Very few follicles on day 5 of stims - poor responder?

[some0482]

My fiancee and I are on the Antagon protocol, without Lupron. She is 32 with high FSH (11-ish). I am 30 with good sperm.

She has been taking Gonal-F 225 IU twice daily (total of 450 IU daily). This is day 5 of her Gonal-F, and she went in for an ultrasound and bloodwork this morning. Apparently neither ovary was doing much ("LEFT OVARY FEW <10, RIGHT OVARY FEW <10" was what was written on the u/s - do you know what this means?)

Now the nurse told her to step it up to twice daily injections of 300 IU Gonal-F (total 600 IU daily). Should we be worried that she could be a poor responder?

[Amber209]

It could be that she is a poor responder, but she might just be a slow stimmer. People with high FSH (I am one) often do not respond as well to stims as others, no you are probably not going to get 20 eggs. I would not worry yet, I mean she is still young and probably the follicles that you have will result in high quality eggs. At day 5 sometimes there is not that much to see. I wouldn't freak out about it.

[mamamolly]

I agree that it's too soon to tell if she's a poor responder. While this is definitely possible, so too is being a slow responder who eventually produces a fair amount of eggs. Increasing the dose of meds does seem to make sense in this case. The notation you asked about referred to the number of follicles under 10 mm that they saw on each ovary. The ones under 10mm are when they're not yet growing, and they often don't start to count until they're over 10mm (ultimately wanting them to get to be about 18mm). Despite her borderline FSH, age will be on your side even if you don't get a huge number of eggs. I'm a poor responder and never got more than 5 mature eggs, but on my 2nd ivf cycle (at age 33) managed to get pregnant with twins (currently 33 weeks pregnant). So, there's hope even for poor responders.

[some0482]

Wow thank you both so much for your informative replies! It's so nice to speak to people who have been through IVF. I will post back the results of Sunday's tests.

[BC-tnahope]

Your fiancee will probably be a slow stimmer. I am also a High FSHer and sometimes it just takes a little bit to wake our ovaries up. Hang in there.

Also you should pop in on the High FSH board. You will find tons of posts that may be helpful

[some0482]

Tests on Day 7 of stims revealed: 1 follicle at 13 mm, 2 follicles at 12 mm and 1 follicle at 11 mm. E2 is 516. We start Ganirelix tomorrow.

Are these numbers healthy?

[lisette]

i think that would be about right for someone with high fsh. i don't have high fsh and i only had a few more than she has. it is good that the sizes are very close like that. as the follicles reach maturity, that is when the E level rises. they say that for every mature follicle, the e level is 200+, so probably by the time of hcg shot, her e level will probably be around 900+. you should ask the RE if he was expecting more of less than 4 follicles. there may be some smaller ones that they didn't tell you about? sometimes they just tell you about the big ones.

[Amber209]

I agree that those numbers are good and that it is good that they are close together in size. My RE often won't mention the ones under 10, so it is possible that some more might crop up in the coming days.

[mamamolly]

I know how disappointing it is to produce only a small number of follicles. Especially when you see others with dozens. But it is definitely possible to have success with this number. And a few more could appear. Good luck. (hopefully this time will work. If not there are other protocols the re can experiment with)