Dear Dr. Sher,

42 year old here desperately wanting to be mother for the first time! 6 year unknown infertility, 99 lbs, 5’6”, eat healthy, taking COQ10 and prenatal, very healthy and no disease illnesses in the past. My AMH is 2.15. Husband all testings ok. Here are my cycles (all in 2023), if you could be so kind to take a look:

1st: Microgynon(BCP) pretreatment, Elonva(Long FSH), Desogen(BPC), Puregon 300(FSH) -> Decapeptyl 0.2 = all empty follicles
2nd: Pergoveris 300(FSH+LH), Ganirelix since day 5 -> Ovidrel 250 + Decapeptyl 0.2 = 6 oocytes, 4 mature, 2 embryos, 0 blastocysts
3rd: Ganirelix 3 day pretreatment, Gonal-F 300(FSH), Ganirelix -> Ovidrel 250 + Decapeptyl 0.2 = 11 oocytes, 8 mature, 6 embryos, 2 AB/BB blastocysts, both aneuploid
4rd: Estradiol 3 day pretreatment, Gonal-F 300(FSH), Pergoveris 300(FSH+LH) and Ganirelix both only on the last 4 days -> Ovidrel 250 + Decapeptyl 0.2 = 13 oocytes, 8 mature, 6 embryos, 2 AB/BB blastocysts, both aneuploid (again)

Antral follicles count at each cycle start: 1st:9, 2nd:7(duostim!), 3rd:12, 4rd:11

For the last attempt of my life (!), I am trying Omnitrope (not sure what dosage). Should I drop any LH? Should I trigger with Ovidrel only and NO Decapeptyl at all? Should I change Ovidrel to 500, instead of 250, even with my low BMI? Also, I can’t do any BCP pretreatments, right? Should I keep trying? Please advise.

Thank you immensely for generously imparting such precious and invaluable information to the entire world. Your efforts truly merit our profound appreciation.

AM