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. […]

I’ve got high FSH/low AMH … what does it mean?

If you’ve clocked in with elevated FSH (usually defined as any reading >10) or OK FSH but elevated E2 (>150 in NZ units, or >40 in U.S. units) or low AMH (<14 pmol/l in NZ units, or 2ng/ml in US units), then you have probably been visiting Dr. Google and have come up with a very depressing view of your chances. Your specialist may also have told you this is not good news. And no, it's not, but here are a few snippets of information I've been able to glean in my travels. [...]

What is assisted hatching?

Assisted hatching is an optional extra procedure used in IVF where a small hole is made in the shell (or ‘zona’) of a Day 3 embryo. This is supposed to help (in some cases) the embryo ‘hatch’ out of its shell and transform itself into a blastocyst (usually on Day 5). Is it publicly funded? Should we ask about it? Are there any risks? A few thoughts and some links to a really good site. […]

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? […]

The Biological Clock: Cool interactive tool from Fertility Associates

Wondering how much time you have left to dilly-dally before seeking treatment? Fertility Associates has just put out a very cool, interactive ‘Biological Clock’ to show you the odds of getting pregnant naturally vs. IVF at your age and beyond, and how long you should wait before seeking treatment depending on your age and how […]

What is DHEA?

DHEA (Dehydroepiandrosterone) is a naturally occurring hormone in our bodies which depletes as we get older. Here’s some info quoted from a UK site (<– click the link for more detailed info):

Description: DHEA, also known as “the mother hormone”, is produced by the adrenal glands and is the most dominant hormone in the body. […]

When and how should I seek a second opinion?

Suppose you had a friend who was grappling with a cancer diagnosis and kept wondering whether his/her specialist had really considered all the possible treatment angles that might work. Suppose he or she had been receiving some treatment but there hadn’t really been any sign of progress. What would you advise? Probably a second opinion, right? For some unknown reason, fertility patients seem to struggle with this notion that it’s somehow disloyal to seek a second opinion. Yes, it is awkward. But actually, it’s just good common sense if there’s any little voice inside your head saying “maybe there’s a better way …” If you think you might want to get a second opinion on your case, here’s what to do … […]

IVF – the hurdles

So you’ve read the IVF manual and are all ready to start a cycle. What are some of the “wish I’d known that” snippets that veteran IVFers can share with you to help fill the knowledge gaps about what to expect? Well, one that comes up a lot is having a clear understanding of the not-so-straightforward hurdles involved in an IVF cycle. Here’s a list of some of the main hurdles you need to clear as you go through the process … […]

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. … […]