Monday, 24 June 2013

Hello Premature Ovarian Failure, welcome to the party

Today we had our 2nd meeting with Dr. Cotter to go over the results of the numerous tests requisitioned in May.  My tests were "the surprise." Aaargh.  Not in a good way.


Mr. Turtle's 2nd semen analysis:
Similar numbers to before, very few sperm with normal morphology or motility after 3 hours

Now on  to me:

No tubal blockages, looks normal. I think that was the main  point.

Ultrasound of uterus and ovaries:
2 Fibroids, one bigger one smaller, but they are not considered significant.
Uterine lining is good
4 follicles on the left ovary (click for more on  antral follicle counts)
No follicles visible on the right ovary


Prolactin: OK

Day 20: Progesterone OK, somewhat low but looks like ovulation happened

1st Day 2 bloodwork:
FSH 3, Estrogen 751

2nd Day 2 bloodwork:
FSH 19, Estrogen 63  (click for more on FSH testing)

Not sure I completely processed Dr. Cotter's explanation of what those numbers mean, but the main point was this: it looks like my ovaries not functioning well. The low number of follicles observed on the ultrasound seems to confirm this hypothesis. Poor ovarian reserve (POR).  Premature ovarian failure (POF). I think I might be more "POR" than "POF"as I do still have a regular cycle, but it is short (average 25 days) and I suspect that I do have some anovulatory cycles.

IVF is still on the table, but the chances go up that I will not respond to stimulation, and therefore not produce enough eggs, or worst case,  not produce any eggs.  It's not hopeless, but it becomes more of a gamble. And more expensive, as I will be taking the higher doses of drugs.  We would do Flare Protocol.

Possibility of IVF with donor eggs was mentioned.

IUI is not recommended due to the sperm issues.

So, our newest homework is to consider whether we want to go ahead with the fresh IVF cycle with our gametes, and what what we will do if it doesn't work, or if we decide that it is not worth the gamble. We intended to make B and C plans in the case of unsuccessful IVF attempt(s) anyway; I will not even start an IVF cycle without a B or C plan.  But since IVF was the most likely path it was  kind of blocking the view of anything else. Now we have to look beyond IVF, and maybe that's a good thing, although the POF is not good news.

If we decide to go ahead with IVF, I will be taking DHEA and co-enzyme Q10 for some months before the cycle starts, to try to give the ovaries  some mojo.

But before any of that, I am having a karotype test to see if I'm a of carrier of Fragile X, which can be a cause of POF.  Should the genetic test come back positive for Fragile X, that would  pretty much preclude IVF and therefore genetically related children, as they would  have to scan the eggs for the gene and I likely wouldn't produce enough to scan.The possibility is low: I think Dr. Cotter said about 1% of POF cases have Fragile X. So it's unlikely, but statistics aren't much of a comfort anymore: it seems like we're on the wrong side of them often as not.

What a maze.


  1. oh my gosh... so sorry to hear this news!

    I know how difficult it can be to mentally process having fertility treatments using a donor. I considered this option a year ago when we found out just how bad my husband's sperm is. It took us two round of IVF to finally come to terms with using a sperm donor.

    Take all the time you need to process this information. Whatever you decide to do moving forward, we will be here cheering you on!

  2. Thanks Gypsy Mama! I really appreciate the support. It will take a while to process. (Maybe it's not always a bad thing that fertility investigations and treatments involve so much wait time.) Seems like every time we think we have a handle on what's going on, and a way to cope with it, there's another surprise (and they haven't been nice surprises).

    I didn't realize you had used/considered donor gametes. I think we will put all the options on the table and talk and think a lot about it.

    1. You are right, there are always surprises in this journey!I don't specify on my blog that we are using donor sperm for our IUIs just because a lot of people in real life read my blog, and I haven't decided if it is my story to tell or my husbands (although he is totally fine with me telling it). I'm sure I will write about it once I am pregnant.

      But I want to support other people who conceive using donor gametes so if you need to talk, shoot me an email :)

  3. Going the Donor Eggs route seems a bit extreme to me at this point. I would suggest trying with your own eggs first. I know of people with DOR who have succeeded with own eggs on the first attempt. All you need is ONE embryo to make it work! And yes DHEA will help.

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  5. Thanks Ariel! I am inclined to agree - based on current info - that we'd like to try with our own eggs. If it makes sense to do so. It's discouraging to hear that the chances of success are reduced....but not game over yet. I wouldn't mind hearing more about the people with DOR who were still able to conceive with IVF. Time to get back doing research.

    Gypsy Mama, it's good to know you are there to talk about donor gametes too! Always so much to learn. At least there are good supportive people out there!

  6. I have a friend who was diagnosed with DOR at the age of 28 (imagine how that feels....) but she conceived twins on her first IVF attempt. From what I have read, younger women with DOR have a better chance than older women with normal ovarian reserve. It's all about quality of the eggs. And early 30s is a good time to start IVF.

  7. Thanks for the perspective! Terrible news for your friend to get at 28 - but wonderful to hear of her happy ending! Egg quality is not something we discussed at the appointment - it all focused on quantity of eggs and how that affects the chances of IVF success. Perhaps that is something to bring up at next appointment. Hopefully we will be less like deer in the headlights!

    The main concern seemed to be that I would not respond as well as they would like to the stimulating drugs and that there was a higher chance of the IVF being cancelled mid-way due to failure of egg retrieval. But it seems to me that as long as my ovaries are producing SOME follicles even on their own, it can't be completely hopeless. I will look for more information on DOR and egg quality - I've had to process the emotional side of this before involving myself with more research, but I'm always aiming to get more informed.

  8. Well, welcome to this crappy club. Just found this post. I'm in the DOR boat as well. If you are interested in reading about some DOR success stories, I'd suggest checking out or Two lovely DOR ladies with pregnancies in process. There are some more, but these are the two that come to mind right off the bat. There's also, who has full blown POF and is going the donor egg route. I'm DOR too, headed to my third IVF in the fall. It's a tough diagnosis but we are tough too.

  9. Thanks Aramis! You're right it is crappy but all the nice comments and blogs make me feel less alone (not that I wish DOR on anyone :-( )

    The people I have found so far seem to be taking similar paths - DHEA supplements, IVF, sometimes donor egg. I will check out the blogs you mention and will be following yours too. :-)

  10. Yes, welcome to our crappy club. There are definitely some amazing success stories out there, which is amazing. I'm not through all your posts, but I'm currently having the donor eggs vs. keep trying with my own eggs. Oh, and my husband has non-obstructive azoospermia, so we're likely going to DS route. It's no fun, but it's nice to know we aren't alone.