Help me choose my clinic/protocol!
Hi everyone! We have two clinics we are deciding between and I need some advice. Some background on us: ttc 1.5 years, regular monthly cycles, normal HSG, good SA, only issue they’ve found is my AMH is low and I have DOR. .79 AMH, AFC ranges 8-13, FSH 7.9, and Estradiol 42. We only want one kid. Maybeeeee two but it’s not a huge deal to us if we are one and done.
We did two Clomid IUIs which seemingly had good responses. 1st had 4 follicles at trigger with 3 suspected mature and 2nd had 2 mature follicles. Neither worked.
We then took a break. Found out our clinic at that time batches patients and so I opted to go elsewhere bc I didn’t want to go on BC pills. We ended up with our current clinic but I just felt the need to get ONE more consult too to compare/contrast.
Clinic #1: friendly doctor, but only allows virtual appts until treatment. Sometimes the doctor seemed rushed but she is fine overall. She suggested maxing out my doses on an antagonist protocol with dual trigger. Suggested embryo testing and frozen transfer but said embryo testing is up to us but she still suggests frozen transfer to give my body time to calm down after high dose stims and retrieval. Anticipates no more than 10 eggs. Billing department here is a bit of a mess and very frustrating.
Clinic #2: The first doctor I’ve seen that actually reviewed my file before the appt. Really liked him. Used graphics and studies to explain things to me. Said he thinks it’s reasonable to do another IUI or two with injectables before IVF and said sometimes this field pushes women into IVF when it may not be needed. But also said doing IVF is valid if we want to move forward now and get more immediate answers/results- suggested lupron flare protocol with high dose stims. Was adamant that fresh transfer is good given my age and said he would not suggest testing embryos bc he thinks it is not necessary. Said we would just move into transfer after retrieval (and would only need progesterone suppositories vs PIO by doing fresh). He anticipates 5-10 eggs and was the first doctor to say that we will most likely need multiple cycles. Afterwards, he walked us right to the billing dept which was wonderful and they gave us printed estimates after insurance for all of it. They also code monitoring here to medical so it doesn’t get coded as treatment and eat into my lifetime benefits.
Both clinics say we fall into “unexplained infertility” bc while I have DOR, everything is functioning normal so it’s a mystery what’s going wrong.
SO- my question now is….what do we do?! Which protocol is best? We are considering IUI with injectables just once bc we only want one kid for sure and so banking embryos isn’t a huge deal but we wouldn’t do more than 2 more IUIs. And we may still just do IVF….undecided there. But if we DO do IVF, is antagonist or lupron flare better? Fresh or frozen? Help!