AMH levels and ivf

[Snowmummy1]

Hi there. I am just looking for some advice/support. We have been TTC for 2.5 years. We have a 4 year old. We have recently received our results from the ferociously clinic and my AMH has come back on two tests and 1 and 2. I will have a follicle scan next week.
Has anyone been in this position and gone on to have IVF?
Thanks

I'm unclear - what was the result of the AMH test?

AMH 2

I’ve had 2 tests. One feb last year and it came out as 1, one in October last year and it came out at 2. Delays due to Covid so rerun.

Hi @Snowmummy1. Sorry for not coming back to you any earlier.

How did your follicle scan go? What do the Drs recommend?

My AMH was 2.6 and I did donor egg IVF due to low chance of success with an AMH that low

@Snowmummy1. I have an almost 2 year who was convinced naturally and had a late ectopic pregnancy 3 months prior to conceiving my daughter. I was therefore quite surprised when in October my AMH came back as 3.5. And had 4 follicles on 1 ovary and 4 on the other. We are due to start ICSI (my husband has also been found to have a low sperm count) on Friday. Our consultant says he doesn't know how successful it will be as can't know how my ovaries will respond to the stims until we try. But says as I am 35 and have recently conceived naturally that makes it better chances than if I was older with an AMH of 3.5 apparently. He says that my ovary reserve is lower but not necessary my egg quality, which won't be known till we retrive eggs and view them. When we pushed for some figures he has said between 15-40% chance.

Thank you that’s interesting. Did they go on more than your AMH then? To make the decision around IVF/ICSI?

AMH isn't always a deal breaker as far as I understand, but 1 and 2 is low. It will be good to see what your AFC is. Not sure how old you are but this plays a big factor in IVF success rates as your egg quality is generally better the younger you are. If you are under 35 your chance of success with IVF over a couple of rounds is probably good. Over 35 the success rate slowly reduces up to 40 and once over 40 chances of a live birth are less than 5% I think.

I was told I had a low AMH (6) age 31 last summer and a poor AFC of 6 (total). We had our first cycle of IVF in November and got very lucky - 6 eggs collected, 5 fertilised, 1 pre-blast day 5 embryo put back in and I'm now 11 weeks pregnant. I had a high dose of stimulating drugs to maximise eggs collected and a double trigger to help egg maturity. Hope this helps. Good luck.

I was told the same as MGee that age is a factor in egg quality. And if you are younger with a low AMH the odds are better. As the number of eggs you have is lower but not necessarily the quality. Our consultant said he couldn't say what my egg quality would be like until we tried IVF. But due to being 35 and having had a child less than 2 years ago he felt there was a chance they would be ok. I may not get too many eggs though and like MGee I will be having a high dose of stimulating meds. We have also opted for embryoscope monitoring which is an add on treatment at our clinic. This means the embryos will be photographed every 10 mins. If the IVF is unsuccessful then this will give a better picture of the quality of my eggs to inform us whether its worth trying again or not. We have decided to go ahead with the ICSI so we can get a full picture of our fertility. We both have said we don't want to look back in a year or so and wish we had tried, when it will be too late.

AMH is solely used as an indicator of how well you are likely to respond to the stimulation drugs and for them to decide upon the dose. I only got 2 eggs from my last cycle and 1 of them was seen going strong at my 13 week scan today. So don't give up hope. Hopefully, your clinic will support you , if they don't there are clinics who specialise in low AMH such as Create. I would also echo what others have said in that age is the best indicator of quality but the only real way to find out about quality is to do ivf. That being said I was 31-32 for my rounds and my quality was also poor (much to my consultants surprise) but I still got there when I eventually produced an "average" quality embryo.

Thank you all for taking the time to explain your own situations at what I am sure is a hard time. Congratulations McGee and SpyroC. I hope you get on well Domino, and that you’re dreams are realised. It’s a comfort to know I’m not alone, although it’s not nice to know others are going through the same, it can be really lonely. I am 36, just turned. Not sure what my AFC is. The consultant didn’t say, as he was the radiologist but we go to see the consultant next week who will tell us. We will then perhaps talk to clinic and see what they think, unless the consultant tells us there’s no point - perhaps that’s when we have to close the door on it. Let’s see what next week brings. I will let you know. Thank you so much. 😊

The scan went well but not result yet, until next week. He was muttering numbers but I don’t want to draw conclusions when I don’t understand it. It’s hard though!

@Eggcellent29 thank you. That’s something that’s been through my mind but I’m just not sure about it. Something to think about, and read up on.

Hi all,
With an AMH of 6, age 39, and 6 pregnancy losses at various stages in the last 18 months, we started IVF this month. I am at day 8, heavy stim with 225 menopur and 225 bemfola. There were 14 eggs at baseline scan, but it looks like only 6 might reach the mature stage for collection at the end of this cycle.
Hope i will manage to get a good one at the end.... i will do embryo banking anyway and PGS.
It is all very new to me, but the forum helps a lot!
S.

@Sophfr17 hello! So sorry to hear of your losses. I don’t understand the acronyms you’ve used - are you waiting for the embryos to get past a certain stage?

@Sophfr17 oh no sorry! You’ve had the stimulation for retrieving your eggs? It would be great if you got 6.

@Snowmummy1 sorry maybe i was not clear enough, as I said, all new to me^^
Yes, i am on Day 8 of stimulation, first cycle, and the retrieval should be on Sunday this week, or next Monday. And yesterday, according to the scan, Dr said that it is likely that only 6 might have the required size. I am going again tomorrow morning to check how they progressed!
Do you think you will chose this option yourself? Did you Drs advise you on your chance of succes, considering your AMH?

Not at all, I think it’s hard to understand let alone explain on a forum. Thank you. Do you know if 6 is a decent number? What was your follicle count? If IVF is an option then we will certainly consider it. Low AMH is an issue but I’m 36 so that might help. We will find out on Tuesday what the prognosis is around IVF and take it from there. She wasn’t optimistic In advance of the AFC scan.

My AMH of 6, which was diagnosed in May 2020, might be lower now. It was not checked again.
During the baseline scan, which is done the day before starting the stimulations, so on day 2 of the cycle, they found 6 in left ovary and 8 on the right ovary. It is quite low in my opinion, but that was expected. Dr is happy though, well good for him^^ I know most follicles are of poor quality..
From these 14, from what i understand, only 6 might reach the suitable size (according to how they progress in terms of size along the stims). I think this is quite low, cause from these 6, a good part wont be fertilised apparently, and then, not all fertilized eggs will reach day 5 blastocyst. So, potentially not much at the end.... I will let you know as soon as i can. I am tired, physically, but more tired about having to cycle back to back 3 times, possibly for a poor result at the end

I see. So there’s a chance of depletion every step of the way in the cycle. Sounds like you need lots of rest. Will be thinking about you and hope Sunday/Monday brings positive news. Take care.

In all honesty, it's best not to get hung up on numbers. Some women have only 1 or 2 eggs but end up with a viable embryo for transfer and a positive result. Some women can get 15 eggs and have no viable embryos to transfer. It honestly is that varied. Some might have all their eggs fertilise, some might have none. You won't know how your body will respond until you do your cycle unfortunately. There is usually a drop off at each stage, but not necessarily, and everyone is different.

For example, compared to @Sophfr17 situation, I only had 8 follicles post stimulation but they got 6 eggs. Obviously a higher number of follicles to start with means you're more likely to get more eggs (you can't get an egg without a follicle)! But that doesn't necessarily correlate with viable embryos. Try not to get fixated on the numbers if you can (easier said than done)! It does only take 1 'good' one. Also bear in mind you may develop more follicles during stimulation so your baseline AFC isn't necessarily your max number. You really do just have to wait and see how you respond, as frustrating as that is! I went for the ignorance is bliss approach - didn't ask many questions throughout the cycle, just did as I was told and assumed they knew best. It definitely helped keep my stress levels down!

@mgee123 thank you. You’re right it’s hard! We have a consultation on Tuesday so hoping that the AFC is positive. Might be worth a chat with a fertility clinic in any event.