What seems to work best for which poor responders and women over 40?

This is one of those areas where we’d hope the empirical literature would be able to tell us what works for whom and under what conditions. But unfortunately poor responders and women over 40 – and particularly poor responders over 40 – are a relatively small group and rather neglected in the research (JMHO). So, […]

What are the main IVF options for poor responders?

What are the main IVF protocol options for women with high FSH/low AMH/DOR and poor responders? This post covers the main protocols, choices of stim drugs to use, and the main arguments for high vs. low-stim options. […]

Conflicting expert opinions – how do I know who’s right?

So, you finally plucked up the courage to go for a second opinion, and guess what – now you have two or more well-qualified and plausible experts with compelling arguments telling you to do the exact opposite. Who should you trust? Who’s more credible? And, can’t we just rely on the scientific literature to give us the answers? […]

New and “untested” treatments

“My doctor talked about the ethics of infertility treatment and how some clinics will try (and charge for) all sorts of unproven treatment where often there was no medical reason for a particular patient to require that unproven treatment.” The unproven treatment issue is a really interesting one because most medical professionals consider “proven” to mean something supported by multiple randomised controlled trials. The problem is that cutting-edge ideas are new and haven’t had the chance to be sufficiently trialled (or, in some cases, don’t lend themselves to such randomised designs for ethical and/or practical reasons). So, should all the new ideas be ignored until they are considered “proven”? […]

What are the main IVF protocols used in NZ?

Basically there are three main protocols used by NZ clinics (plus a few variations, which I’ll try to add later): 1. The ‘long’ protocol (default for young women and those with normal FSH; not generally used on high FSHers unless they are quite young, and seldom on anyone over 40 because it can easily oversuppress those with diminished ovarian reserve). 2. … […]

Questions to ask a prospective specialist

Before committing to working with a particular specialist, it’s a good idea to ask them a few questions to get a feel for their approach to treating patients like you.

All too often I have talked with women/couples who have gone through their first consult with a specialist and simply assumed that whatever treatment plan […]