# what to do next, IUI or IVF? is AMH of 4 that bad???



## lilybird2003 (Oct 15, 2004)

1st time posting a message, so hear goes 

ttc 15 years, 6 m/c and one healthy 7yr old conceived naturally despite unexplained infertility (no cause found after recurrent miscarriage tests)

been trying for a 2nd child for many yrs...GP referred me to gynae at hospital 18 months ago and this appt ended with me in tears and being told I'm too old (44 at that point), need donor eggs despite AMH 4.  SO I saw an advert for Create natural IVF.  The consultation was all a bit too 'quick sign the form and give us your credit card' .  My friend said not to use them having heard adverse comments on an assortment of forums.  I bought a Duofertility monitor and one year later nothing. 

Last week I went to see another consultant who said I need DE but he'd let me do one IUI with clomid, any stronger drugs could push me into premature menopause.  From Duofertility I know I ovulate....should I blow £1k and do IUI when I'm being told it wont work or find a clinic to do IVF  My head has been all over the place and I just don't know what to do anymore.  any advise would be much appreciated, thanks


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## CrazyHorse (May 8, 2014)

Well, I've done 4 rounds of IVF drugs with an IUI of 1.8, and I don't seem any closer to menopause than when I started (and am now 12 weeks pregnant). 3 rounds were relatively high dose (300 iu/day of Gonal-F), the last round was mild IVF (letrozole, which is like Clomid, plus 75 iu/day of Menopur). I think you need a different consultant, as this one seems eager to scare you into DE. 

To be honest, given your age, DE is probably a good option in terms of achieving a successful pregnancy as quickly and cost-effectively as possible. Even though your AMH is not that bad, the percentage of your eggs which are chromosomally normal will most likely be pretty low at this point (< 10% is the typical figure, research seems to indicate). That means that, on average, only about one egg in 10 will have the possibility of creating a healthy pregnancy. But I understand very well the desire to give your own genetic material a chance (hence my own four rounds of treatment). 

Have you considered looking at clinics abroad? There are more of them that seem to be accustomed to working with older OE patients. Also, if you haven't had your FSH tested on day 3 of your menstrual cycle, you should consider getting that done, as AMH alone is not always that reliable an indicator of how well you'll respond to stims. It's much cheaper than an AMH test as well.

Wishing you lots of luck, whatever you decide.


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## bombsh3ll (Apr 19, 2012)

Hi lilybird2003,

I know this may not be what you want to hear, but the chances of OEIVF working at 45 are negligible, & frankly I think it would be unethical for a clinic to take money off you for that. You've been given the best advice about going for DE. 

I wouldn't bother spending money on IUI, unless male factor is also an issue you have no reason to believe the sperm & eggs cannot get to each other by themselves. Simple AI would also achieve this if you can no longer face intercourse.

Clomid and timed intercourse/AI would be worth trying whilst you get things in place for DE, this is relatively cheap & non-invasive.

Best of luck,

B xxx


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## lilybird2003 (Oct 15, 2004)

thanks ladies for taking time to reply, appreciate the advise to go overseas, sounds like Drs are more positive and open minded ie less ageist!

have some queries about Clomid. at my 1st London consultation, the consultant man originally steered me away from IVF saying eggs are best left in situ, IUI is better given that I have been pregnant previously so can conceive naturally. I mentioned this to my GP who said that in the passed she would have prescribed Clomid but is no longer permitted to without a consultants prescription (funnily enough Clomid is what Duofertility recommended I try). I called the clinic to ask if he could advise my GP what to prescribe, I had to pay another £150 for him to answer the phone call (!) and all he did was vere off the subject and said phone for baseline scan day 1-3 when he'd give me the prescription. Do I really need to have scans to use Clomid? I had IUI about 10 years ago and all scans showed text book reaction to drugs (injecting). I was looking at the screen and saw him type 2x20mg for 5 days and now I'm so frustrated that I'm seriously tempted to buy some on the internet even thought its a prescription drug, looks like you can buy this from USA websites.

Please Note: Fertility Friends does not endorse any type of self medication/DIY drugs administering. We strongly advise you to seek advice from your GP/clinic on any aspects when self administering drugs of this nature and do not do so without professional medical supervision/approval.


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## bumpinprogress1978 (Apr 22, 2014)

Hiya

I did two nhs cycles where the outcomes were disaster with nothing to transfer and each follow up they insisted that donor eggs was the only route for me.

My Amh was 4.2 and I was told my eggs were rubbish and I would never produce more than 4 eggs.

Decided to go to ARGC in London for a third attempt with own eggs before turning to donor eggs and they got me to embryo transfer for the first time, my egg quality was excellent and I produced 7 eggs, 6 out of these fertilised.

Might be worth you having a consultation with them?

Another option is that serum in Greece do a tandem cycle where they use your own eggs and have donor eggs as a back up.

Good luck xx


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## lilybird2003 (Oct 15, 2004)

Hi

I did contact ARGH and unfortunately they said they had never had success with anyone over 42.  

anyone recommend a clinic overseas? seen an assortment of clinic names; Dogus in Cyprus recommended for us 'oldies' but when I googled this a message came up about Dr. Fridevs is no longer at Dogus Fertility Clinic-seems to have set up her own clinic Cyprus IVF..anyone any experience or recommendations to share>

thanks


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## deblovescats (Jun 23, 2012)

Hi lily
Sorry you're having a difficult time. When you say ARGH had not had success with anyone over 42, do you mean with OE or DE? If you are ready to go for DE, UK clinics will treat you up to 50. You don't necessarily have to go abroad. I had 2 attempts with DE at a UK clinic - both BFNs, but then changed to CARE Sheffield and can't recommend them highly enough. I went straight to DE because of my age and finances being limited and wanted to maximise chance of a baby. On 3rd attempt (first with CARE) with DE - got a BFP, and 3 frosties. I now have a gorgeous 11 month old son  - can't believe how quickly the year has passed. I'm now planning on trying for no 2 at CARE in Oct. I was 46 when I started treatment and 47 when I gave birth to my son, so it is possible over 42!
Good luck with whatever you decide.
Deb


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## bombsh3ll (Apr 19, 2012)

Hi lilybird2003,

If it is tandem you are looking for you will probably need to look at North Cyprus or possibly Serum in Greece.

I had DE at 31 for other reasons - I wasn't concerned about genetics -  and can 100% recommend the clinic that treated me in Spain, FIV Marbella. My experience of Dogus (OE) wasn't very good to be honest. Dr Firdevs was good but general communication & organisation was poor, & also they didn't have vitrification so we had to let our surplus embryos perish as the old fashioned freezing technology has very poor success rates. As I subsequently miscarried I then had to endure another round of stimms whereas at another clinic I could have had several FETs.

Spain however probably not offer tandem and it is definitely illegal to transfer embryos of different parentage in the same transfer there (Cyprus allow a mix of OE and DE embryos transferred at once).

Best wishes,

B xxx


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## lilybird2003 (Oct 15, 2004)

Hi bombsh3ll 

sorry to hear about m/c -  very painful experience

my 1st email to Dogus was replied to with 'sorry we took so long to reply'! Dogus recommended tandem cycle and its not something I feel positive about particularly having read bumpinprogress1978 very positive result having an AMH 4.2, this raised my hopes of using OE.  I do need to get my AMH redone, my result of 4 was a year ago (re-testing frightens me incase is completely 0).

which clinic did you use in Marbella?
cheers
Lilyx


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## bombsh3ll (Apr 19, 2012)

Hi lilybird2003,

I used FIV Marbella for my DE cycle. I found the communication & support from Michelle there great and they also respected my wishes and choice about using DE at a young age with normal ovarian function, and also my choice to transfer 3.

Best wishes whatever you decide,

B xxx


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## TiggerBounces (Sep 6, 2014)

Hi Bombsh3ll
Just wondering, could you pm me your experience of FIV Marbella? We're considering going there end of August. Thank you! x


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