Hello,

I am 40 yr old female with low ovarian reserve. I responded poorly to my first protocol OCP/antagonist. That cycle was cancelled and I was restarted on estrogen priming antagonist protocol with clomid and omnitrope adjuncts. I cleared my baseline US on 5/18 with follicles seen on both the right and left. However today on my day 4 US, they said both ovaries were “quiet” and no follicles seen. How can this be?

In addition, my estradiol level was checked and is below 5 and I feel awful. I’m horribly fatigued with horrible brain fog making it almost impossible to get through the day. Why would it be so low after estrogen priming? It was completely normal on all previous checks, with the last just two weeks ago?

To give you a better timeline of events:
Esterase 5/13-5/18
Cycle day 1 and baseline US 5/18
Started Clomid and Omnitrope 5/19
Started gonal f (150) and menopur 150 5/21
Finished Clomid 5/23

My AFC and AMH were very low at baseline when I started IVF. My expectations are realistic given these numbers. However, I’m hoping you can help me understand a bit more about what’s going on.

With gratitude
Amanda