Advice please - v low AMH at 34, try acupuncture and wait 3-4 months for treatment?

[Rosiestraws]

Hi everyone

I have posted before but a bit of background. Age 34, healthy BMI, dimished ovarian reserve - 0.8pmol and 4/5 follicles seen on scans. FSH was 12.5 on day 3 so I have an oestrogen priming protocol.

Have had one successful cycle of egg freezing in March and have 2 more cycles left in my package (to be taken within 1 year). For those that don't know, the egg freezing cycle is basically the same as short protocol IVF I believe, but obviously eggs are just frozen after EC.

Since my unsuccessful cycles (4 follicles flushed, no eggs found - but there are various things that might have gone wrong which are being corrected this time - so not sure if this an indication of my likely success or not) I have been taking 600mg Coenzyme q10. Have made some of the changes in It Starts With The Egg to do with avoiding plastics etc and trying to eat more healthily etc and plan to continue this.

Have just started acupuncture (for fertility and anxiety) and she has suggested delaying my next cycle (planning to start in 2 weeks) for 3-4 months to really benefit from the acupuncture, and of course she has suggested changes to my diet which I am already aware I should be making - I don't have an unhealthy diet as such but she thinks too much carbs every meal and need more protein/veg etc. I only drink decaf tea (one or two a day) and have barely been drinking alcohol at all this year, although I have not cut it out entirely.

My concerns are about delaying:

• If I have such low number of eggs left for my age, what if this delay means I basically run out of time and they are gone? Is this likely/possible to happen in just a few months. I hope not but who knows. I do know my AMH was 1.4 at age 31 so hasn't dropped that much but I'm fearful of the decline at age 35 etc of course..

• I am single and obviously ideally trying to meet a partner to try for a baby the usual way. It isn't ideal to be going through this fertility treatment and trying to date/explain why not drinking on dates etc. Although I appreciate could do it.

• Will the acupuncture/diet changes really make a difference? In particular I appreciate the acupuncturist has a vested interest in me delaying 3-4 months and continuing to go to see her weekly - she'll make a fortune!

Really struggling to make the right decision on my own. Of course I could go ahead with this second cycle now and see what happens with the medication having been changed etc, and then make all the changes for the third if it did not work. But it's so much money and I have such low AFC anyway that if the best I'm even likely to get is 4/5 eggs a cycle then it's the difference between having maybe 4/5 eggs on a third cycle or 8/10 eggs frozen if the next two cycles go well...

Thoughts welcome...

Sorry I should have clarified re being single - so if I go ahead with a cycle in 2 weeks then I'm not in a relationship/not seeing anyone and it wouldnt matter.. If I delay then once things are fully open in the Summer and I hope to be regularly dating/maybe seeing someone then it might be less convenient to do 2 cycles then

Personally I would not delay. I was also advised to delay for 6 months to do acupuncture to improve my chances for my next cycle - I did so and ended up with a worse round than the previous one.

Have you had your testosterone tested however? I did delay for 3 months at a different time as mine was 0.1 and should be 1.5-2 and that does seem to have made a difference to my egg quality.

Maybe get that checked and if you were doing 3 months of DHEA you could also overhaul diet and do acupuncture.

Basically I would not delay for acupuncture alone as they tend to make a lot of promises but deliver very little in mine and in my friends experience!

Sorry - that should read I have had one UNsuccessful cycle!! No eggs in my first cycle - no success :(

Thanks for the replies -

Haven't had my testosterone tested - is this something I can/should ask my clinic about? Any particular day of the cycle?

I have asked them re DHEA and they do not recommend it. Given the side effects (oily skin, spots, possible extra hair growth etc) and the fact I am single and wanting to find a partner I also did was not keen on taking it though! It's one thing in a relationship trying to make a baby with someone who loves you and doing it but I think the possible side effects would just be awful for me being single and increase my anxiety/upset about the whole situation!

I appreciate that acupuncture might not make a difference.. but I also wonder if longer for Coenzyme q10 (started this 21 March) to help, diet changes etc might play a part. My big fear is if a 3-4 month delay would mean I could enter perimenopause/menopause and mean I've missed my chance :(

@Rosiestraws I’ve had zero side effects from DHEA as my levels were so low they’ve just been brought up to normal. I’m surprised your consultant didn’t recommend it - I’ve had it recommended by consultants at both clinics I’ve been at. It’s a blood test you can do any time to check your testosterone levels. I was actually looking fantastic on the 3 months I took off to take DHEA as no meds, healthy eating, exercise and lots of vitamins!

@Rosiestraws I definitely wouldn’t delay for acupuncture anyway as it’s unlikely to do much if you’re worried about perimenopause

Hi @Rosiestraws sorry you find yourself in this situation. Tho not quite the same, I remember being single and worried about not being able to become a Mum in my mid-30s and it was hard. In my case I didn't freeze my eggs and now having nightmares trying to have babies in my 40s (we managed one but the sibling is a challenge).

I would go ahead with the egg collection sooner but continue acupuncture anyway as you may end up doing multiple rounds of collections so feel the benefit eventually.

I totally get where you are coming from as I would be the same but I very much doubt your acupuncturist is just trying to keep you there to make money. They're not usually short of clients and would have to be pretty disreputable to think that way. Naturally they believe acupuncture will help or they wouldn't do it. I think it can help (clinically proven in some cases) but probably not enough to be worth delaying.

It would be good to test your free testosterone and DHEA S levels and then take DHEA supplements if they are low. That might be worth doing before a cycle. As @ForeverAintEnough12 said I didn't get those side effects because my levels were so low and were just being brought up to normal. Maybe if I had excess testosterone I would have had that side effect. You do need to re test after 5-6 weeks. It is only something to take if your levels are low as it can mess things up otherwise.

Best of luck xxx