My Dec 2025 HSG showed bilateral tubal occlusion — but that's not the same as hydrosalpinx. Only the latter is embryo-toxic. A dedicated TVUS is the missing test.
Strong evidence that hCG + GnRH-agonist co-trigger outperforms hCG-only on MII oocyte yield in DOR / age 40+. My Grace cycle used single trigger.
My endometrium was 6.1 mm at trigger. Best-supported approach: freeze-all → natural-cycle FET; intrauterine PRP as adjuvant; hysteroscopy before cycle 2.
Evidence is mixed: ~1 extra egg per retrieval and possibly lower miscarriage, no average live-birth benefit. My low T puts me in the likely-responder subgroup.
CoQ10, melatonin, omega-3, Mediterranean diet, exercise — what's supported, what isn't. Honest framing: nothing reliably moves live birth, signals are on surrogate endpoints.
Zhao 2026 RCT in DOR / age 40–45. Protocols matched overall; mLP showed a strong subgroup signal for fresh 2-cleavage transfers but didn't survive correction.
What I can actually change to get more eggs, and whether it costs me on quality. Real movers: 3 cycles not 2, dual trigger, CoQ10 at 600 mg. Skip: testosterone, GH, DHEA, DuoStim. Avoid: OCP priming + antagonist.
Realistic prognosis for my profile: ~20–30% cumulative LBR after 3 own-oocyte cycles. Curve plateaus at cycle 4. Prior natural birth doesn't predict IVF success at age 40.