Low AMH & high FSH, not sure if I can accept donor eggs are our only option.

[Doodles27]

Looking for some perspective on our situation. I’m 38 and partner is 46 both with no children we started TTC 2.5 years ago and have never got pregnant. Our initial appointment at the fertility clinic was meant to be at the end March last year and everything closed due to COVID so it has taken much longer to get to where we are now and what we know. AMH tested in Oct was 3.9 with a FSH of 19.6 (day 1-3) our consultant basically said that I had significantly less that 1% chance of conceiving with IVF with my results and to consider using donor eggs.
This came as huge shock and obviously really upsetting, after a lot of thought I decided I wasn’t ready to give up on ever having a child that was biologically mine. I decide to try everything I could to improve our chances, started back on Accupunture that I’d taken a break from, improved my already good diet, cut alcohol completely even though never drank much, started taking ubiquinol and asked to have the tests done again. The second set of results have come back worse still, AMH dropped to 2.1 and FSH has increased to 24.3. I’m really shocked that they have gotten so much worse in a short space of time. I have have been tracking my temps for 18 months + and nearly always look ovulatory, I get positive ovulation tests and egg white CM so quite shocked. My periods are light and only last 2 days so I’m now worried I could be peri menopausal? Not sure how to know if I am.
I’m now so confused with what to do now, do I give up on the chance of a child that’s genetically mine? Consider a donor? My younger sister has offered to be a donor she has 3 children. I definitely favour this option to an anonymous donor but would still need a lot of thought. Has anyone been through anything similar? How do you move forward?

Hi @Doodles27

I am sorry you have had such a rough time. Hopefully I can give you some hope.

I have very low AMH (2), High FSH (24.6 at its highest) and low AFC (4/5). I am 41 this summer, and we are using my partners spend that has been frozen for 23 years. We were given less than 9% chance of success. I was told I’d have a better chance with donor eggs, but that isn’t something I personally would consider.

We should have had our first round last March, before I hit 40. Covid hit, it was delayed, and we had it in Feb/March this year aged 41.

I managed to get 3 eggs and 2 fertilised with ICSI. I had 1 day 5 transfer. The other went to day 6 but wasn’t good enough to freeze so we lost it, so all hopes were on the little embryo inside me.

I got my BFP 2 days ago.

Never give up hope x

*sperm, not spent 😂

@Goldilocks2528 thanks so much for your reply and that really does give me some hope and huge congratulations on your BFP 😍

We have no problems with my partners sperm it’s just my results but your AMH/FSH are very similar. I don’t think I have a AFC result I’m not sure what that one is. I had considered trying IVF with my own eggs but everything I’ve been told is that it would be a complete disaster. I think if I’d been told 9% chance of success I would give it a go but I’ve been told significantly less than 1%

Hi @Doodles27
An antral follicle count (AFC) is a good indication of your egg reserve. I believe it is used in connection with your AMH. I was told I had diminished ovarian reserve. It is an interval ultrasound your clinic perform. Maybe you’ve had this done but bot been given the results? X

I had an AMH of 2.2, FSH of 19-22 and an AFC of 4 when I was 28, I tried two own egg cycles (1 failed and 1 cancelled) then moved onto DE and after a few attempts had a son, when he was 7 months I did conceive naturally and had another son, I don't regret using DE as had been trying 9 years by the time I conceived naturally. Good luck whatever you decide

Also to add

Your AMH gives an indication of your egg count and quality

Your AFC is an indication of how many eggs you may produce

Your FSH can fluctuate, your body kicks out FSH when you are ovulating, if your body is struggling then your FSH gets higher, as IVF meds are also FSH then with a high level already it can be difficult to get a response, women with a low AMH often need an aggressive stimulation so if your FSH is high it can make it tricky. My FSH did actually drop to 8 the year after it was in its 20s

Just to clarify a bit more re AFC-it is the number of follicles they can see on your ovaries when they do an ultrasound. It stands for antra follicle count. Each follicle is likely to have a growing egg in it (80-90%) I was told a good number for AFC was around 15, certainly into double digits. (I have had 4 or 5 depending on when I have had scans and AMH of 0.8pmol so diminished ovarian reserve also) Sadly I don't have a positive cycle as my egg collection recently had no eggs despite 3-5 decent sized follicles but I think mistakes were made so that's a diff story) So naturally each cycle you should grow a number of follicles and then one becomes dominant (the biggest/best egg) And at a certain size it ruptures and releases the egg. The other smaller follicles wither and disappear. and the cycle begins again next month. If you have any copies of your scans it might tell you this.

Then the Ivf meds stimulate these follicles to grow and when they get to a certain size they stop you from ovulating and try to retrieve via egg collection and get all of them (as opposed to the one you'd get normally on a period)

I'm not clear on what your position is re IVF- are they refusing to refer you and only option is IVF? If not, I would personally try if I could afford it anyway. You don't know how you'll respond unless you try? 1% in my opinion is 1 in a 100 women get pregnant right? I would give it a go if I could in your position. Surely some clinics would be able to do something to help with FSH? I had a high FSH although not as high as yours (12.5) and I was on an oestrogen priming protocol so presumably something similar can be tried?

also...how long did you try and make those changes between the 2 results you've said?as I wonder if you're shocked at how quickly they've changed then I would think you could say on the other hand that the changes you've made might not have had long enough to take effect?

Sorry I see you said it was Oct to now. So about 6 months I guess..

Also see less than 1%...so say it's 0.5%... again...that's 1 in 200? Still seems worth a shot if you can afford it, have a clinic willing to try etc. 🙁

@Doodles27 sorry you are going through this. At 37 my AMH was 1.0. FSH fluctuates but mine has been around 19 before. Got told to use donor eggs but went and sought a second opinion. My AFC (that's follicle count) was 2. I am surprised he's given you that statistic without checking AFC as I was given a 10% chance across 3 cycles so I decided to do it and I am currently pregnant. I appreciate that I am extremely fortunate with the stats I was given and I do think a lot of it is down to luck as to whether you get a viable embryo on that particular cycle.

Thanks @Lauren83 @Goldilocks2528 @Rosiestraws @MabelG for your replies. I’ve had an internal scan the first I had in January and they said I had a cyst one one of my ovaries and went back to check at the start of my next cycle and it had collapsed but they never said anything about follicle count. I might try and find out.

@Rosiestraws I don’t know if they would refuse to refer me but basically said they would only get 1 or 0 eggs per retrieval and most would not be good enough quality. I haven’t been offered any other options really than using a donor.

@MabelG I think if I was given 10% chance across 3 cycles I’d give it a shot too as I’m sure they said that normally each ivf cycle is only 30-40% chance which is what I would have using donor eggs. Huge congratulations on your pregnancy bet you’re so grateful you went for the second opinion

@Doodles27 this sounds really similar to my situation. My AMH was 3.5 and AFC 9, 6 months ago (I am 35). I have just had a failed IVF in which I hardly responded to the medications. Had to stimm for much longer on the max dose of drugs. But we did manage to collect 3 eggs, however 1 egg was immature and 1 was abnormal. The 1 egg did fertilise but it didn't divide correctly. We had a review with the consultant about this failed IVF on Friday. And the consultant was surprised I responded so badly considering I have a 2 year old (naturally conceived) and the fact I'm 35. But he now advises donor eggs if I want a pregnancy. Prior to this failed cycle we were advised they don't know how you will respond till you try and gave 10-40% chance of success (so vague as he just didn't know how I would responded or know what my egg quality is like). So although it failed awfully I can still say I am happy we tried. We are currently processing this thinking about the implications of donor eggs. There are obviously financial and emotional implications but personally I didn't want to regret not trying. But I don't think I want to try again as we now know its not possible.

OP can you ask for copies of your scans? I could easily see/count my follicles as I have so few..they look like dark circles in the ovaries..Although ofc there is the danger you dont really know what you're doing...but perhaps worth asking for copies and/or for them to confirm the antra follicle count. Although of course this doesn't mean much on its own...there's lots of other factors to take into consideration...

If you do decide to try and go ahead privately then I think some places like Create fertility specialise in natural/low modified IVF so they focus on just trying to get that 1 egg each month and try fertilizing etc.

Oh and I've just remembered by doc said above 30 for fsh indicates peri menopausal so you dont appear to be there but I'm of course no medical expert

@Doodles27
Just to add to the others.. I had an amh

Don’t give up hope, my amh was 2.3 and we were given 5% chance with icsi. I only got 1 follicle which somehow had 3 eggs in, 2 of which good enough for icsi and both fertilised. I had my positive last week and waiting for the scan xx

@MabelG hello, I have very similar numbers to you and the same age. I was just wondering who you did your ivf with? I'm looking for recommendations in London but do not know anyone with my particular diagnosis thanks and congratulations!

@Katie567 it was Create who do have a branch in London

@MabelG thanks!!! Sorry if you have a moment, would you mind telling me what your experience was like there? I've heard so many mixed things and also what type of IVF/ protocol you did? Thanks so much for your response!

I have a low amh 0.8 on 2nd test! 1st round of ivf wasn’t successful, 2nd round, doctor put me on testogel, that round I got 5 eggs (got 2 first time) & now have my 20 month old. I wasn’t ready to consider DE. X

You could do a tandem cycle? If you feel that's something you could consider. I did. 6x 5 day blasts. 1 was mine. Put 2 (1 donor and mine) back. MC at 8 weeks. But I've got 4 in the freezer. Personally I'd obviously 100% prefer my own genes! But I'm not willing to not be a mum for that.
There are some good books on donor conception. Give it lots of thought.