IVF for diminished ovarian reserve

[dxp87]

Hi all, i’m new to all this and sorry as know there are lots of threads out there already. I got my test results today- 2.7 amh and 14.8 fsh. We had been trying to conceive since February and discovered dermoid cysts, one on each ovary in April. My amh then was 8.4. I had them both removed in May, and my periods returned normally. I am 32 and recently married and had no idea I would score so badly. I hadn’t yet considered the ivf route but I think I’m going to go straight for it. I am just worried I will be a poor responder due to my awful scores. Does anyone have any suggestions or recommended clinics for ivf in London? Many thanks.

Some clinics won't accept low AMH - Create specialises in women with low AMH

I'm with them - not necessarily due to AMH level although that is lower than average but because I wanted to do mild low stimulation IVF

Low AMH does mean you don't respond as well but it's about quality not quantity - plenty of women I've seen on here are high responders and get 20+ eggs but end up with the same (or less) viable blastocysts than someone who produces much fewer eggs

AMH does fluctuate a bit so it's possible your ovaries just haven't had chance to recover from surgery - I would start taking a good pre conception vitamins like Proceive and additional coq10 and also there is DHEA for women who don't produce many eggs (difficult to get hold of but there are a few websites you can get it from)

I'd recommend going to a few open evenings - choosing a clinic is very subjective and people can have very different experiences

Thank you. When I got my 8.4 Amh score in April I already thought this was low so started on 400mg of umbiquinol and a raw prenatal. Have also been taking r lipoid acid, NaC, vitamin c, vitamin d and fish oil. My acupuncturist says I’m still young and can conceive naturally. I can’t help but panic though after no success and now these low scores.

I did look at create but was put off by some of the comments on here. How do you find them?

I had also seen the bad reviews but most of those centred around the call centre (once you're signed up you get the clinic mobile number) and I think the Bristol branch

For me Create have been really good - although I'm with the Birmingham one (I have had scans at the London one as I often work there) - the staff are lovely - I had a failed transfer in March and conceived naturally straight after - they were great about supporting me and proscribing medication to try and help prevent miscarriage (the miscarriage clinic at my hospital were useless) unfortunately it didn't work and I did mc. My second transfer ended in ectopic and they have been very caring and compassionate - my hospital refused to scan me even though I nearly died from an ectopic last year. Create got me in straight away and called the ambulance - the nurses all came in to give me a hug and they have called regularly just to see how I am and how my husband is.
I can't fault the treatment I have received and the after care. I'm going to do another full cycle with them next month

Thank you for the information they are definitely on my list. I have an appointment with CRGH next week just to see what they say and what they suggest for us and will do a bit more research on other clinics. Good luck on your next cycle xx

My results were similar to yours at 34 OP.

Since then, I’ve had an Ivf baby and 2 natural pregnancies - one of which took one month of trying.

Don’t rule out natural conception also unless you have reason to.

My Ivf also worked first time despite only 2 eggs being collected - it felt like a miracle- but in fact, it’s all about quality over quantity and at your age, your eggs will be good.

Good luck.

Thank you for sharing @Ilikeviognier. It’s always so lovely to hear success stories and gives me some hope Did you start ivf first before your natural pregnancies? The plan was always to try naturally until Christmas, but the test results has made me think I should at look into ivf now as I don’t want to waste any time. I also have a short luteal phase (8-9 days) which I don’t think helps matters! (That was reason for getting tested so early on into our TTC journey, and then discovered the dermoid cysts!)

I started ttc naturally first- got pregnant, had a miscarriage, then did Ivf which worked.

When the baby was 8 months and my period came back I thought I’d better start ttc again as I thought it would be a long job/might not happen. Instead I got a bfp 4 weeks later and now have 2 boys with 16 months between them!

My advice would be to do both. Also supplements can help you- eg ubiquinol.

Ditto for ubiquinol, and a water and fat-soluble form absorbs better.

Thanks, have been taking umbiquinol 400mg since May. I may up the dose to 600. Has anyone used DHEA supplements? Do UK clinics endorse the use or is this more US led?

@Ilikeviognier do you mind sharing what clinic you went to for IVF? Was this in London? Did you do a stimulated cycle?

Hi,

My scores were fsh 11.8 and and 8.4 age 31. However on a scan they said I had a good number of follicles (don’t know how many)

WE had ICSI for male factor reasons but were told to do it ASAP because of my scores (has your partner been checked as this may effect your decision).

We got LOADS of eggs - 20 cycle 1. 22 cycle 2. I now have a baby boy and two Frosties I’m planning to use ASAP. I asked the consultant how I could have gotten so many eggs with that amh and fsh and he said age is a more important factor and no one knows how many eggs you really gave until you have a cycle of ivf.

I didn’t go to a special clinic, first round was nhs and stayed at same clinic for second private round.

If I were you I’d book for some open days ASAP and just canvas some consultant opinions. Try not to panic - I coped with it all by just knowing I was doing everything possible so wouldn’t have any regrets. Good luck

Hi OP I did Ivf in Leeds actually, yes stimulated cycle.

I was on the max dose at 450 but still only got 2 eggs. I was totally ready to give up tbh. But somehow that one embryo became a bfp and then a baby! And then his brother was conceived 9 months later. So clearly it’s not hopeless.

Hi dxp,
Thought I’d also echo what others have said. Don’t get fixated on your blood results if at all possible, like I did. My results were worse than you (amh less 2, fsh 17) and ivf did work first time for me (stimulated cycle) and surprisingly I’m now pregnant naturally with a second. I was 37 when I had ivf too. So much older than you! I suppose no one can ultimately tell you how things will pan out, but you can’t predict from blood results alone. You have age on your side, unlike I did! Good luck x

I know this is a very old thread but I just wanted to update 2 years later as I spent a lot of time here looking at old posts and the success stories gave me such hope. I did three rounds of batching/EC in Sept/ Oct/ nov 2019 and ended up with only 4 day 3 embryos across the three cycles. In January 2019, the 4 embryos were thawed and 3 made it to blast. I had 2 put back in a FET and 1 took and became my lovely little boy who is now 9 months. I’m hoping to go back for a sibling for him soon (which has got me lurking back on here again!) but I wanted to share my story in case helpful for anyone xx

Thank you dxp for sharing. I’m on here as I just got a 2.8amh and your story has given me hope x

@Ems123456789 my friend is 38 and has an amh of 1.2 pmol. She recently told me she conceived naturally and is now 14 weeks pregnant, she was due to start ivf in aug. In our case my OH also had v bad scores with his sperm dna fragmentation so we went straight to icsi in the end and gave up trying naturally. As others have said I hardly got any eggs each round but it did work for us. Good luck with your journey @Ems123456789

Thank you for sharing. My accupuncturist keeps reminding me that my low amh does not mean I cannot get pregnant naturally. It’s good to to know. It’s good to know the story of your friend and I wish you the best of luck in your next journey too. X

@dxp87 thank you for updating us with your story. Always great to hear a happy ending. So interesting that your husband has high DNA frag. I have low AMH of 2.1 and we've had 1 natural chemical pregnancy in 2 years. We did a round of IVF in April which gave us 1 5AB blast which sadly didn't take. We've since found out my husband has a high DNA frag of 37%, now I'm wondering if it's been his sperm that's been the issue the whole time? We're trying to lower with diet and lifestyle but if that doesn't work maybe we will try another round with ICSI. I had heard PICSI might be thing, getting lots of conflicting information about ICSI 🤷‍♀️

My husbands high comet score was 34%. He went to see a urologist (Jonathan Ramsey) and he advised him to do two sperm samples for our ICSI- literally one after the other and give the second one to the clinic to use. (He also gave the first just in case they couldn’t find anything in the second 😂) he also had a varicoseal diagnosis which we thought could be the cause but he only had that removed post my egg collections so wouldn’t have contributed to an improvement in our embryo quality at the time. We haven’t retested yet but we plan to soon as ideally we would like to try naturally for a bit first before going back to ICSI. I’m not familiar with PICSI, I’m not sure if it’s something my clinic offered at the time. I guess my take on ICSI is that it’s still a gamble as they can’t tell which sperm are damaged but as I had literally one or two eggs per cycle I couldn’t take the chance of normal IVF. Wishing you all the best with your journey @Dbop100

@dxp87 thank you! Good luck with yours also. Would be interesting to see how the dna frag might have changed since your last test. We've been trying to reduce with lifestyle but who knows if it will make a difference x

We did try with lifestyle too and getting back on it now. We saw a nutritionist at the time who advised lots of watercress and a spoonful of glass jarred organic tomato purée with olive oil everyday (for my husband to take!) and a course of symprove along with all the normal stuff about low sugar, low starchy carbs etc. Difficult to know if it all helps but I told myself that if we tried it all and it still didn’t work at least we have done all we can. X