Question
Hi; we have had three cycles of IVF using ICSI in the UK. Prior to be referred for IVF I had a laparoscopy and some endometriosis lasered. ICSI was used as my partner had initially been found to have a low sperm count but at the time of our last cycle last year this was confirmed to be normal with abstinence from hot baths for a number of months! During the cycles they also established that I have low ovarian reserve (diagnosed via an AMH test). I have read in a number of forums about women with low AMH still achieving successful pregnancies using different stimulation protocols such as short phase and "natural IVF". Our 1st cycle achieved no eggs with low stimulation of 150iu of menopur stimulation. 2nd cycle we got 2 eggs, both fertilised but no pregnancy this was on 300iu of Gonal F. 3rd cycle 375iu of Gonal F and three eggs, only 2 fertilised and were put back ? miscarriage, didn't do a pregnancy test until 10 days after I started bleeding as fell into a deep d epression but what came away was not normal menstrual blood (grey/pink worm like tissue) and had severe menstrual cramping. Miscarriage suspected by doctor but no medical proof. During each cycle I have produced follicles in my left ovary but none of the follicles have contained eggs, I have also found it extremely painful being scanned on the left side to the point of crying in pain and suspect that I have a problem with that ovary. I have asked to be referred back to my gynaecologist to have further examination on this.
I am not ready to consider a donor egg option. Could you please advise what you would consider our best treatment options to be taking account of our history and what the cost would be, including the drugs. My friend Emily Bates had treatment at your clinic 5 years ago and had quads!!

Answer:
We would like to try our best to help you have your baby. According to your medical history, it seems that it will not be easy for you to get pregnant but you must try again and again. As long as we can obtain eggs from you and make the babies in the IVF laboratory and transfer them, you may get pregnant. It is a luck that you are still 38 but probably next year you chance will decrease a little bit more which means you are also running against time..
Please note that 10 to 15 % of our patients are coming from abroad especially from UK.
To realise what we can do differently for you, we should understand your condition in detail. Please send us the copies of all your medical records you have, (hormone levels, sperm analysis, HSG report, details of your previous treatments and surgical operations etc..) to understand your medical condition. We will check your reports and tell you the extra required tests if any. Probably it will be better for you to use oral contraceptives for 30 days to prevent the formation of cysts which may interfere our treatment.
If you choose our Centre for helping you, during the treatment period, Mrs Aysan Candas, who is responsible for foreign patients will guide you for every aspect. There are also many reasonable options for accommodation near to our Hospital. We may send the details if you'd like.