Would anyone look at my test results and give me tips?

[AWombWithoutAFoof]

I'm 43, DP is 39.

He has an "essentially normal" SA, "with some anti-sperm antibodies". I think the level was 12%, but that's not in the report.

My numbers are as follows:

Day 4
FSH 6.1 U/L
LH 4.5 U/L
Oestradiol 119 poml/L
Prolactin 115 mU/L
This apparently indicates "good ovarian reserve"

Day 22
FSH 5.7 U/L
FH 11.2 U/L
Progesterone 1.2 nmol/l
Oestradiol 328 pmol/L
Prolactin 132 mU/L (102 - 496)

Day 2 of the following month
FSH 6.3 U/L
LH 4.8 U/L
Oestradiol 100 pmol/L
Prolactin 197 mU/L
Ditto the ovarian reserve

We can't afford IVF, but the consultant said there would only be a 10% chance of it working anyway.

"Good ovarian reserve" sounds positive to me, what else can I do? Happy to rattle with pills!

I didn't have such detailed tests Si can't help much. did you have amh tested? that also looks at ovarian reserve? your day 22 prog seems low but they measure differently in different places, are you in UK? have you had an hsg to check tubes? not sure why they are saying only 10% chance of ivf working if you have good reserve? also FSH and LH are supposed to be similar levels on day 3, hopefully someone else can tell you if they look close enough.

Yes, the day 22 progesterone definitely indicates that ovulation has not taken place.

hi shell

of course it could have been done at the wrong time which may not mean you didn't ovulate. day21 test should be done 7days pre AF (7dpo if you have a 14day lp)

Yes very true lildottoe. The day 22 test just shows that ovulation has not taken place up to that point. But I wonder with such an unusually low FSH for age 43, it seems to indicate that ovulation perhaps does not regularly occur, and hence the higher than normal egg reserve.

Thanks for replying.

I have two letters that the GP printed off, containing the figures for day 4 and day 2 of the following cycle. They both contain the phrase 'good ovarian reserve'.

There is no letter for day 22, instead the GP gave me a computer printout. It has no dates on it so I'm assuming it's the day 22 test.

There is other info in a third letter, which is a summary of my last appointment. The consultant mentions the day 22 test and says it was ovulatory.
He also repeats that the chances of successful spontaneous pregnancy are low and the chance of a successful IVF at first attempt are low. He told me at the appointment the chance of successful IVF was 10%.

I'm concerned that you think by those figures I may not have ovulated, he definitely told me I had, and said he didn't recommend Clomid for women who were ovulating normally.

I haven't had an AMH test, does that indicate anything other than ovarian reserve?

I had an HSP before conceiving DD, it was fine.

Yes, I'm in the UK, although I'm NI, I'm not sure whether maybe things are different here.

Sorry, forgot to say, I get positive OPKs, but I don't temp due to never normally getting enough sleep in one stint.

I'm sure ovulation would give a result >30. amh just does ovarian reserve but there are thoughts it may also indicate egg quality (not proven yet though). +opk doesn't confirm ovulation, just that you get LH surges. how long was the cycle you were tested in? is how long after the cd22 test did AF show? as I said I don't know much about FSH but from shells comment I'd want to research/ ask questions.

really don't understand 10% comment. average is 30-35% and if you supposedly have regular ovulation and good reserve you should have a chance.

also just because tubes were patent before dd doesn't mean they are now. id want a hsg.

I assume you will have to go private as you already have a dd so I'd take results to another Dr and get a second opinion.

This is all worrying.

Tests were over a year ago, I was drifting in the NHS system for ages. I looked up a few clinics and their ICSI results for my age were 10%.

Yes, I know OPKs only predict ovulation, but is there a way of checking it's happened apart from temping?

Can you pay for an HSG privately? I do actually think that helped me get pregnant.

you can only confirm by temping or blood test.

I am NHS funded so not sure what you can get privately but I imagine you could get hsg done.

can you get gp to do new bloods maybe to compare the prog and do amh? amh can be done any time. mine was done with day21 test (not on day21 as I have long cycles). if it were me I'd ring around a few clinics and ask how much they would charge for u to email ur results and get some feedback/recommendations.

Can you remember how long the cycle was for the day 22 tests? Were they done seven days after your positive opks? How long do you normally have between a positive opk and your period starting?

Sorry, the tests were done so long ago I don't know the cycle length, although it was probably 30 days.

I normally get the positive OPK 14 days before AF.

Thanks for your help, this is starting to worry me. We absolutely cannot afford IVF, or to wait in the NHS system for months before asking for a second HSG. I wonder whether we could afford a private HSG, and how much that would be. I reckon there'd be new tests on top, plus consultation, wouldn't there?
To give an idea, we got DP's SA results about 8 months after they were done, I had an appointment I'd waited 8 months for postponed for another 4. It's just so frustrating when you're my age.

The poster who commented on a figure being low for my age, do you mean low good or low bad?

you are allowed to choose clinic on NHS. look on hfea website for ones near you to check waiting lists. 8months for sa results is disgusting. we waited 2 weeks and that was bad enough!

I don't think the NHS can offer me anything now, I'm 43 and have one DC.

I'm going to enquire as to whether I could have had a second HSG on the NHS, and if so I'll push for one. The problem is the time it may take to find that out.

I thought an HSG was just diagnostic, why do you think a second one would be useful? Are you taking any supplements? Angus castus, myo inositol and soy could all be useful for you. I am surprised the consultant thinks that was an circulatory cycle. Could you go private to get a prescription for Clomid?

I got pregnant two cycles after the HSG and the consultant mentioned that that isn't unusual. I'm clutching at straws.

The consultant specifically said Clomid wouldn't be recommended to women who are ovulating normally. I'm worried that on here people think that the test results show no ovulation but in his letter he says the opposite. Last cycle I got a very definite 'popping' sensation, but of course we all symptom spot when we're desperate. This is really stressing me out, to think there might be more to this.

I'm having acupuncture and Chinese herbs, plus wellwoman conceive.

It's possible there's a mistake in your print out or that the consultant misread it (my friend was actually pregnant the month she was told her progesterone was too low to have ovulated). You could ask your GP to repeat the test?

How do I raise that with a GP, do you think? I don't really want to say that MN tells me my consuktant's wrong.

I'm in a real panic now, this has all been going on for two years, and at my age every month is crucial.

I think I'm focussing on the HSG because I do believe it helped in the past, and I've been holding on to being told I'm still ovulating like a lifeline.

OK don't panic. the main thing is to find out if you are ovulating. if it were me I'd speak to a sympathetic gp and ask them to do a repeat day21 test (7days after pos opk, not day 21 necessarily) and get them to order amh on same test. if they say know ask how you get it dine privately. you don't have to mention mn. Google will give you plenty about prog needing to be > 30.
once you have that you will:

1. know if you are ovulating 2)have a clearer idea of ovarian reserve

I would also find out about getting hsg done. the fact it helped last time suggests there may have been a problem which may have recurred since. hsg is important for my next suggestion.

but first you haven't mentioned dh (or if u have I've forgotten so sorry). has he had an sa? (usually they do 2)

if his results are good and you are ovulating you could try iui as a cheaper alternative to ivf.

if you are not ovulating you may be able to get gp/fc to give you clomid. if not soy isoflsvones are supposed to be natures alternative. they cost pence in Tesco.

keep us posted and share any other results you have/get.

Thank you, have got into a bit of a state about this today.

DP's SA came back as "essentially normal with the exception of some anti-sperm antibodies". The consultant told me the level was 12% and that the effect is has is that the sperm don't slip past each other as easily as they might. He downplayed it and said not all SA tests even look for it.

I am in Australia so I would just go to any GP and ask for a blood test referral. Not sure how your system works and if it is that easy over there.

As for my progesterone result, the report says:
No ovulation ,5 nmol/L
Luteal phase 10-70nmol/L
Day 21 / mid luteal > 30 nmol/L

So if yours is 1.2, seems to suggest definitely no ovulation.
Perhaps the other thing to take a look into is egg quality rather than just egg reserve. I am 37 and having had 8 attempts at IVF, I have read all sorts of research and stats on egg quality and age. Even at my age up to 7 out of 10 eggs are genetically abnormal. Not sure how much this increases by at age 43 and if perhaps even if ovulation was to occur, the chance of that egg being genetically normal is very very low. Wasn't sure if I should mention this as I don't want to come across as a horrible person who is dashing your dreams, but perhaps something to look into to help come to terms with your situation and make a plan B.

I know when I had my day21 I read us/UK/aus measure in different ways so I've found reference ranges for you on an NHS university hospital site. may give you a starting point to speak to gp with. hope the links work as no www's!

FSH

progesterone

oestradiol

LH

prolactin

I'm starting to get really upset now. looking at the day 22 printout (the only thing the GP could find, and it's in a different format to the letters that the consultant sent), it says 'collected on' a date in March, yet the letters refer to tests done in August. I'm starting to worry that we have wasted literally years in the NHS system when we may have been best advised to have different treatment. I'm going to go to the GP tomorrow and try to sort all this out. I'm so upset by all of this.

I completely understand you bring upset. just try and focus on a plan of action rather than dwelling on what has been. you can't change it so put all your energy into fighting for what you deserve - fast answers.

You definitely have not ovulated with that CD22 score.

DNA fragmentation below 30% is fine.

AMH is the best indicator of ovarian reserve/quality that there is at the moment.

There is no point getting panicky at the age of 43 - you know the stats - you have a 3% chance of conceiving naturally each month or 11% via IVF. A couple in their twenties with normal fertility only have a 33% chance of conceiving every month.

You need, of course, to ascertain whether you are ovulating at all, in any cycles. Please, please don't listen to GPs - they know very little about fertility. It is said in some quarters that Clomid is 'bad' for women over forty who are already ovulating, but my gynae has happily prescribed me 100mg (I begged). Who cares at this age if there is a small chance there is a negative impact?? This month I went for my CD14 scan to see what ovary action there was and two eggs were about to be released. You can't hope for better than that.

If you can scrimp and scrounge £5.5k from someone as a loan you can get donor egg IVF abroad (inc accommodation and flights) and you have a 68% chance of a take home baby at your age (I did this at 42 - my baby is the love of my life and I'm going to scrounge and bawl my way to another loan from my parents to get her a sibling ). I wouldn't even consider IVF using your own eggs.