Low amh / 3 lead follicles - need some hope!

[VenusStarr]

I'm doing my first round of IVF, this is my one and only nhs round. I have low amh (5) so was warned they weren't expecting much from me. I have had 4 naturally concieved miscarriages and am following an immune protocol but worried about my low numbers.

I've been on stims since Thursday and had my first scan today. I have 3 decent sized follicles: 2x12mm, 1x10mm plus 5 smaller ones all about 5mm. The nurse seemed happy but thinks that the smaller ones won't come to anything. Follow up is Wednesday and looking at egg collection sometime between Friday and Monday.

I'm on another thread and everyone has loads of follicles / eggs, so struggling not to compare. Due to my low numbers, we've already discussed a day 3 transfer, but I'm worried we won't even get that far.

Please share any positive stories. X

@VenusStarr did you not say there were other smaller ones? Maybe they can also catch up? I have seen many who had 3 eggs retrived and got pregnant though.

I had my scan, I have the same 5 quite grown by now- largest is 18 i think. I have 3 smaller ones, not sure they can make it? I am told to go back on monday and most likely trigger that night. I got a bit worried that the biggest follicles may become too large (overgrown?) by then? Is there such a thing? I am with NHS so they don't have scans as often unfortunately.

That's good news @jolly86 that was my worry too about them getting too big, but my clinic said they expect my 2 bigger ones to go to about 23mm by Monday which is OK. Hoping this means the eggs are getting to a good maturity 🤞

I do have some smaller ones, about 10-12mm, so there's always a chance I guess, but there's quite a difference on the chart now but they're focusing on my top 3, 2x21mm and 1x16mm.

Have you had your bloods done? They might ask me to do extra cetrotide tomorrow to stop me ovulating before collection - I think it will be if my lh levels are increasing. X

@VenusStarr my biggest one is already 18 mm today and I am two days behind you. It is strange that they just told me to come back on monday- they could have done another scan tomorrow and see right? I didn't get any bloods done. I am doing frymedal as usual but no extra. Quite worried now, feel they aren't keeping track of things as much :(

Oh and i wonder maybe when the follicles are large enough they don't grow as quick??

Try not to worry @jolly86 can you give the nurses a call to ask them to talk you through it? I had to call mine in Wednesday as I couldn't recall anything.
I'm trying to trust them - they do this all the time, so have a plan for you ❤️

The frymedal will stop you from ovulating and hopefully your follicles are maturing nicely. X

Just seen your second message - you might be right about that, my smaller good follicle has shot up about 3-4mm in a day, but my top 2 only did 1-2mm @jolly86 x

@VenusStarr that is reassuring. I am scared waiting for smaller ones may mean the bigger ones become too mature. Some nurses are more encouraging than others and it changes so much for how you feel!! I try to trust them as it is a routine procedure for them but because its NHS they are very strict with timings: can only do egg collection 3 times a week etc so they aren't very flexible. Anyways, you and me are on track and will end up having 2 days between our egg collections too X

@VenusStarr I'm on the short antagonist cycle just got the planner through today 😬 x

I’m not sure if this is helpful - I also have low amh and I had a low number of follicles. I cried at my appointment when they said they were going to go ahead with EC with just three larger follicles.

In the end they got 8 but it didn’t matter as the smaller 5 did not fertilise.

I had 3 5 day blasts for my three eggs, one hatching blast transferred who is now my two year old sleeping upstairs and one blast in the freezer (apparently the other one wasn’t worth freezing in the end).

So on the one hand it is a numbers game but on the other, the quality does matter. Nature doesn’t necessarily make 15 quality eggs per natural cycle. There is a huge amount of wastage as only one would usually be perfect enough for nature to choose it. Those are the most oestrogen recipient follicles which grow most quickly. So collecting those is very important!

That definitely does help @Passanotherjaffacake thank you for sharing :) I'm so pleased for you. I'm not entirely sure how I'm feeling (other than bloated!) I'm definitely not hopeful but I'm not negative about our chances. I'm hoping these extra couple of days have given them chance to be good eggs.

@Luan82 glad you've got your protocol, are you going to be on bemfola? I took 225 of that and cetrotide.

Had another blood test this morning, just waiting for them to call to confirm what dose of cetrotide to take tonight. Very glad I've got a day off injections. I'll be on clexane from egg collection.

How are you today @jolly86? X

@Passanotherjaffacake thanks for sharing that's very encouraging story!

@VenusStarr I am ok I had a call back yesterday as I was worried and nurse said saturday would be too early for me as many follicles still below 18, hence I go on monday and expect that they'll ask me to trigger.
How is your chedule are you triggering tonight? Also are you doing IVF or ICSI? I learned we're doing ICSI yesterday, trying not to worry about it.

Yes, triggering tonight! At 8.30 @jolly86 just about to do my last cetrotide. We're doing ivf, but if my dh's sample is not ideal, they'll do icsi instead. What are your concerns with icsi?

I'm glad the nurse called you back and reassured you. 🤞 For Monday. X

@VenusStarr good luck for the trigger! It must be so exciting to get there!

The sample he gave was much worse than the one last year. I am reassured that we do ICSI as it is better for fertilisation when sample is bad, just worried that the sperm quality being bad may affect embryos forming or developing? On top of my low amh. I guess I read many bad stories that's what happens when our only source is internet.

Thank you! 💕 @jolly86 it does feel good to get to this point :)

I think with icsi, the embryologist will pick the best looking sperm, so hopefully even if the sample isn't ideal, there will be some good ones in there 🤞 it's so difficult not to go down Google rabbit holes isn't it? I'm definitely guilty of that! X

Hi all!
I’ve been lurking and reading this thread and just wanted to add some reassurance.
I have ok AMH for my age (39) although I consistently have low AFC (had loads of scans on letrozole and clomid) which apparently is more accurate than AMH at predicting IVF response. I had a long protocol and a high dose of menopur at my base scan there were about 4 follicles on the right and 2 on the left and after 8 days only 3 of the 4 on the right had developed and they weren’t big, I was so worried. They kept me on the stimulation for 13 days and it was only on the final scan that it looked like there was any chance the left ovary might catch up. Anyway I had collection on Monday and got 7 eggs, 6 mature and 4 fertilised.
Out of those 4, 3 made it to blast! Had 2 transferred (1 4AB and 1 4BC) and 1 frozen (4AC) yesterday.

No guarantee of success but there was a point where we discussed switching to IUI or cancelling so hang on in there.

Wishing you all the very best and thanks to the ladies that posted reassuring pregnancy stories. It is hard hearing people say they got 12-25 eggs but everyone’s story is different and there are so many different reasons for infertility.

I hope it all works out for you all!

@39andabit thanks a lot for writing that is really encouraging! It sounds like you had such a good fertilisation and blast rate. Why were you doing IVF to begin with?
Best of luck X

@jolly86 thanks!
It’s a bit of a long story... I previously tried with an ex in my early 30s for 18months and we’re referred to infertility clinic but the relationship was not good and we split. No obvious issues for me from tests and really regular cycle but he had sperm quality issues.

This time round my periods and ovulation disappeared and I was diagnosed with hypothalamic amenorrhea, Probably caused from stress, Iosing too much weight and over exercising. Despite sorting all that out I didn’t recover and clomid/letrozole didn’t work. So we’re trying IVF. I have a lot of hormonal imbalances but his sperm is good so at least we’re lucky in that respect. Just wish I was a few years younger!

I know you are worried about losing your bigger follicle- I was too but I must not have as they did get 7 eggs in the end even after 13 days of stims. I’m trying to remember the size - I think it was similar to yours maybe more at day 12, triggered day 13. It must be frustrating they limit the days for collection!

@39andabit thank you. I will know tomorrow how much bigger that big follicle is.

@VenusStarr good luck for egg collection tomorrow. X

Congratulations @39andabit thank you for sharing. Lovely that you are pupo with 2 on board 🥰 keeping everything crossed for you!

I'm home from egg collection, I got 7 eggs! Chuffed with that, obviously don't know how many were mature, but 🤞 they're getting busy with dh's sperm.
I've got a cyst and feel a bit sore so just resting. Got a provisional transfer time for Thursday, but we'll see how tomorrow goes..

Did you have a scan today @jolly86? X

@VenusStarr great news! Keeping everything crossed for you, hope you have had an update by now. Have a good rest now.

@jolly86 hope the scan goes well.

@VenusStarr that’s great news! You must be so relieved. How do you feel after the EC?

I had my last scan, 5 over 18 with the biggest one now 23! Some of the smaller ones grew but not sure enough to make mature eggs, I think they still collect them and see. Will trigger tonight. No more stimms today just frydemal and then trigger.

@39andabit thank you .

I'm sorry I didn't come back yesterday, slept all afternoon, was quite sore from collection but it's eased today.

I just got my fertilisation report and we have 3 embabies 🥰 so pleased. I'm booked for day 3 transfer but they'll call either way on Thursday to give us an update and if they're looking good, we'll be pushed back to Saturday. I feel like I can breathe a bit now. We got the 3 we were aiming for ❤️

@jolly86 I hope your trigger went OK last night and you enjoy the day off meds 🙂 what time is collection tomorrow? X

@VenusStarr that's excellent! Seems those 3 lead ones did the job in the end :) Now you just have to relax and wait.

I had my last frymedal and then trigger yesterday, 8.30 so egg collection would be 8.30 tomorrow- will be at hospital 7.45.

Did you find egg collection ok? Also can you eat anything when you come back home or does it have to be light? Nurse told me I have to lie down after EC so I need to organize what we eat from today- don't trust my husband with food :)

Same time as me @jolly86! They took me through about 7.55, gave dh a kiss and left him in reception. I got changed immediately and then the anesthetist and doctor came through to talk through things, meds etc. I had a nurse do my obs and then a different doctor came to do my cannula with the anesthestist. I walked to theatre and immediately got strapped into the stirrups. The embryologist came in to say hi, redid our personal details and lay back, then I had the ecg monitor put on and the liquid was put in my cannula, I vaguely heard him say about the oxygen mask and then I woke up in my bay with the mask on. I came round quickly and they sat me up quickly. I had some paracetamol in my cannula as I was sore. But got some water, hot chocolate and a biscuit. Had my obs done a couple of times but got dressed about an hour later.

I did feel a bit sick just before I left, so they sat me back down, had an anti sickness and more water and then I left.

Dh said his bit was weird, he got taken to a room with paper thin walls and he could hear two girls chatting outside the room 🤦🏻‍♀️, with a computer for porn but it didn't work 🤣 there was a little hatch, he had to ring a bell to put the sample there and just left.

With regards to food, they said nothing too greasy or rich. We had leftover lasagne for lunch and then I had salmon and veg for dinner.

I was tender all day, everytime I needed a wee, it felt like a pressure, similar to cystitis and my stomach was quite swollen. Even though I drank lots of water throughout the day, I still felt a bit dehydrated. But I was up every couple of hours in the night. It's gone down a bit today and the tenderness has mostly gone. I started progesterone last night too and that was fine.

Sorry that's long, but hope it helps!!

And thank you, I'm really pleased with the 3, hoping they're meant to be ❤️ x

Ps, I remember waking up about 9.30am and I left about 11. Dh went to the local high street rather than go home as he'd have just been stuck in traffic. X