Is my doctor just money grabbing here?

[MercuryTTC]

Hi there,

I had a fertility MOT last year, aged 30. One ovary had 5 follicles and the other had 4. AMH level was low - 4.3 or similar (haven't dug out the exact stat). Caveat was that I'd been on the POP for 13 years and I now know that's this will have negatively impacted test results. Ultrasound said womb, tube and ovaries looked good, 'textbook'.

After these tests a clinic receptionist rang and went really hard on selling me egg/embryo freezing. Not one professional ever said anything about the effects of the pill - even after I flagged it, they wanted to go straight to freezing.

I pushed back and came off the pill. That was 9 months ago. I just had a second round of tests (for me and DH). Sperm all normal, my results were slightly improved: 10 total follicles visible via ultrasound, AMH risen to 9.1. Still low but better. Organs still looking good.

We've never actually had unprotected sex before, but we've decided that now we're going to TTC. Pretty much see what happens, as we've never tried and just don't know. Doctor seemed ambivalent to this as an outcome of my consultation and has pushed the freezing hard again on the phone today.

What is your gut feeling on this / the docs pushing for freezing? Is he just trying to get us signed up to pay, or is this good advice and the odds are against us naturally?

How long should we be TTC before accepting medical intervention will be needed? And am I a candidate for IUI? Nobody has ever mentioned this at all, just straight to freezing.

At the start of the process and very confused, so any advice would be very welcome. Thank you!

Hi,

I'm pregnant with an IVG baby, due to male factor infertility so not the same as you. If you end up needing IVF then you'd got through that process anyway that leads to egg freezing with stims and collection, so I don't see why you can't ttc for 6 months beforehand and then make a decision from there? You may get pregnant naturally and save the expense and intervention of IVF.
Your AMH is low for 30 but as you say its rising now you're off the pill, so trying naturally for a while may be best, but I also wouldn't linger past 6 months and I'd maybe get another AMH test in 3 months to check it's still going the right way. Sounds like you're very proactive with your fertility though, hope it all works out for you! :)

Thank you, that seems really sensible advice.

May I ask what IVG is? I've never heard of it before and I'm getting more confused Googling. What makes someone a good candidate?

No that's a typo apologies, meant IVF! You may not need any intervention at all, there's probably just a protocol at the clinic you went to where if AMH is lower than a certain threshold they advise, and if private possibly push, for egg freezing. Until you try naturally it's all an unknown quantity though, if you feel you can spare 6 months to try and make sure you're monitoring AMH then it's worth trying. The NHS won't do IVF I think unless you've been trying at least 12 months under 35, though this may not be the case if you already have proven low amh etc.

Haha that makes sense! I found something called vitro gametogenesis and was very very confused 

Right, so - another AMH in the autumn, bang til Christmas and then make a proper decision. Did you see multiple clinics? Unsure whether to stay with current one as I haven't loved them, but may make sense to stay with the people that have all my records?

Records can be switched across and some clinics sill insist on doing their own tests anyway tbh. I had tests on NHS as did my husband when we hadn't conceived after 8 months, which is where we found out about a varicocele husband has that made his parameters very low, and the private IVF clinic we used accepted the sperm parameters but did my tests all again, as its crucial they have those results as a baseline just before an egg collection/IVF cycle. My AMH at 34 was 16.9, follicle count on the month we did the cycle was 11 (was 21 month before, sods law!). But got pregnant on first cycle and now 34 weeks and have 4 embryos frozen. If you're going to do frozen eggs you may as well do the full IVF cycle so if you feel you have time and don't want to go full IVF yet then worth trying. A clinic will advise about IUI too, we couldn't do that as our issue was the sperm so went right to IVF with ICSI.

Thanks so much. This has genuinely been more helpful than my doctor has been. Really appreciate it.

At your age I would actually TTC for a set period of time before moving to egg freezing, the process and the hormones for which can mess with your periods anyway. Even if AMH is low your egg quality is likely to be good. So if you do decide to move on to IVF then hopefully you could create good embryos.
Do not stay with a clinic that you aren't fussed on, you're under no obligation to them and the fact they have your records is not significant in the grand scheme of things.

I have low AMH and the number of follicles has varied so much between cycles.
It's good to be focused on your fertility but until you try it's all theoretical. Good luck.

Thank you, TTC is now long the plan. How long would you recommend, given my stats? Terrified of missing my window, if it is at all possible for me.