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Ovarian reserve - AMH test combined with Ultrasound Scan

(11 Posts)
Theia Tue 27-Sep-11 15:40:31

I'm ttc my first and 44 years old. Just got some pretty sad news following a AMH test (0.07pmol/L) along with transvaginal ultrasound which showed only one follicle which is 15mm. The consultant has advised my chance of pregnancy at less than 2%! Have also been told that IVF will not help my situation.
In addition, the scan showed fibroids and a bulky uterus (not sure what that means)
Has anyone else had this combination of tests with low results? Should I give up now?
Would really appreciate hearing from anyone who has faced any of these issues

kat2504 Tue 27-Sep-11 15:50:31

I have no knowledge about your situation I'm afraid and hopefully someone else will come along soon.

But if it is too late for using your own eggs, even with ivf, perhaps ivf with donor eggs might be a possibility? Is that something you have considered or asked about?

ghislaine Tue 27-Sep-11 16:01:46

I don't know where you are in the country or how far you are prepared to go (or how much to pay - I assume you are already have investigations outside the NHS), but I do know that the Lister Hospital in London has a very good success rate with women who have low AMH. I didn't use them myself, but the chatter on the fertility boards indicates that they at least would be able to give you the most up to date and honest appraisal of your chances.

Theia Wed 28-Sep-11 16:53:53

Thanks very much for your messages.

The consultant did suggest donor egg but this is not a route I wish to go down. He also said that fibroids could cause a miscarriage.

@ghislaine - I will investigate the Lister Hospital, thanks for the lead. The consultant I have been using is private and in London. His name is Dr Nardo.
Anyone else seen him?

Teds77 Wed 28-Sep-11 17:32:55

Theia very sorry that you've had this news.

I have low AMH and at best probably 5 or 6 follicles.

We're having IVF/ICSI because of DH's very low sperm count. It didn't work first time but I remain hopeful it might do in the future.

However, from our perspective, IVF is it's the only way we're ever going to get fertilised eggs and I did get 3 eggs during our failed cycle - the odds are with only one follicle you'd probably only get one which might be why your consultant doesn't think IVF is for you.

I do think it's worth getting a second opinion either from the Lister (we're doing our next IVF there) or it might be worth investigating 'natural cycle' IVF. If money is no object then by pursuing IVF it's possible that you could increase the chances of your follicle definitely producing an egg, increase the chances that egg is fertilised and once you have an embryo there is a a fighting chance it becomes a successful pregnancy. But I'm afraid I'm no expert.

Good luck x.

kat2504 Wed 28-Sep-11 17:45:35

I think it is also worth bearing in mind that regardless of the fibroids, your age related risk of miscarriage is about 50%. It is a harsh statistic but one worth bearing in mind if you are going to be spending a lot of money on ivf.
I don't know about AMH much, but don't the drugs they give you before ivf treatment make you produce more eggs anyway?

Theia Thu 29-Sep-11 11:26:21

@Teds77 Sounds like you have eggs and age on your side so wishing you lots of luck xx My understanding is that it's impossible to see the immature follicles in the ovary and AMH is the only 'window' into the likely reserve. A few follicles will mature each month and the 'best' one ovulates. Then the follicle disappears and the whole cycle starts again with new follicles. In my case there was only one visible this month.
Next month who knows? However, low AMH is supposed to indicate a low reserve so my ovaries are sort of rationing the rate of release. This lowers the chance of getting a 'good quality' egg. @Kat2504 Yes, I also thought the ivf drugs should stimulate more follicles to mature but the consultant seems to think this won't work because of the low reserve. So frustrating

MoJangles Fri 30-Sep-11 21:55:01

Theia , sorry to hear you've had this bad news. I've had a similar experience, with an AMH of 1.3 and FSH of 15. I decided to go in search of the elusive one good egg anyway, and 3 rounds of IVF (only 1 of which got to embryo transfer despite off the scale drug doses) later I was much sadder and poorer. Like you, I rejected donor eggs (not my baby, something slighly frankensteinish about it) and furiously took supplements and researched natural cycle IVF. The most useful thing anyone told me was Dr Nargund at Create, who scanned my ovaries, found one follicle, and said 'there is no point in stimulating these ovaries'. I was 42 and needed to hear what my options really were. I had a big think about whether I wanted a childless future or to have children a different way, which was very tough. My donor egg DS is now 10 months, the most precious thing in my life and utterly mine, people even say he looks like me. I'm on the 2WW to see if we can give him a sibling.

Obviously what's right for me wont necessarily be right for you, but my key message would be to find a specialist who will be honest with you (rather than just encouraging) so that you can really measure up your options. Very best of luck.

hopefulgum Sat 01-Oct-11 08:56:53

Theia, I'm sorry about this news. I have also had a very low AMH result. I was told that it is "abnormal ovarian reserve". However, I am not surprised at how low it is given my age :44.

I just wanted to say that despite this I have had two pregnancies in the last 8 months. Sadly they both ended in miscarriage. I wasn't aware that low AMH put me at risk of miscarriage, but my doctor said she was very surprised by the amh result because I did get pregnant. The first miscarraige was due to a trisomy, the second one, we aren't sure.

I have read that AMH level won't change, but I have heard of one woman (on this website) who's level went up!

I've also recently read that as long as there are eggs there, there is hope, and the ovarian environment will determine the quality of your eggs. It is important to keep the blood flowing to the ovaries and there are different ways of doing this : aspirin, acupuncture, massage, exercise, yoga, manuka honey (heard about it recently on mumsnet).

If I had a DH on board I would do donor eggs, but for me it has to be natural. I haven't given up hope, but I am aware that it may not happen.

I wish you all the best.

hopefulgum Sat 01-Oct-11 09:03:24

I just read this thread which was quite positive:

hopefulgum Sat 01-Oct-11 09:05:58

Oh - forgot to say that DHEA is supposed to help with quality of eggs. Perhaps you could mention that to your doctor. I am going to start taking it soon.

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