Testing ovarian reserve???

[tenpoletudor]

I am 49.
I have 2 children which involved icsi ivf as my partner had MF issues.
I am separated.
I have met someone. He would like children in due course.
I suspect I am too old and if that is the case would rather know now, having been through the misery of infertility (although I was very fortunate with the outcome I realise)
I want to ask my GP if it is possible to check my ovarian reserve as I am obviously knocking on a bit. I am still menstruating bang on, (and I assume still ovulating due to EWCM each month?)
I cant afford to go private, I dont want to ask my GP (tiny remote village and GP does not keep secrets in the village).
I have an appt at the sexual health clinic in the nearest big town.
They will do my smear which is due. I asked if they could test my ovarian reserve. They said yes if there is a medical reason.
It is more than just 'curiousity'.
I need to be able to plan my next few years and that includes knowing if there is a chance i am still fertile. There were complications re the ivf (frozen embryos that ex-H would not give permission to use, which expired) and not being able to 'use them' was exceptionally painful. The thought of 'trying again' is hugely tempting, but no point laying awake at night dreaming if I have no eggs left.
Will they accept this as a 'need'?

[Scottishgirl85]

I'm sorry but at 49 your eggs will not be genetically normal, even if you are ovulating every month. The nhs will not treat you or investigate you for fertility, not only due to your age but also that you already have children. At a private clinic you would need to use donar eggs and obviously there is an additional cost to this over and above standard ivf costs. I'm sorry if this comes as a blow but you need to know the reality. Hope you can find peace with your situation x

[tenpoletudor]

Scottishgirl

thank you for replying.
I have no intention of using assisted conception or donor eggs.
I just want to know if I am still ovulating?
ie could i still get pregnant naturally?

and how can I find that out?

[Scottishgirl85]

An amh test will tell you about your ovarian reserve. But it tells you nothing about quality. At 49 you will not get pregnant naturally, your eggs will mostly be genetically abnormal and so conception and maintaining healthy pregnancy would not occur. I'm really sorry but it is impossible to fall pregnant naturally at 49. You may still be ovulation but your eggs won't be viable. Celebrities that have children at that age have all used ivf with donor eggs, even if they don't admit it x

[SleepFreeZone]

I'm not sure I would go so far as to say impossible. You do hear of these mad cases where a 50 year old falls pregnant naturally but it is once in a blue moon.

If it were me I would get myself some ovulation sticks, have timed sex and see if you are one of those amazing people who has a baby just before menopause.

[tenpoletudor]

Well I know it's not impossible as 2 female relatives had babies at 49 and 53 respectively (babies had no genetic issues)
but I appreciate it is unlikely even though fertility can peak a bit before menopause.

How do I get an amh test done? I realise it doesn't predict, esp quality, but if there are no eggs left at all I'd rather not hope.

It would be better for my mental health to know if there is no hope.

[Persipan]

You can certainly get an AMH test done if you feel it will help you - you'll need to go private for that, I think. I feel, though, that Scottishgirl's point is valid. By age 49, the vast majority of your eggs will be chromosomally abnormal (I believe well over 90%). Your odds of conceiving with your own eggs are less than 1%, and your risk of miscarriage would be extremely high as well. I doubt that any doctor is going to tell you that it's absolutely impossible for you to get pregnant until after you've passed the menopause (particularly since it can occasionally happen, as with your relatives), just that it's very, very, very unlikely.

It sounds as though what you're really hoping for is that someone can give you that '100% no chance', though, just fit the sake of your mental health. I wonder, then, whether it might be more helpful to you to look into getting some counselling or support with how you're feeling, since maybe this would enable you to get some peace from this.

[EarlGreyT]

There is no test which can categorically tell you whether you are still able to get pregnant or not.

I'm sorry to be blunt, but I agree with PP, the chance of you becoming naturally pregnant at the age of 49 is almost zero. Not zero, but almost zero. Your female relatives having babies at 49 and 53 are very much the exception and this is very unusual.

An AMH test only tells you about your ovarian reserve (I.e. How many eggs you have left), but won't tell you anything about the quality of those eggs.

An early cycle FSH/oestradiol will give you some idea of egg quality and how hard your body is needing to work to stimulate a cycle each month.

A progesterone level done 7 days before the expected start day of your period (e.g. D21 of a 28 day cycle) will tell you whether you ovulated on that particular cycle, but nothing about previous or future cycles.

The problem with all of theses tests is that none of them are perfect and none of them will be able to definitively say that there's no hope. I.e. Even if the results are not good it doesn't mean there's definitely no chance of pregnancy and conversely if they're ok, it doesn't mean that you'll necessarily be able to conceive. The most predictive factor of whether you'll be able to get pregnant is your age and unfortunately this isn't on your side.

[EarlGreyT]

cross post with Persipan

[tenpoletudor]

Thank you for the further info.
I do remember having tests to see if I was ovulating when ExH and i couldn't conceive.These would have been the FSH ones, they did them over a few months.

Are the over the counter ovulation prediction kits worth a candle?

Sounds like the NHS might not be willing to do an FSH test for me (ironically given i was tested inside out before they found it was MF 15 years ago).

I DO appreciate that you are all trying to make me see sense.
I know that having freakily fertile rellies (and getting pg myself both times with only 2 cycles of ivf ) doesnt mean i am stil fertile.

A tiny bit of hope is a dangerous thing, so if they said my FSH was really low then I'd just tell him and be done with it

[EarlGreyT]

if they said my FSH was really low then I'd just tell him and be done with it
It's the other way round with FSH-if it's high that suggests poor egg quality which is why your body makes a lot of it, because a lot is needed to try to stimulate a follicle (egg) to develop.

[tenpoletudor]

Oh. {I'm an idiot} thank you EarlGreyT

I wonder if a kind GP would test it, if I explained?
I suppose I can but ask.

[Chattycat78]

Really sorry, but I agree with the others, although there is no evidence that fsh tells you anything about egg quality- only how hard your ovaries are having to work to ovulate. The amh test would only tell you how many eggs you have left and nothing about the quality of those eggs. No such test exists to test egg quality, and at 49, it's pretty unlikely that you could find a good egg. I won't say it's impossible, but really not very likely.

[Loopytiles]

53! Bloody hell.

[Chattycat78]

Pregnancy at 53 must be very very rare. TBH I'd say anything after about 43 Is most unusual.

Also I think you can carry on ovulating here and there til menopause. Doesn't mean the eggs are any good though, which is the key thing.

[tenpoletudor]

I come from fertile stock and am pretty fertile myself.
(2 lots of icsi ivf, pg both times straight away, prev pg whilst on pill)
BUT
I see that finding out I have ovulated after any particular month doesnt mean I have done so any other month, as it were.
Plus it doesnt mean any particular egg is any good.
Plus the chances of miscarriage / a non standard fetus skyrocket.
I DO see all that.

I separated from my H in Oct.
Partly because the 5 embryos we'd had in storage for the last 10 years (since my dd's cycle) he would not give permission to use. I was unable to donate them (age at creation) and couldnt bring myself to give permission to destroy them. Eventually, it timed out and they were destroyed by the clinic. I went alone to collect them.

I had no intention of trying for any more children. I cherish the two I have. But at around the same time i reconnected with the love of my life. We separated 25 years ago (I wanted children, he wasnt ready) but it was a mistake. He has never had children and always regretted it. He knew of the embryo situation. He told me that he wanted to give me / and me to give him, a child. He wants it very much.

It is very hard to deal with.
I keep telling myself - I am 49. it is not going to happen (and if it did there would be horrible complications).
But a sliver of hope is proving tenacious.

Thank you for your sensible input. I am grateful.