hi there (long..)

Hi there,
My situation is similar to yours and I think my RE was realistic about my outcome.
I am 38 with a high FSH of 14.6 and I've just done one IVF cycle (I had one 3 years before which was successful). I am in the 2ww now but I was on max stims Follistim 450u, 10 units low dose HCG in the morning which was upped to 20 units around day 6. My antral count was 9 follies in total before stimming, then during stimulation, I did not respond well at all. Only 3 follies grew with a fourth lagging behind. We had to decide whether to proceed or cancel but the RE felt that we should proceed because he didn't think we'd necessarily get a better response in another cycle. He felt that unfortunately, this was just a result of my age and that there is always the possibility of getting more eggs, but also there is the possiblity of getting less, and certainly I will not get many eggs anyway because it was clear I am a poor responder. I asked the RE about whether I would respond better on a lower dose of FSH (In my very first cycle 3 years ago, I got 8 follies with 300-400 units Follistim) but he said that all the research shows that my protocol was the most evidence-based and effective for people like me.

So to answer your 3 questions:
1. I don't think your doc should be so negative, but he should be clear about your chances so that you know where you stand. There are plenty of women here who have great FSH-friendly REs who are positive and willing to try other protocols. For us, we are self-pay so we do not have the option of cycling over and over again but if you do have that option, you should try to find an RE who will be more positive to at least do all he/she can to improve your chance of success.

2. Other women here have done EPP protocols, low stim and high stim protocols. My protocol didn't produce what I had hoped for but my RE didn't think it was worth cancelling the cycle and trying a new one. I wouldn't say that my RE is specialized in high FSH cases but I do think that he did what he could.

3. I ended up with 3 big follies (19 - 15mm) and one 13mm follie before ER, and the other 5 "disappeared". My u/s only lasted a few mintues too but the technician was excellent. It is possible that your RE missed something but probably not.

I hope this is not a downer for you and that you keep trying for your dream if you are able to continue. I feel that it is important to be realistic but the body is unpredictable and science incomplete. Out of my poor 3-4 follies at ER, only 1 measly egg was retrieved and my RE said that it was disappointing but not unexpected in women with high fsh at my age. But surprisingly, that one little egg did become an 8-cell embie and was transferred...so if we could do limitless IVFs, we would! I am in the 2ww and am hoping the little egg sticks but if not, I am comfortable knowing that my RE and I gave it our best shot.
Good luck to you and I hope your next cycle is lucky!