TW: mentions of prior success

We're TTC at ages 39 (me) /40 (him) for a second using timed intercourse with severly low AMH (.014 last I checked.)

To conceive my first we did intensive cycle monitoring (regular labs and ultrasounds), with a trigger shot when an egg was mature enough and progesterone for luteal support. Both the trigger shot and progesterone were sort of "supportive, just-in-case" kinds of decisions to optimize chances each round by cutting off *potential* problems. I ended up accidentally conceiving on a cycle with a super early ovulation when we lucked out randomly having sex for pleasure (who would've thought.)

This time around we started out trying bare-back (no meds, just tracking), in part because my fertility clinic which was AMAZING and affordable and like 5 minutes away sold to a predatory private company and I can't afford services there anymore. Luckily I'm still in touch with my old RE who moved into generic "women's health" but can't bill under fertility anymore so is limited in how she can help.

From there, we instantly ran into some new problems (yay!):

- My first cycle out the gate was my worst nightmare -- weeks and weeks of flatlined estrogen and not recruiting. We ended up just doing a round of progesterone to reset on my old RE's suggestion.
- The next cycle was weird probably from adjusting to the exogenous progesterone introduction (my temps stayed super high the whole time then I started a period right when I thought I was about to ovulate.)
- I then tragically lost a really good looking cycle because I started a period at 5 DPO (which is when I learned that my FSH is high enough now that I seem to sometimes be successfully recruiting during the luteal phase, which can crash-end my cycle.) I considered just starting progesterone again once I was 100% positive that I ovulated, but I was full of self-doubt and, as I mentioned, no longer had access to ultrasounds to help me confirm. In hindsight I feel I was definitely certain enough I should've started progesterone.
- Then on the next round I quickly moved toward ovulation. At this point I finally got into another clinic with more reasonable prices (far away unfortunately) after waiting nearly 5 months to get in, and got an ultrasound. I had grown two great eggs --one on each side-- but they for some reason didn't release and have grown too large, so now I'm at risk of LUFS (when eggs begin to luteinize--aka become corpus lutea--without the follicel rupturing, so they're trapped inside the ovary instead of moving down the fallopian tube) -- but am starting progesterone tonight to try to shrink them down and start over before that happens, because otherwise it can take 1-2 entire cycles for them to go away on their own.

So now with my new access to this clinic, finally, I will be able to get some help in spotting/confirming ovulation in a timely manner, and I'm going to go back to using trigger shots/progesterone to ensure both egg release and a long enough luteal phase.

But now my old RE/new clinic have both introduced this idea that maybe I should be taking estrogen as well. There has been a lot of different talk of how I could approach it:

- Luteal phase only, to suppress FSH and therefore prevent luteal recruitment, which would be extra luteal insurance and possibly regulate my cycles just a touch (possibly going from 17-62 day range like I've been lately maybe to more like 21-45 day range, say)

-Kind of ongoing, to suppress FSH and also help me to generally feel better.

But I have read that ongoing estrogen CAN be really hard to fine-tune to individual physiology to make sure it doesn't accidentally completely block ovulation, and the idea of going through all that troubleshooting is not appealing to say the least.

I've even heard that luteal-only estrogen can make things wonky for a while/require a few cycles of adjustment. I really don't want to throw more wild cards in/put myself in a position where I'm having to monitor things even more and make adustments and think about a whole other variable -- I'm in full time grad school + practicum with a toddler at home and my cognitive load is already very high -- but I am wondering what people's experiences have been with this.

Thanks for any and all thoughts.

Without getting too much into it, I have a condition that generally makes conceiving very hard. Often people with my Dx end up using a donor egg. We nonetheless conceived my first in 7 months, a true miracle.

She‘s now 19 months. We had a “scare” at 12 months when we were technically cleared to start trying, and I flipped out— was clearly not ready, which shocked me bc I thought I’d be in a hurry to try for a second since we want 2 and it’s a big question mark whether we’ll be able to.

Two months ago, we decided to stop being careful. It Unfortunately happened to be a hellish 62 day cycle with a few near-ovulations but no success.

Whenever I thought I might be near ovulation, I’d suddenly panic about having a second. We’re really struggling with money! I’m in grad school! We’re not stable! We’re already stressed! What are we thinking?!

Then as soon as it was clear I hadn’t ovulated, I’d panic in the opposite direction. What if that’s it?! What if it’s not going to happen? What if we only have one? And I’d feel so sad, and look at all the women with two around me, and pray every morning for another child.

If ovulation seemed near again, I’d yet again panic about having a second…

What do I do with this craziness? Anyone relate?