# Disappointed after 1st IVF appointment,low follicle amount, Advice please!



## T_73 (Apr 10, 2013)

Hi,
I've just come back from our 1st IVF appointment where they did a follicle scan and looked at FSH to determine what protocol to put me on. FSH now at 8.7 and Dr could only see 3 follicles.(although the kind nurse reckons she maybe saw another couple)
So she said there was a good chance I wouldn't respond to the drugs. They are putting me on the highest dose to give me my best shot. I'm gutted that I'm not even starting in a good position and now everyone is telling me I need to be positive. I know I need to be but finding it very hard to feel this way   
Norethesterone starts in couple of weeks then I get another scan. Do they check the follicle amount again before you start the stimulation drugs? Can the follicle amount increase when you start stimulation or is it just to stimulate egg growth?



Thanks for the help xx


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## Polargirl1 (Jun 28, 2013)

Hi there
I recently also had a follicle scan and was told by my consultant that the number of follicles can change for a variety of reasons. He said the number could change depending on who does the scan, one nurse might see 3 and another might see 5-6 (as perhaps in your case?). He also said it can change every month although not dramatically, so 3 now could be 6-7 or more another month, or maybe 2 the month after.

They will scan again once stims starts and then maybe daily or every other day depending upon what is happening in there.
Unfortunately it seems the first try (albeit expensive!) is a bit trial and error but a HUGE learning curve you for and the clinic to see how your body responds.

There are loads of success stories on here about people who have had low numbers but still managed good quality eggs. I think its important to have confidence in your clinic though as it will help you feel more relaxed through the whole process.
Good luck xx


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## KandK (Nov 17, 2011)

Oh geez I hate this doctor response to low follicles.... The WORST thing to do is throw high doses of stimm drugs at you, it will get a terrible response and destroy what eggs you do have.  They should be optimizing QUALITY not quantity.  All the research shows that low dose protocols are more successful for people with poor response or low ovarian reserve.  Flogging a dead horse isn't going to help (not that I am implying you are a dead horse!).  Please do some research on low dose protocols and shove them under your FS nose - or better still save your money and go to another one who actually knows what they are talking about.  Please go for quality, get yourself on lower dose meds and avoid preparations that contain LH (so no Menopur and the likes) stick to gonal-f.  If you are doing a long protocol make sure you take Lupron as well, it counters the ovary dampening response.  I can see the future for you - and it's bleak if you continue this regime.  They will say we gave you maximum dose and you didn't respond, the 2-3 eggs we got were of poor quality and didn't fertilize or arrested soon after.  Or they fertilize them then push you for a 2 or 3 day transfer (so they get paid) and the poor embies fizzle out after the third day (which is the crucial day).  Then you will get the "we suggest donor eggs" spiel.  

Feel free to PM me if you need more help - my DH is an ob/gyn and does plenty of IVF so I am not speaking from my rear end here    (not to mention I had my cycles messed up with high dose protocols and learnt the hard and expensive way).


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## T_73 (Apr 10, 2013)

Thanks polargirl1, I wish they had mentioned something like this at the time. We had to go with this clinic as its NHS funded as we get one cycle free.She mentioned I get a scan before I start the stimms. Then only really mentioned one other scan to see when EC would be. Should i be getting a few more scans during this period?  Hospital is around 2 hour drive away so this just adds to stress!

 xx


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## Polargirl1 (Jun 28, 2013)

Hi
I am certainly no expert as only starting my own first treatment next month but as we are paying privately I have done quite a bit of research to make sure we get the right clinic and right consultant at that clinic for us so that I can relax in relation to knowing we are being well looked after and comfortable with the decisions they make for us, as we are a little in the dark with this being our first time.

I don't know how the NHS system works unfortunately but if there is a clinic slightly nearer or you feel would suit you better could you switch somehow? Sometimes little white lies are useful in these situations  

I was told I would get a scan on day 2 and then blood tests and scans possibly daily from day 7 until egg collection, but they said it all depends on how I respond so they cannot give me definite timescales. They seem to like to keep a close eye on their ladies!

I'm sure your clinic will know what they are doing but perhaps they have just forgotten the art of communication! I think sometimes, because they do this day in, day out, they forget that we don't !

Hope all goes well x


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## T_73 (Apr 10, 2013)

Hi,

That is the nearest clinic to us! Going to be a bit of a treck. So do you know your protocol and drugs etc now then? 

I know I should have asked a lot more questions but I lost the thread a little after her blunt chat. 
I think I will get back in touch and ask about protocols, drugs, dosage, scans etc. 

I'll let you know how it all goes. Good luck to you too! Keep me posted 

Xx


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## Altai (Aug 18, 2013)

Hi there 

Am not an expert either and can only tell from my experience of 2 ivs. 
Do you know your AMH?  I think this is how they can sort of predict your response to ivf drugs. 

I had "mild" ivf in London clinic specialising in natural and mild Ivfs. 
Baseline scan showed  12 resting follicles but actually only 7 were clearly visible, the rest he had to press & search to find and they were small. 
I started with 150u of gonal f which was increased to 300u after 3 days. At that stage it didn't seem like mild anymore to me but the clinic said for my weight (bmi26) it is fine, no way is a  high dose. 

The result- only  2 grown follicles after 8 days of stimming.  I wanted to cancel the cycle but the dr persuaded to go ahead, saying that next cycle might be even worse no follicles, of course its my choice but at my age its is not bad at all etc.
My point is even if you start baseline at relatively good position, it won't always materialise into good result. As previous responder said - first cycle is an expensive trial and error. And 
you have to stand up for yourself and if you feel the treatment is not gojng as good as you' expected, then don't let them to talk you into going further and wasting more money. 

P.s. In my case, menopur gave better number of follicles. No bpf yet thou. 

Good luck with whatever you decide to do.

A.


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## Polargirl1 (Jun 28, 2013)

Hi T_73

I start on 150 Menopur followed by 0.25 Cetrotide and was told I would start scans and blood tests at Day 7. Although they won't change the Menopur itself throughout the treatment they might change the dose, depending on what the follicles are doing. 
My fear before starting was that the clinic starts everyone on the same sort of drugs and doses etc on a "one size fits all" policy, but I guess there are only a handful of drugs that they can use and thousands of women who go through the treatment every year. I guess as well as a learning curve for us, it probably is for them too (so long as they use the info they get).

Hope all goes well and keep us updated.

I am not starting until end of next month (due to work travel and general faff   )
x


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