u/DryClient4833

36F with DOR looking for feedback on first IVF cycle, especially the low maturity rate.

Background:

• AMH has ranged from ~0.6–0.85
• FSH 7.8
• AFC usually around 10–12
• stage 1 endometriosis treated via laparoscopy in July 2025 (not on ovaries)
• 5 prior medicated IUIs (no trigger) before moving to IVF

Round 1 protocol:

Priming:

• 35 days estradiol 6mg
• 15 days Prometrium suppositories 200mg

Stims (13 days):

• Clomid 100mg
• Follistim 250
• Menopur 225

Suppression:

• Ganirelix 250mcg started stim day 10

Trigger:

• Pregnyl 10,000 units on day 13

Monitoring/labs:

Baseline:

• E2 18
• Progesterone 2.5
• AFC ~10–12

Day 6 of stims:

• E2 66.9
• Progesterone 0.4
• LH 6.4
• Around 6 follicles, all 9mm or smaller - doctor said they were growing very slowly

Day 12 of stims:

• E2 1154
• Progesterone 0.6
• LH 5.4
• 3–4 follicles on right, 1 on left - sizes 18–21mm

Trigger day:

• E2 1782
• Progesterone 1.0
• LH 5.8
• 3–4 follicles on right, 1 on left - sizes 21–26mm

Retrieval:

• Retrieval on day 15
• 5 eggs retrieved
• Only 2/5 were mature and able to be ICSI’d
• Both fertilized normally (2PN day 1)

I’m mainly trying to understand:

• Does 2/5 mature seem unusually low given these follicle sizes/E2?
• Could trigger timing have been off?
• Does anything about this protocol stand out as potentially over-suppressive or not ideal for DOR?
• Has anyone had significantly better maturity in later rounds after protocol changes?

TYIA!