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Hi,

I am 39 years of age and have a *very low* AMH (ovarian reserve), and just had an unsuccessful IVF cycle for the 2nd time, but this one failed at a different stage of the treatment, and possibly for a different reason, as compared to the 1st one. The details are as follows:

** 1st IVF cycle:
Time: June 2012
My age: 38 years and 5 months
Stimulation time: 11 weeks
Drug used in stimulation: Menopur 450 iu
Time between hCG shot and egg recovery: 36 hours
hCG drug: ovidrel 250 MCG
Outcome: 11 follicles, 6 eggs (4 mature and 2 immature), 3 fertilized eggs, 2 eggs tranferred to uterus and 1 blastocist egg frozen, 1 pregnancy followed by miscarriage.
Frozen egg was transferred to the uterus in October 2012, following the miscarriage in August, but it did not implant.
This cycle was considered good, as it seemed that the quality of the retrieved eggs was good, as well as the response, considering the poor ovarian reserve and my age.

** Between 1st and 2nd IVF cycles:
Blood tests showed genetic incompatibilities between female and male genes triggering Natural Killer Cells. Female presents absence of cells to protect embryo from the Natural Killer Cells. So, in the 2nd cycle, intralipids and steroids are to be used to prevent miscarriages or implant failures.

** 2nd IVF cycle (with intralipids and steroids):
Time: April 2013 (10 months after the first cycle)
My age: 39 years and 3 months
Stimulation time: **10 weeks** (1 day shorter than the 1st cycle)
Drug used in stimulation: Menopur 525 iu (higher dose)
Time between hCG shot and egg recovery: 36 hours
hCG drug: Pregnyl 10 000 iu (different drug)
Outcome: 6 follicles (two of which with sizes 23 and 21 mm), 2 eggs (both immature), 0 fertilized eggs -] end of cycle 2.

Taken the above details into consideration, my questions are as follows:

(1) Is it possible that the reason for my only two eggs being immature in the 2nd cycle is a brutal drop in the quality of the remaining eggs in my reserve in only 10 months time? It is obvious that the number of eggs dropped significantly...

(2) May the fact that the 2nd cycle had a shorter stimulation time also be a factor?

(3) If (1) is true, can I have any hope for success in a 3rd cycle?

(4) A question for the experts: does anybody see anything wrong in the description of the protocol for the 2nd cycle?

(5) Any other views in what could have gone wrong?

Your answers will be VERY appreciated!
Thanks, Drita.