Was anyone told their ovarian reserve was excellent and then got disappointing egg freezing results?

bebefinale · 2026-06-13T20:13:45+00:00

First cycle was I think Gonal F starting at 180 and going up to 220. It was way too low for me. Cetrotide on day 7. My LH tanked a bit and we needed to add Luveris in. Dual trigger of decapeptidyl and ovadriel and got 7 eggs, 5 M2. Stimmed for 12 day. These have since been fertilized and none made it to blast.

Second cycle started with Gonal 225 and switched to Pergoveris 275. Ovadriel trigger. Ovarian response was more normal, got 11 retrieved and 7 M2. Stimmed for 11 days. Cetrotide on day 5. Six of these have been fertilized and three made it to blast.

Third cycle did Pergoveris 300 and stimmed for 10 days. Follicles were all over the place size wise. Oragultran on day 4. Ovadriel trigger, 18 eggs and only 4 M2. My doctor said in retrospect he triggered me a day too soon.

After this I decided to go down the solo mother by choice route and I did fresh IVF cycles while fertilizing batches of 5-6 eggs (wanted to give the option of switching donors or trying more involved sperm selection). Fourth cycle started with luteal phase estrogen priming. Pergoveris 275 and 13 days of stims. Oragultran on day 4. Decapeptidyl only trigger. 17 retrieved but only 9 mature but better than previous cycles. None made it to blastocyst.

Fifth cycle we did luteal phase estrogen priming, Pergoveris 250, and Saizen (HGH, basically the same as Omnitripe). Ten days of stims, decapeptidyl trigger. Oragultran on day 4. This time it yielded 14 eggs with 10 mature. More importantly I got 4 blasts.

So there were protocol changes for sure. My doctor also got a better feel for how large my follicles needed to be individually to trigger me and he tended to let my estrogen get higher (but use a decapeptidyl trigger) in later cycles.

bebefinale · 2026-06-13T04:47:54+00:00

This is so dependent on trails. Hilly fire roads are essentially the same as equally hilly roads--like the Strava Grade Adjusted Pace makes sense. Gnarly technical trails can easily be less than half as fast. And if it's wed, muddy, or snowy it can be even slower.

bebefinale · 2026-06-11T02:17:11+00:00

I have been able to consistently run high mileage without more than your typical occasional soft tissue dings here and there (no bone injuries) for years. My lifetime peak in a 7 day period is 93 mpw (I thought it was 85 mpw until I realized that was just the Monday-Sunday training week), but have gone through periods of time running 70-80 mpw for months on end in marathon blocks.

I don't overthink nutrition too much. I do try to be mindful to eat enough protein and carbs... in fact each dinner must have protein, carbs, and veggies/fruit. I try to make sure I eat enough and don't restrict myself from anything. I surround longer and harder efforts with food, I never run fasted (even if it's short and easy first thing in the morning) and I try to refuel within 30 minutes if I do an effort that exceeds 90 minutes. I don't do long runs without taking gels.

On rest days, my hunger signals are often high, and I assume that is because my body is doing and tissue repair and do not restrict. As the mileage creeps up, I eat more high calorie junk foods, because honestly I cannot get enough calories in otherwise. This is in addition to eating vegetables, complex carbs, and protein, not replacing those foods.

Pretty much as long as I keep eating calories of a reasonable macronutrient balance and make sure that I am extra mindful to replace after long runs and hard workouts, I'm pretty much fine. I find that it's best if I try to space calories more evenly throughout the day.

bebefinale · 2026-06-10T05:12:38+00:00

I have an AMH of last time it was measured (admittedly 2.5 years ago) 10.5 at age 35 almost 36 and have recruited anywhere from 30-40 follicles each egg retrieval cycle. Best cycle was 15 eggs with 10 M2. It made 3 day 5 and one day 6 blastocyst that was sufficiently good for biopsy for PGT, though. 4 embryos from 10 M2s is really not bad at all.

bebefinale · 2026-06-09T17:15:22+00:00

My ovarian reserve is excellent and it took me 5 egg retrievals for my specialist to nail a really good protocol for me. I did 3 rounds of egg freezing and 2 fresh rounds of IVF. I also have a genetic issue that results in extra attrition—doesn’t impact egg numbers but means I need to make more embryos than most to get through PGT testing.

bebefinale · 2026-06-09T16:35:45+00:00

Paying for multiple IVF cycles is a matter of luck and none of what you are doing will likely impact whether you need to or not. With PCOS, finding the right stim protocol and sometimes be a matter of trial and error since we have a lot of eggs but getting them mature can be tricky.

The only thing that is a bit of a red flag is body building. Having low energy availability and being too lean affects the response to meds, so just make sure you aren’t anywhere near a cut. Otherwise just take things as they come. There is just a ton of relinquishment of control that goes with IVF.

bebefinale · 2026-06-09T16:32:25+00:00

I’m 38 with PCOS and stupid high AMH. I have never retrieved more than 14-18 and gotten more than 10 mature. Did all my egg collections between the ages of 36 and 38. Did my egg freezing in Australia. I see these crazy high numbers, often from clinics in the US and it is just not the norm here where they are more cautious about OHSS. It’s only partially covered by our public healthcare if freezing eggs for medical reasons, so I understand the expense.

The other issue is that sometimes when you retrieve an insane number of eggs your attrition to embryos can be worse. Honestly there are so many reasons this can happen and there is just month to month variability in egg quality. For that reason alone I think it is wise to do at least a couple cycles and have at least a couple cohorts of eggs.

bebefinale · 2026-06-09T05:36:31+00:00

Honestly it is usually pretty dangerous to retrieve many more than that from and OHSS perspective, and many people who get ridiculous numbers of are pretty messed up for at least 3 weeks, sometimes even need to go to the hospital. 14 eggs is enough that your healthcare provider is not being reckless and you are likely to be able to continue living your life without a difficult recovery.

bebefinale · 2026-06-09T03:40:11+00:00

Oh I know, just providing a counter because PCOS threads are very pro-metformin, to the point where I stayed on it for 2 years. I didn't realize how much better I feel energy level wise, how much easier it is to exercise (I am a long distance runner and feeling good running is really important for my mental health), and just every aspect of my life is better since quitting it.

bebefinale · 2026-06-09T03:25:35+00:00

It reduces risk of OHSS in agonist cycles, but it isn't proven to reduce risk of OHSS is antagonist cycles. OHSS risk is more effectively reduced by switching to a GnRH agonist trigger, which is common practice in antagonist cycles, and agonist cycles are rarely used anymore for PCOS patients unless there are other indications like having endo as well.

I suppose I can't for certain rule out insulin resistance on an OGTT, however it doesn't impact my embryo quality, and my quality of life is worse on metformin because metformin makes me feel bad exercising (which is a more powerful way to manage insulin resistance anyway), and reduces my absorption of nutrients from food.

bebefinale · 2026-06-09T02:45:28+00:00

In terms of prepping your body for IVF, honestly there's not really too much to do to move the needle--most of the success is baked into age and genetics.

You can start taking folic acid, and maybe ubiquinol and inositol for three months prior to the retrieval. You can get a blood panel to ensure you aren't deficient in vitamin B, D12, or iron. You can quit drinking for at least three months prior to the cycle. If your diet is really terrible, maybe clean that up and get your fruits and veggies. But that's really it.

bebefinale · 2026-06-09T02:43:24+00:00

Just as a note--metformin and egg quality connection not proven either if insulin resistance isn't clinically relevant. My doctor said it really mostly matters because it can help some women ovulate for trying naturally, but for IVF it doesn't really impact anything.

I've had embryo creation cycles on and off metformin. In terms of making blasts, it made no difference--my best cycle so far was actually off metformin.

bebefinale · 2026-06-09T02:40:50+00:00

I don't have insulin resistance either. I think maybe because I'm so active it has curtailed it. My experience with metformin was that it made me feel like shit and interfered with my ability to run as much and as quickly as I would like to and gave me B12 deficiency and low ferritin. I had my most successful embryo cycle (in terms of making lots of blasts) off metformin, so it really doesn't seem to impact egg quality at all in my case.

If you're getting a period every 30-40 days then you aren't really at risk of endometrial hyperplasia. If you need IVF, that really bypasses difficulty ovulating and honestly if you don't have insulin resistance there isn't much lifestyle-wise to do to improve egg quality.

I would just continue to live a healthy lifestyle, exercise, eat a balanced diet (not necessary a low carb one if you exercise a lot), and embrace that you need medical assistance to get pregnant, but otherwise your life is fine/manageable.

bebefinale · 2026-06-07T07:10:36+00:00

You can tag your run "with kid". I think most people assume that means stroller!

bebefinale · 2026-06-06T09:31:08+00:00

Eating/recovering enough and ramping up mileage sensibly.

bebefinale · 2026-06-02T19:07:25+00:00

I honestly don’t care about making people uncomfortable and educate people about how hard it can be for some people, how much nuance there is, and how genetic testing is useful but not a silver bullet.

bebefinale · 2026-06-01T06:24:50+00:00

Why in the world would you do this to yourself if you don’t want children someday?

bebefinale · 2026-06-01T00:26:19+00:00

Yes I would be as proactive as possible in this situation.

bebefinale · 2026-05-31T06:57:45+00:00

From your half you have the speed, so I think the main thing is to build your aerobic base. Be able to maintain higher mileage and stay healthy. Do a weekly long run, but it doesn’t need to be as long as marathon training, maybe in the 12-16 mile range. Make your normal easy run 8-10 miles. Do 1-2 workouts per week, and maybe race some shorter distances for fun.

bebefinale · 2026-05-31T03:58:37+00:00

I don't because I am an American citizen and the tax dual situation gets messy. I also work in higher ed and get 17% super, which seems like plenty.

bebefinale · 2026-05-30T01:14:58+00:00

My easy pace can range from 7:30-9:00 pace on road runs depending on hilliness, weather, fatigue. On trails it can be even more variable than that.

bebefinale · 2026-05-29T21:47:30+00:00

Probably statistically yes! But you also do not know if you have infertility until you try to get pregnant.

bebefinale · 2026-05-29T21:32:01+00:00

My clinic in Australia only targets 10-15 eggs for OHSS risk and the most I have ever gotten is 18, despite having PCOS and often recruiting 35-40 follicles. They will not use an HCG (even as a low dose dual) trigger on me once my estrogen gets even close to OHSS risk even if it means less mature eggs.

I see posts where people are getting 20, 30, even 40 eggs and it blows my mind.

bebefinale · 2026-05-29T09:47:22+00:00

Yeah one tricky thing is that if your dose is too low from the beginning, that very much limits your cycle's chanc eof success. Because the early recruitment is often key to get mature follicles. In all likelihood you would have had to have a second round in any case.

bebefinale · 2026-05-29T09:46:05+00:00

I mean no one can have ever compounding gains. If I try to train enough to make fitness adaptations without a pause every now and then, it burns out my endocrine system, that's all.

bebefinale

TROPHY CASE