Treatment or no treatment

[Attagirl79]

Hi all

I'm fairly new to this and would appreciate your advice - I posted part of my query on another post so apologies for the repetition. I have a 20 month old DD luckily easily conceived and have been trying for no.2 for 8 months. Early days many of you will be thinking. I felt like something was wrong, so after 6 months of TTC I went for some tests which showed I have an AMH of 4.39 (I am 32 so pretty low!) I have since had the test redone at a different lab and it came back at 8.12 but without doing a third time I guess I don't really know which is more accurate. I have had all the other tests which seem appropriate and they don't show anything being wrong, even my FSH seems normal.

Clearly if it hadn't been for my AMH result I would have given myself a talking to and told myself to stop stressing but I find it difficult to ignore on the basis that it is already so far down the low fertility bracket and will ofcourse (save for lab errors) only decrease further.

Also add into the equation that I do a fairly stressful job which I am desperate to give up but without knowing what treatment I might need (and the cost of it) I flit between the obvious, having a child is a billion times more significant that money... and how would we pay for it?!

So I am not in a position where I need to arrange an appointment with my consultant re the action I should be taking. He isn't being particularly proactive so I want to go in with a strong prefferred action plan. Do I go for IUI on the basis that in theory we might have just been unlucky on timing so far and this would add about 10% probability to conceiving in a given month, do I take the more drastic approach of going for IVF which as some of you commented on another thread below is far more likely to work and is not that much more invasive or do I do something seemingly unrelated, give up my job take a bet that the lower levels of stress etc (at least in the short term before we miss the money!) might help might assist....though this seems really risky given the speed my biological clock is ticking at!!! Given that my ovulation seems to be ok, would clomid be of benefit to me?

Apologies for my rambling, any advice much appreciated.

Thanks so much!

Hi, just read your message and thought i would share my story in the hope it will help.

I am a 36 year old with a 3.5 year old DS and was TTC my second child for 18 months. Thankfully i am now 18 weeks preg but it was a struggle to get to this point. Like you i had an inital low amh score (6) and had 2 further amh tests (17 and 10). My faith in the amh test is v low - it is supposed to be consistent over your cycle and this wide spread of results told me and my consultant nothing really concrete about my fertility. So, i would either ask for the amh to be repeated or ignore this and embark on other tests.

My consultant (i was lucky enough to go private thru my medical insurance) made me do various investigative tests. I doubt any consultant will fast track you to ivf or iui before doing more tests, especially as you are still young. My partner had a sperm test (normal) and i had several tests including dye in my tubes and a camera through my belly button to see the womb etc. These showed i have one blocked tube. Only at that point did they suggest ivf (about 6 months after all these tests). Tney did not suggest clomid as my amh score was low and so producing more eggs of potentially poor quali was, apparently, not going to help me but as per above the amh test does not fill me with confidence. Anyway, we went for the ivf consultation and was about to start the drugs when i found out i was pregnant. I think the main factor for me was almost 'giving up' TTC naturally as i knew ivf was on the horizon. We were also on holiday when i conceived. This seems to be a common trend and, for me, demostrates the power of the mind in all this fertility business. Its all very well someone telling you to relax though - totally impossble!

As for your job, i too have a stressful job (although one i enjoy). I really put work on the back burner throughout all this stress though - i had more important things on my mind and work just had to come low down on my list of priorites. As my partner said 'youre not barack obama - your job is not that important'.

I really wish you well in your consultant appointment - i found everytime i went i came away feeling down about it all but glad i was being proactive and doing all i could to get preg. Its a very stressful time for you and your partner - keep your chin up and soldier on. Xxxx

Thanks so much Helen. Congrats on your pregnancy. I hope it is all going smoothly. It is really interesting that you had a big variance in your AMH results. Were they undertaken by the same lab? My consultant said he had never come across a variance as large as mine let alone yours. I have still yet to meet with my consultant though he has prescribed me with 100mg of Clomid days 2-6 for three months without any explanation whatsoever! I am trying to get an appointment to see whether he intended this to be taken in isolation, whether he should be monitoring me at all and whether I can have IUI this month. I think that I will feel much better when I have a finite plan. At the moment I am feeling quite down about it all. I am a compulsive planner so this is a little difficult for me to handle!! I am also feeling better about packing in the job. I think I am going to resign in about 10 weeks time (unless I get pregnant before then - fingers crossed!)

All the best.

Atta, as you say, 8 months isn't that long. And as Helen points out, sometimes it will just happen with patience and chilling out. However, I sympathize with needing to have a plan, and on your question of whether to have iui or ivf, I would be aiming at ivf. I think iui is a waste of money and time in most cases. But as Helen also wisely says, you should go for the tests first to see if they lead you anywhere and to give yourself a few extra months of trying naturally while that's going on.

Hi attagirl79
Yep the tests were all done in the same lab - consultant had no explanation. My gp thought that it could be stress related as it is a hormone test after all, but all the talk around amh says stress should not effect it. Its a new test and i think they clearly need to work out how to use these results!

Like you i need a plan - makes me feel more in control. Its good he has put you on clomid - worth a try at least.

Keep us updated with how you go. Its v easy to get down about this. Towards the end i found myself mildly resenting friends who were pregnant and counting the number of children in families i would see out and about. Weird! And not like me at all but it is a very easy to find yourself consumed with it all. Plus my consultant was not the most sympathetic and its a hugely emotional issue.

Im feeling for you and wishing you the best of luck. Xxx

Thanks whiteshoes and Helen.

I have finally tracked down my consultant and his sec left me a voicemail telling me he wants to discuss IVF. I have yet to be convinced he even remembers who I am, so I am not sure I want to resort to IVF quite yet. I think I would rather give myself some time off work and recuperating from the stress I feel at the moment and see if it works naturally...anyway will let you know what he says.

I have still been managing to show that I am genuinely happy for people with bumps until last night when a night out with a group of friends when several people asked when I was going to have no.2. The first couple of times I laughed it off but on the third question my eyes just welled up :0( I felt like I wanted to spend the night hiding in the loos but instead put on a brave face and left at the earliest non-suspicious time. I gave myself brownie points but it was not a pleasant experience!

Anyway enough whingeing from me! Thanks so much for your support!