November 2009- Start preparation process (charting, diagnostics, picking donor)

Realize I have 2 types of cycles: The first, with a day 16 ovulation has a short luteal phase (11 days)
The second, with a day 20 ovulation has a longer luteal phase (approx 13 days).

April 17th 2010- IUI # 1 (unmedicated), in the day 16-ovulation type of cycle:  10 DPO: BFP Pregnancy # 1 underway
6.5 and 7.5 week u/s- All is well
12 week u/s- no heartbeat, missed m/c, possibly around 8 week point.

Products of conception chromosomal analysis = Normal XY
Some RPL testing-Positive for anti-thyroid peroxidase antibodies (TSH 2.86) and very slightly elevated anti-cardiolipin antibodies.

September 25th 2010- Start Synthyroid 50 mcg

October 7th 2010- IUI # 2 (unmedicated) in the day 16-ovulation type of cycle; 10 DPO BFP; pregnancy # 2 underway
15 DPO beta 457; progesterone 46.9; 18 DPO beta 1702
Repeat anti-cardiolipin antibody test = negative.
8w1d u/s- HB 150, CRL 8w1d- breathe big sigh of relief, start to think all will be well.
8w6d u/s-  no heartbeat -- missed miscarriage

Testing (in chronological order):

  • Products of Conception Karyotype: Turners Syndrome 45 XO
  • My own karyotype is normal XX
  • Further Testing results (to investigate  for PCOS).  No insulin resistance, Low AMH (1.1 ng/mL), Vitamin D3 deficient (16 ng/mL) , Testosterone (elevated) 85 ng/mL, DHEAS elevated and consistent at over 200 ng/ml. Overall------>confusing!!!! Especially the AMH which is supposed to be high in PCOS
  • Freak out about low AMH, think I have a case of diminished ovarian reserve.
  • Find  a study that shows that the AMH gene can be 'turned' on by Vitamin D3, leading to the notion that maybe the gene needs good levels of vitamin D3 to be expressed properly. Start Vitamin D3 supplementation (60,000) IU weekly. Over 2 weeks later, recheck D3, AMH and do an ovarian ultrasound (to look for PCOS).
  • Results: polycystic ovaries, antral follicle count is 30
  • Vitamin D3 levels are bought up to high range (70 ng/mL) after 2 weeks of massive supplementation. 
  • AMH- now high, a 4-fold increase to 5.18 ng/mL. Overall, this puts me in the abundant ovarian reserve/ PCOS range.
  • Start taking 4000 IU vitamin D/day. 
  • FMR1 gene testing normal.
  • Cycles look great for a while: Day 20 ovulations with 15-16 day luteal phases. 
  • AFC now 16.
  • At some point, I add daily calcium to my supplements, and prenatals as well, bringing total Vit D/day to 5000 IU/day. 
  • Glucose tolerance test passed with flying colors.
  • A couple of months before I start TTC again, I realize my Ovulation day has shifted to Day 17. Luteal phase still at the 15-day length.
  •  Blood testing prior to IUI #3: Thyroid- very much under control; Vitamin D3- too high, close to toxicity at 86 ng/mL
March 2012 IUI # 3 (unmedicated) - BFN

Vitamin D supplementation reduced to 3000 IU  (2000 Carlson Tabs + 1000 IU in prenatal daily)

June 2012 IUI # 4 (unmedicated) with ovulation on day 17.  BFP 10 DPO- Pregnancy # 3 Underway
13 DPO beta = 71, progesterone = 25
15 DPO Beta = 137; progesterone = 23.5
Nervous about lower progesterone and betas and slower doubling times that previous 2 pregnancies, but find study showing that Vitamin D can regulate beta-HCG production
17 DPO Beta = 324; progesterone = 33
21 DPO Beta = 2456, progesterone = 28
6w6d U/S HB = 110, CRL 6w2d
8w2d U/S No HB, missed miscarriage possibly around 7 weeks. Earliest pregnancy loss so far. 
Testing results show Trisomy 4. 
RPL panel reveals I am heterozygous for PAI (PAI4G/5G) and the MTHFR C677T mutation.

Break, return to India, Still taking around 3000 IU Vitamin D/day and start metformin
IVF # 1 (October 2012)
Supplements: Folvite ( 5 mg), Metformin, Vitamin D (2500 IU/day) 
AFC = 13
Microdose lupron flare protocol (starting from CD2). Stims start from CD4 (300 IU Folligraf). On day 8, due to a poor response, bumped upto 450 IU (150 IU folligraf + 300 IU menagon)
Good E2 response, many follicles
Trigger: 10000 U HCG
Get 11 eggs, 4 M2, 3 fertilize, 1 makes it to 3AA blastocyst on day 5.
Jan 2012: FET for surrogate: BFN

Discover microdose flare protocol may not be ideal for people with PCOS, and other flaws in first IVF protocol.
Stop calcium completely, take only 2000 IU vitamin D/day, skipping one day per week.
Start taking myo-inositol (1000 mg/day) Ovulation day moves  back up to day 19/20.
Jan-March 2012: monitor AFC: holding steady at 25.
Experiment with myo-inositol: Over 2000 mg/day bad for me, as determined by changes in my natural cycle.
Take myo-insoitol daily (1000 mg) + Vit D (2000 IU) + folvite (5 mg)  for a few months.

IVF#2 (June 2012) (protocol designed by me to minimize LH as well as the FSH stim dose, to mimic my natural cycle as closely as possible)
Supplements during stims: 1000 mg/day myo-inositol, 5 mg/day folvite, 200 mg/day Coenzyme Q10, and 2000 IU/day Vitamin D.  
AFC = 24
Antagonist (0.25 mg) on CD 1 and CD3,  and then restart when lead follicle hits 14 mm, every alternate day.
Stims: Fixed dose Gonal F (150 IU/day) from CD2 onward.
Monitor both LH and E2. Lowish E2 response 48 hours before trigger (2574 ng/ml). Could be attributable to low LH (under 0.5 ng/ml) and myo insoitol.
LH had become very low (under 0.5). To compensate for this, I modified my stims on the last day:  75 IU Gonal F + 75 IU Menagon (i.e., 75 IU FSH + 75 IU LH) to give a total of 150 IU FSH + 75 IU LH
Trigger: 500 micrograms Ovitrelle
Retrieval: 19 eggs: 15 M2, 2 M1, 3 GVs
16 eggs fertilize with ICSI (14 M2 and 2 M1)
8 blastocysts (5 4AA, 1 3AA, 1 2AA and 1 1AA) frozen in pairs.
1st Transfer of two Day 5 blastocysts (not my idea, my RE decided to freeze in pairs without informing me of it, much to my displeasure) BFN
2nd Transfer of two Day 5 blastocysts: BFP
Healthy baby girl born at exactly 37 weeks!


  1. When ou say 60,000 iu per week, was that 10,000iu supplement per day?

    I'm going to try this as i am in the same boat too. Very low amh and deficient in Vit D.

  2. HI there! I just found your blog. I too have a stork blog.
    I hope you get your take home baby very soon!