH was cheaper than Gonal F! Implied he was helping me as I'm paying privately this time around. I'm fascinated about getting drugs direct. That one needs to sink in. 

Buster - FSH. Now then, is this the one that tells you if you are ovulating ok? I seem to remember they thought this was ok for me - I think it was 8 - does that sound right? Bless your sister and I'm so sorry you had a BFN but you are so fortunate with your frosties! They are a silver lining in my eyes.  

Emma - Hi!

I'm genuinely excited to have learned more from you all in the last 10 minutes than I've understood in the last 2 years from consultants. THANK YOU! I'm going to start with looking into AMH I think....

Jxxx

P.S. I'm getting treatment in Canterbury and I live in West Kent if anyone is local?


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## Miranda7 (Feb 12, 2007)

Hello again! It's a really steep learning curve, but you'll get there!

There are a few tests of ovarian reserve - the amount of eggs you have left - but the main one is FSH, which should be below ten, but it fluctuates from month to month. You should have this tested on day 2 or three of your period, but you've had that. The AMH test is newer, so few clinics offer it - I had mine done at the Lister in London and it cost £57, but you may find you have to pay a consultation fee too.
The AMH doesn't fluctuate and I think it's a better test - my FSH is normal, but I only produced one follicle on the long protocol and then they tested my AMH, which was 0.69 - it should be between 2.2 and 6.8. (Other clinics use a different measurement which goes up to 45, but it's the same test)

If you have reduced ovarian reserve there are fewer eggs for the ovaries to call on when they are stimulated. It doesn't spell the end - as you can see, I got pregnant with just four eggs - but it does tell them how much of the stimulating drug they need to use.
There are loads of different stims, but Menopur seems to be the drug of choice for poor responders. Though I was on a mix of Menopur and Gonal F for my successful cycle.

Yes, 450 is high, but 600 is the ceiling, and you're not there yet! Try to get them to put you on five days of Clomid, too - that will help produce more follies in the early stages.

It's a Clomid flare protocol, if you want to talk jargon at them!

Menopur was £18 a vial at the Lister, and I was on five a day for 11 days, so i should have ordered from fazely, which is £12 a vial. The numbers are at the top of the IVF section, in a topic called 'where to buy cheap drugs'.

Or you could do what I did and go abroad - much cheaper! And high success rates too, plus you get a holiday out of it.

Does that answer everything? I've tried to be thorough, but you never know...

xxxxxxx


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## teenasparkle (Jun 5, 2006)

Hello!

Sorry not to read all the replies etc but its because I have a 4 week old in my hands!!

I have stage 4 endo, and its grown everywhere including nerves, my husband didn't have the greatest of sperm and all I can say is I'm now the proud mother of Toby! Ok so it took 2 goes but in the end we didn't even need ICSI when they thought we would!

Good luck,
Tina x


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## Joeline (Nov 14, 2007)

Christ Miranda - thanks again! 

So much to go at here. I've actually PRINTED your reply and am going to read it in bed and think about it. I'd be grateful if I can come back to you again with findings and other questions when it's all sunk in - is that ok?

You say "as you can see I got pregnant with four eggs" - am I missing your profile / history somewhere? I'm still getting used to this set up!

Thanks again - invaluable. Be back to you soon!

Jxxx


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## Joeline (Nov 14, 2007)

Tina  

You are the first person I have heard from with the same symptoms and who has had a baby! Fabulous to hear from you!  

Question - the stages of endo. I've never really had a clear answer on how bad mine is. I had 5cm choc cyst removed one side and 2.5 cm removed other side and a few other areas of endo found in pelvis and near bowel I think. What stage would you say this is?

Thanks and hope the baby is behaving


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## Miranda7 (Feb 12, 2007)

Hey there!

Yes, my profile is at the bottom of my messages, along with my ticker to say how far gone I am! 

No problem, re the questions - we all start somewhere and if people hadn't done this for me I'd never have got this far. So fire away!

One other thing you might like to think about is taking the steroid hormone DHEA to improve your egg quality. You can only get it from America - www.agestop.com - but it's very cheap. You need only take up to 75mg a day, but try to take it for four months before a cycle.

A few of us on the poor responders thread are on it - I know my consultant in Turkey was really pleased I was taking it.
This will hopefully boost your egg quality so that more of them fertilise. I'm a year older than you and found 50mg a day did the trick.

xxxx


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## MillyFlower (Apr 6, 2007)

Hi All,

Joeline, wow, your posting helped me. Thank you. Yes do stay in touch. Or PM (personal message) me if you need to chat. If we have to go again I am definitely going to get a AMH test done and asking to follow the clomid flare protocol sound a great idea. Oh, and I was not told what stage my endo was/is and even after the op I still get really bad af pain and need to take mefenamic acid 

Thanks Miranda for all the information. Oh, and congratulations. You must be over the moon.   . Can I ask how it was going abroad for treatment? I have had to pay for both my cycles and my consultant just agreed that that was just going to be the way I responded and if we have to go again I would like to change to a more innovative clinic. Did your DH stay with you the whole time? How much roughly did you spend including flights, hotel, drugs etc? If I have asked too much just say, I wont be offended. 

Teenasparkle, I am so glad it worked for you honey. Congratulations 

LOL, Milly x

I


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## Miranda7 (Feb 12, 2007)

Hi Milly!

I actually wrote a review of the clinic, which I will PM you when I get home.

But the short answer is, it was brilliant!

xx


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## Jackeen (Mar 22, 2007)

Joeline, great thread.

I've got Endo too and have had three IVF attempts, I had 4 follicles, two eggs and a BFP on my first attempt but sadly MC at 9 weeks.  The other two attempts had no results, no follicles at all and I've been advised not to have any further treatment.  My FSH is 10 and was 8 last year, I also used Menopur last cycle 600 and the first 300, but have not had a AMH test as yet, that will be my next request.  

I have read loads of stuff on the internet and Menopur is not always recommended for people with Endo so I'm looking for a clinic who will hopefully be willing to try again with me on another drug.  I am a private patient as I've never reached the top of the NHS list and am unlikely too prior to being 40.

Miranda, congratulations.... I'm interested to hear about the Clomid too.  It's never been offered to me I wonder if it woudl help.

Teensparkle, lucky you a 4 week old.  Congratulations.  Can I ask why they mixed your drugs.  My last cycle they said there was not enought oestrigen does Gonal F add that?


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## Miranda7 (Feb 12, 2007)

Hi jackeen!

Gonal F doesn't add oestrogen, I don't think, but spurs your body to produce it? I'm probably wrong there - someone will be along to correct me. I was on that plus oestrogen tablets, because the letrazole I was on, which does the same job as Clomid, reduces oestrogen.

Clomid or letrazole basically increase the number of follicles in the hope that they will all be full of eggs. It's only used for poor responders, as far as I know, or on a natural cycle.

Why isn't menopur recommended for endo patients? Does the LH do something to the endo?

xxx


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## Joeline (Nov 14, 2007)

Hi all

Hi Jackeen - good to hear your story - I'm keen to hear how you get on next time. Keep in touch.

Miranda - I've finally found a clinic to give me the AMH test. The clinic I have my next treatment at doesn't offer it (not a great response from them either on the 5 days of Clomid - "oh we don't do that"). Lister would not have me as I'm not a patient but my local private place will give me the test no problem for £40. Brilliant. I'm now feeling a little nervous, however, as to what the results will be. I suppose it's better to know now than have more IVF unnecessarily?

Doh - my mate had a transfer today. She has PCOS and got TWENTY ONE EGGS AND 15 FERTILISED. She doesn't know how lucky she is.  

I'd really like to know the answer to the Menopur questions regarding Endo - does anyone out there know? My clinic is putting me on LH and I have endo. Gonna do some surfing I reckon on this.

Jxxx


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## Miranda7 (Feb 12, 2007)

I must admit, I've not heard of Menopur not being given to endo people.

Brilliant price for the AMH! When are you getting that done? Are they giving you a consultation?

Yes, lots of clinics are completely inflexible. I loved the Jinemed as they were so very flexible with protocols and appts - I could just stroll in when I wanted for scans and jabs.

I couldn't cope with an inflexible clinic now - too impatient. Having to wait out the weekend would kill me!

Sod your pal's eggs - yours will be far superior!  

Good luck for the AMH.

xxx


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## Jackeen (Mar 22, 2007)

Hi Ladies,

I read about the Menopur on the net, sorry I can't seem to find where now.  Maybe I'm completely wrong.


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## Kamac80 (Nov 24, 2005)

Hi and welcome to the site 

You have come to a fantastic place full of advice and support and i wish you loads of luck with everything.

Kate xx​


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## Caz30 (Jul 22, 2007)

Hi 
I wanted to reply to your message as my husband and I are in a similar situation.  I have moderate Endo (lazored away last March but has probably come back by now) and he has sperm antibodies.  We are on our second ICSI and going for egg collection on Mon however it has been a very stressful few weeks!
I am not a great responder either and am struggling to understand why I have to have 450 Menapur when I am only 31 and my FSH is 7.  First time round we got 6 eggs and only one fertilised.  Got a BFN.  On this first cycle I was on 150 menupur which got upped to 225 halfway through.  I had high hopes this time of achieving lots of follies as started on 300 menapur however it was worse when we had our first scan!  Only had 6 follies.  I was devastated as thought the higher dose would surely work.  Anyway, some good news now as I am conscious I am focusing on the bad, on my 2nd scan during stimulation, 3 more follies had grown so we now have 10 although 3 will probably not grow big enough before EC now.  I guess there is still hope for us slow responders but it is the most awful feeling going for scans and getting bad news.  I am so nervous about EC and ET now however trying to draw strength from the lovely positive stories on FF.  It is keeping me sane!  

One question I have is, how does Endo affect response to the stim drugs?  I was told that it has no effect on the result of IVF at all however am now thinking differently.  Any answers on this would be greatly appreciated as I feel like I am going mad sometimes.

With regard to ICSI itself, I have been told that sometimes the eggs need to be more mature for this process than standard IVF however am rapidly losing faith in the things I am told as they seem to be different depending on who you speak to!  

I am sorry if this has been a depressing note I didn't mean it to be.  I guess all my worries and anxieties are coming out as we are getting closer to EC!  Think I need to practice some relaxation techniques!  Also wanted to say I know exactly how you feel!

Take care and don't give up hope.  I am sure one day it will happen for us.  Sorry if that sounds cliche as I know how awful it is hearing those things all the time from people.
Caz xxxx


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## Jackeen (Mar 22, 2007)

Hi Caz,

I think each hospital is different and they offer different protocol's.  My FSH was 7 when I started Fertility treatment less than 2 years ago and I was on 125 menopur too which was increased after a week to 300 as I was a slow responder. I did get qa BFP with 4 follicles and two eggs but sadly MC.  In the past year my FSH has gone up to 12 and my AMH is .020 which is very low for my age 39 3/4, the doctor's think some ovarian tissue was removed when my right tube was removed.  I've never had follicles on my right ovary either. 

I'm a week in to my 4th cycle at the lister and the drug protocol is completley different at my first stimms scan I had 6 folllicles, I;ve only ever had 4 before so the clomid which I took at the beginnign of the cycle has kick started my system.  The last hospital refused me treat me any more as my FSH was too high and they only used Menopur so I'm glad I sought a second opinion.

Good luck with your cycle, I hope you get your BFP


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## dtw01 (Jan 28, 2007)

Hi all ,

Sorry to barge in on your thread, but i too am a poor responder with a high FSH, never had my AMH tested but thts next on my list !!!

I have been to see my GP twice now asking if i could try clomid, both times they said there is no point, you did not respond to Menopur so clomid will have no effect, however my mum tried for 8 years to conceive my sis and in the end did so on Clomid, obviously in them days they never tested your hormones, just gave you the pills and told you to go away, she is always saying i should try it but no one seems to give me a chance , do you think its worth demanding it, am i allowed to do that ??

Keep posting ladies, you are an inspiration !!!!!!!!!!

Hxx


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