Low amh, DHEA and a hidden ovary!!!!

[Babybana16]

Hi all

This is my first time posting. I'm 36 and looking to start the ivf multi cycle at Care Fertility in Birmingham. I've had my amh test done which is below average for my age at 5.7. My AFC showed 9 follicles 3 in my left ovary which were small and 6 on my right which were decent size but my consultant is worried that even if I create decent eggs in this ovary she might not be able to get to them as my ovary is HIDING behind my uterus! As if ivf isn't stressful enough that my ovaries decide to play hide and seek! Has anybody else had experience of this? What can be done to boost my chances as I don't want to end up with a cancelled cycle (which is what my consultant has said is a possibility in order to manage expectations :( ☹).

I'm looking to start DHEA to boost my egg quality but i would love to know if anybody else has had successful cycles despite a hidden ovary.

I don't have any knowledge about hidden ovaries I'm afraid but please don't start DHEA without discussing it with your consultant. It is a hormone which can affect your body in other ways and may have a negative impact on your cycle. There is also no good quality evidence it offers any benefit, many clinics don't recommend it.

Hi indeed I have a similar situation with low amh (3) at age 34. I plan to start ivf in april, when I had my scans last august I also had right ovary behind uterus. At that time nothing was said about being able to reach that ovary as it was the first scans. I wonder if this is a common thing to have if so I imagine they must have experience and I checked that for the nhs clinic I have inability to retrieve eggs is a low probability.. But reading what your consultant said makes me worried now :(

Hi

My consultant recommended DHEA and I will be testing every month to see where my levels are at so hopefully I can lower the dose if I need too.

Hi don't worry. If your consultant isn't worried that means they are have ways to get to the ovary. If anything it means mine was a bit sloppy and not giving me all the options. What clinic are you at if you dont mind me asking

Hi no its not that my consultant didn't worry- at that time we weren't at IVF stage as it is the first scan. It was a nurse doing as it is NHS. Where are you having your treatment? I am at Coventry. Indeed mine was postponed as I had a spontaneous pregnancy (after 16 months of ttc) and miscarried...

Also, when i learned this i was scared i may have endometriosis (although I never have any symptoms of it!) Is there a reason why your ovary is behind uterus or did they say this is normal? May I ask why you are having IVF? We are classed as unexplained although my Amh is very low for my age...

Oh I've heard coventry is good. I'm at Birmingham care. Apparently our reproductive areas are always moving around so. Maybe get a rescan now to see if its moved. Sorry to about your mc

@Babybana16 I had my baseline scan on Monday. And the nurse struggled to see my right ovary. She pressed around on my tummy a bit and managed to move it. And I have heard that when you start stimulation injections the weight of the eggs growing often cause the ovaries to drop down. So hopefully you will be fine.

@jolly86 I am also having treatment at Coventry and have low AMH.

@Babybana16 the way NHS is at the moment I think I ll have to directly start after my info session. I don't think we got those extra scans as we want. Indeed, I have a doctor abroad who told me it is very unlikely that an ovary is inaccessible- but maybe that is the case for them and I am not sure how experienced the nurses at NHS are.. I do hope Coventry is good but until now I didn't get that impression unfortunately :( I am more used to being treated by doctors and don't take it well that here in UK we only ever see nurses and consultants are there at a distance.
@donimo did they say it was behind the womb before? Mine was consistently there and when i had the miscarriage I went to early pregnancy unit and it was still there... I am extra worried as you imagine given I already don't have much follicules and not likely to produce many eggs. Also being classed unexplained doesn't help as it makes me think whatever the problem is may also cause fertilisation not to happen during IVF :( I know this is psychological and I am catastrophising the situation by thinking the worst but can't help it. If i knew for ex my tubes are blocked I would be more confident about IVF as by making the egg and sperm meet would easily solve the problem.

So she thinks that the ovary might be hidden because I had a c section with my daughter who I also conceived through ivf 6 years ago. I'm 36 now and we are going private and paying £6800 without meds and without all the extra bloods and scans. The cycle ive opted for is a multi cycle to give me the chance to have two fresh cycles and unlimited frozen transfers but the reality is I just am not confident I will produce the amount of embryos I want to give me higher chances.

Saying that though I have truly believe low amh is not the end of the world. As long as you are ovulating and producing eggs every month you only need to concentrate on the quality of the eggs and there is so much you can do to boost egg quality.

Ah that makes me feel optimistic. I mean in reality it makes sense that they should be able to poke and prod around until they can access it but my consultant just seemed a bit unenthusiastic about the whole thing.

Hi, just saw another post mentioning difficulty to reach one ovary... This must be a common situation so I don't understand why they haven't got better with accessing them. @Babybana16 @Donimo could you update whether yours were finally accessible or not? Good luck X

Hi well i haven't even started my treatment yet. I'm waiting for my next cycle to start so that they can re scan me to see if the ovary has moved and if they feel it will be accessible. I've also started acupuncture and I'm going for a fertility massage to see if they can move it around.

I know its just so stressful knowing that you might have viable eggs you pay all that money for ivf and then your chances are decreased if they can't access your ovary.

I haven't got great news unfortunately. But they did kind of find my ovary. I had my 1st scan to check my response to my stims today. My left ovary wasn't really responding had only 2 follicles. And they couldn't really find my right, nurse thought it was because it wasn't responding to meds. I have thus had my medication changed. And have another scan to see whats going on booked for Friday

@Donimo I am sorry to hear that. But surely the right ovary will be seen at some point right as it was before? Also I read that follicles can catch up later, I hope this is the case for you. I read on the booklet they gave that at Coventry failure to retrieve egg is 0.5 % but I assume this is the number for when they can't access either ovary. I managed to get a call from nurses at Coventry just for some reassurance, obviously she can't say anything before seeing me but she said when we are under anaesthetic in EC they try and move the ovaries and they do what they can to access them and it is rather rare that they can't. We just have to hope I guess.

Hope the change of medication helps .. my first scan was terrible I left in tears, when it came to egg collection I only had 1 folicle, but that somehow had 3 eggs in.., 2 were good enough to fertilise and both have done well so implanted back into me today ... obviously might still fall down at this stage, but it does only take 1 folicle and 1 egg.. fingers crossed for you xx

Hi everybody.

Hope you are all well. I started my cycle early this month so my scan was moved to today. The nurse still couldn't really move my ovary around. She said it looks like its stuck from adhesions. I have no idea what that means or what I can do about it. My antral follicle count was only showing 2 follicles when it was showing 9 last month so that was a bit disappointing but apparently things can change from month to month. I'm seriously considering changing my clinic and possibly opting for a mild / natural cycle as I've read its better for low amh.

Hi, babybanana sorry to hear that. It is quite striking that it can change so much from cycle to cycle, maybe you should wait for a cycle when you got more follicles then? I am not sure for mild ivf my feeling is it makes sense to try the normal one first, and if the response to drugs is really bad then can consider the mild one?

I'm sorry about your scan and stick ovary @Babybana16. I think (but not sure) follicles develop whilst on the stimms. If we go for another cycle I would consider a different protocol but I do think your first cycle is trial and error and hope for the best. I have my egg collection booked in the morning

Hi @Donimo good luck for your egg collection today. This wasn't a cycle it was just the preliminary tests for me but I feel so much more positive since yesterday because at least I know what I need to know before I start a cycle.

@jolly86 thank you for your response I rang around a few other clinics yesterday and they seemed a lot more optimistic about my chances so I don't feel as deflated about the 2 follies anymore. They reassured me to use my day 2 scan as a guide over my day 11. My day 2 one showed 9 so that makes me feel better. I havent done enough research into mild but the generic theme that I've seen is that it's less invasive on the body the focus is on quality over quantity and the chances of pregnancy are higher because there are less meds in the system.

@Donimo let us know how you get on please

@Babybana16 good to hear that! Funny that i read your name as banana :) I think AFC does change a lot. First time they counted 8 and the next time they counted 5 for me in just a week or so... this was last august-september. Also I heard many times more follicules appear during the cycle. It is about the size of them I guess sometimes they're not visible but then do grow and also depends on the sonographer counting them!

@Donimo best wishes for today hope it all goes well.

@Babybana16 that sounds much more positive. And during my stimms follicles developed during it.

So egg collection was ok. And got 3 eggs, which is what we were hoping for. Not that many considering what others get. But after no real response just over a week ago. Fingers crossed they fertilise and grow well!

Hi ladies , I really hope you don't mind me hijacking your posts? 🤦🏻‍♀️ And I hope that you are all doing ok. 💕 I've been diagnosed with low amh and only just really got my head around it tbh it was such a shock, my AFC was 7 and my AMH was 4.6 - I've started taking CoQ10 and had a HyCoSy due to an ectopic last June, about to start the IVF process and having to pay privately because my nhs consultant refuses to acknowledge time is a factor and claims my level is only 'on the low side' for my age !! (38) I've been on the waiting list for laparoscopic surgery for about 6 months now, genuinely feel completely lost with nowhere to turn- anyone had experience like this? Xx

@Luan82 hi there sorry I hadn’t seen the message! Why do you need laparoscopic surgery , were your tubes found to be blocked as a result of hycosy? They caution about these operations especially for people like us with low AMH as it can decrease egg reserve further!! I was just about to start treatment had my period yesterday but i am taking antibiotics for bv since Friday so it seems i will have to delay 1 cycle. Not happy about it especially bc i have a very difficult time coping at the moment. I am 35 this year and it is first child, AMH 3. AFC was 8 and 5 last year.