FSH, AMH, AFC

[MrsT8509]

Hi all!

Had referral to fertility clinic through NHS. Had day 3 bloods and TV ultrasound.

Results:

AMH 2.4
FSH 13.4
AFC 8
Age 38

Consultant said very low to no chance of conceiving with donor egg ivf. I'm ovulating each month comfirmed with bbt, and opk's. Got pregnant last year but ended in early loss about 5.5 weeks.

Any info, opinions, success stories will all be welcome! I honestly don't think donor eggs is a route either me or my husband want to go down.

I'd get a second opinion, your AMH is alow but follicle count not so bad. Are you in a position to go private?

Hi, my NHS results were;
AMH 1.8
FSH 48.3
AFC 4
Age 38
1 inaccessible ovary which had 3 folicles.

I didn't understand much but about IVF or my results when I started/got these results. I was also told impossible and given info on different or eggs.

We went private had retests with a few private clinics and my results were different, AFC was anywhere between 2-6 and FSH 11 - 24 . Noone in the NHS explained that FSH and AFC can change month to month. We had consults with 4 private clinics 2 said wasn't possible without donor eggs, 1 said unlikely but could try and the 4th said it will be hard but its not impossible and just depends how long we want to try for. This clinic was the last one we saw after extensive research into results for my age group.

1 and a bit years of back to back freeze all stim cycles, 10 in total, 3 got to egg collection, the other 7 didn't start due to high FSH or were abandoned due to no response to meds. We got 4 embryos into the freezer from those 3 collections (1, 1 and 2).

Our goal was 4 before transferring.

We transferred the 1st embryo we created and it stuck 😊❤️ so not impossible, hard, long, but not impossible.

I was ovulating each month too, but from being in IVF found out that some months FSH would have been too high for folicle to create an egg and even if it did I was ovulating prematurely before the folicle was big enough. Both had to be suppressed with medication for my IVF to give the folciles chance to grow big enough for collection.

I hope this is helpful. ❤️

@MrsT8509 I know you posted a while ago but wondered if you had an update on your fertility journey?
I had a scan yesterday and could only find one follicle on each ovary, I'm 38, feeling so upset and hopeless and taking comfort in positive stories on the Mumsnet community.
Your AFC obviously a lot better than mine ❤️ but wondered how you were getting on xx

@SPR40 - just read your story! Really wonderful hearing your positive outcome. Can I ask how old you were when you go these results? Did you do anything to reduce your FSH during your ivf? I've heard wheatgrass can be good 😊 any tips for someone in a similar situation would be hugely appreciated xx

@smashedbanana hiya, I probably didn't explain it very well but FSH can just naturally fluctuate from month to month. That's one thing that I wasn't aware of it was the clinic we had the final consult with that said "well we just need to wait for a good month" and we were like what do you mean and they said a good FSH month....and we had a few naturally low FSH months.

I did also have oestrogen suppression in my initial cycles so you can see if your clinic offers that. It was oestrogen patches before the cycle and that dramatically reduced my FSH there was only a few months it didn't have any impact...again no rhyme or reason. There was a point that although my FSH was low my AFC was also low or non existent which is why I adjusted my protocol and waited for a naturally low month.

There wasn't anything specific I did to reduce FSH,but in general healthier diet than before.

Wishing you all the best x

@SPR40 thanks for explaining, great tip on the oestrogen patches, I'll definitely mention that.
Can I ask which clinic you went with?
We're with Bourn Hall in Essex. I worried my partner won't want to go ahead with treatment if the odds are ridiculously low. TTC has already taken a toll on us and the money invested makes it a hard decision if the odds are low :(
Thanks again for replying and sharing your story x

@smashedbanana we went with CRGH based on their success rates with my age group (39 when I started 41 now).
We had a long walk and heart to heart before we started and said if we looked back in 5 years would we regret not trying with the money with had available and knowing we had truly tried everything. We agreed if at the end of the money we weren't successful at least we could be at peace knowing we genuinely tried everything within our control.

I wish you all the best, it can be really hard going, financially and emotionally.
The forums are such a blessing because you are far from alone ❤️✨️

@SPR40 thanks for replying. we are outside London so I'm not sure CRGH are an option (logistics around jobs with the multiple scans and probably multiple rounds etc)
I do feel like I'll regret not trying but it's also my partners decision who thinks about it logically (rather than emotionally). We would be able to afford max 3 rounds so will have to see what % odds we are given at the consultation next week.
Thanks for the wishes, and yes, thank god for these forums. I've decided not to tell any friends if we do go ahead with treatment as for me it adds to the pressure so these chats are such a blessing right now xx

@smashedbanana CRGH have a satellite clinic in Canterbury, not sure how far that us from you but it's one of the other reasons we went with them as it meant I only had to go into London for collections and transfers. And when my cycle fell on a weekend which happened a couple of times. But the benefit was we were going against the traffic flow on the way there and it was early morning appointments from 8am which meant minimal impact on work for scans, bloods and monitoring.

I hope your consultation goes well this week but please remember that different clinics may deliver in different ways. So you have to do your own research in comparison to what they say and make your decisions. The one thing that got me through IVF was feeling I was in control rather than a helpless passenger (my 1 cycle with NHS when I had no idea what was happening or why) so when I went private I asked all the questions I wanted to and more in my consultations, throughout the cycles and it was always us that made the decision whether to proceed or abandon based on advice, but it was always our choice

For me NHS said it was impossible and to adopt or egg donation. Then 2 private clinics said it would be a waste of money. But we decided we would happily waste the money on trying if it didn't work then we would be at peace knowing we tried on our own terms.

Sending much love to you and your partner and sending you all the positivity for your next steps ✨️ ❤️

@smashedbanana PS I have a logical partner too. The balance worked fantastic when I was an emotional mess from the 7 abandoned cycles in a row he was there to say...ah well 🙃..it worked for me as it put it into perspective. So much is out of our control we can only control the controllable, which is physical and mental health and wellbeing.

We didn't tell any family or friends either so the forums were the most amazing source of support 🥰 xxx

@SPR40 thank you for your kind words when I needed them most. Had a really negative appointment today and the news delivered by harsh doctor deliver - basically said we had no chance of ivf working. My AMH was 0.41 and partners sperm tested poorly on all 3 parameters. She basically said to use the money for a nice holiday instead. I really didn't like her and found her like a robot.
I phoned another clinic straight after and they said we can send all the results to them and we'd just have to pay for the consultation. Did you get the tests redone or just different consultations? I'm feeling so low.
We have been pregnant naturally so she did say it was worth continuing to try naturally....

@smashedbanana

Just wanted to say that I'm sorry you has such a negative experience yesterday. I went to a clinic on October and also have very low AMH of 0.55 at age 38. Tje consultant had literally zero bedside manner and pretty much told me IVF was a waste of time. I was crushed and felt like I was grieving for a while after that.

I've decided to switch clinics and had a scan today at CREATE St Paul's. Bedside manner was very good and I have my full consultation later this week. My AFC was only 1 today. I know how gutting it is to be told those numbers. Happy to be a source of support on here through this journey xx

Hi @GingerRCD thanks for your reply. I'm sorry to hear about your experience in October. These clinics must have lots of people our age group coming to them and you'd think they'd be better at delivering bad news as it's had a negative impact on their reputation.
Have you looked at going abroad at all? I have contacted NewLife in Greece today having been up all last night reading reviews about ivf abroad on Mumsnet. We could afford more rounds there so overall our chances are better.
How long have you been TTC? Yes please, nice to have someone to talk to... it's a lonely old journey, I don't talk to my friends about it and my family don't seem to understand really. Good luck at your consultation, please let me know how it goes xx

@smashedbanana

I know, I really thought these clinics, knowing how emotive all of this is, would show much more compassion!

We've only really just started out on this ivf journey so I haven't even considered abroad. Are there ways to check that the clincs are reputable/safe etc? I assume you have to stay away there for a couple of weeks at a time?

We've been trying around about a year. I had always had very consistent cycles but in this last 18 months or so, my cycles are a bit irregular in length and I've had two where I know that I haven't ovulated.

I know, and it's hard to talk to people of they've never experienced problems with conceiving even when they are well-meaning. It's nice to be able to chat on here with other women who really understand and are going through it at the same time.

Thanks, I'll defo let you know! What are your next steps? Xx

@GingerRCD
Irregular periods are so frustrating when TTC, I had a few times last year where I went for 3 months without a period - it was driving me insane. Makes you feel so out of control.
I have contact our U.K. clinic again today and asked if there was a reason they didn't prescribe clomid, did this yet mentioned to you at all? It might not be an option but I'm clutching at straws.
I have also requested all my test results emailed to me for me to send onto the clinic in Greece and then hopefully have a call with NewLife next week. They are regulated but I need to look more into it, if I find out anything interesting on the call I'll let you know. We would need to go out there for 10 days I think. You start the meds here and then get scans, egg retrieval and transfer done there (I think!)
Are you self funded or nhs?

@smashedbanana I hope the call next week goes well. Let me know how you get on. I guess a big part of the decision will be how flexible you and your partner will be able to be with going abroad on short notice and that it's properly regulated there so you're well looked after.

We're self-funded. I've been going to see the NHS about fertility since March and they've only just sent off my referral. I'm not sure I'd qualify for ivf as I think the cut-off is an AMH of 5, but I'm interested in exploring clomid and ensuring there's nothing else wrong with me.

At the consultation, the doctor discussed going for a 3 or 6 cycle package. That would be 3 or 6 egg collections followed by an embryo transfer at the end of those collections (so that, hopefully, there was a good choice of embryos). My husband seems keen on the 6 cycle package, as (if we were incredibly lucky) it would open up the possibility of having more than one child through ivf. I see that as a benefit too, but the thought of potentially nor being pregnant for a further 6 months or so seems like another hard pill to swallow. The doctor did say that it might be better to maximise collecting eggs now, whilst I'm 38 as he said they can get women pregnant through ivf at 45+ but that egg quality will decline. What do you think? Xx

@GingerRCD 6 months seems like such a long time doesn't it... but if you want more than one baby it's probably the right decision? Do you have to decide now or could you see how the collections go, if you're getting a good amount eggs you could try a transfer at 3 months? @SPR40 had 10 cycles back to back which must have been really exhausting but she got pregnant on her first transfer! Literally amazing 🤩

Did they mention Clomid to you? I've asked our clinic if we'd qualify but not heard back yet.

I'm going to call Create tomorrow too as they seem much more open to trying different protocols than my current clinic. If only we had unlimited money I think I'd be feeling more hopeful but our budget will only get us a few cycles now we also have to pay for ISCI 😩😩

Did they test your FSH? We can't even have ivf unless I get my FSH down under 15... x I've ordered some DHEA and been having wheatgrass shots every few days (that's about all I can stomach as it's so disgusting!!)

Hi @smashedbanana

How did the call with Create go? I've found them a lot more personable and, like you say, open to other protocols, than Bourn where I was before.

I finally received my NHS referral appointment yesterday, but it's not until mid-Feb. I was going to ask at that appointment about clomid because I do wonder whether that has the same chances as natural modified ivf, given that with that sort of ivf I'm only likely to get one egg at best each cycle. Are you thinking of trying that before ivf?

My FSH has been 15, 16 and 18.6 when tested this year :( Waiting for the next set of results at the moment. I think for natural/natural modified ivf, they care more about LH rather than FSH. Bourn had said they wouldn't do conventional ivf with me if mine wasn't below 15 because I wouldn't respond well to the drugs. What is your FSH like?

What potency of DHEA have you bought? I've got some but I'm unsure as to whether to take it. X

Hi @SPR40

Your story certainly gives me hope! All the numbers we're given just makes you feel all the odds are stacked against you.

Do you mind me asking what sort of protocol you were on - was it natural or natural modified because of your AMH and FSH results, rather than conventional ivf? X

@GingerRCD sounds like our stories are very similar. My FSH is 16 so working to get it down. Got 25g Microdized dhea off iherb, taking 2 a day atm.
Heard back from Bourn Hall today to say they're happy for me to try clomid but will need a consultation first. They set different doses depending on your test results and then scan you and then give trigger shot so you know exactly when to BD. We have male factor too so not sure it'll work for us... will ask all of this in the consultation I guess, will let you know.
I don't know the price but the nurse mentioned about £500 per round.
I still need to call Create, I'm busy at work this week so haven't got around to it.
What are your next steps? X

@GingerRCD spoke to Create and they sound much better than Bourn in many ways, lots of different protocols etc but they don't offer funding through Access Fertility which is the only way we can afford multiple rounds...
They can scan me this week - it's only £150 for the scan and consultation so much cheaper than Bourn in that regard

@smashedbanana sorry to hear you had such a terrible experience. I really don't know how some people are so bad at delivering the results.

The results are just that the results of tests at that moment in time.

I had my tests redone with each consultation but I also shared the previous results I had available so they had all the info available.

I'm catching up on the messages so will reply again to any others. Sending you both lots of love and strength. ❤️

@smashedbanana @GingerRCD hello to you both.

I started with Mild IVF, my protocol was closed for first 7 days, then stims via injections at max dose but every other day. I could only start is FSH was below 16. I initially had oestrogen priming prior to cycle starting to help FSH reduce. This was via oestrogen patches. I also had ovulation suppressant as I was at risk of premature ovulation.

My highest FSH recorded was 48.6, my lowest 1 with oestrogen priming, 14 naturally without priming. In the cycle where was suppressed to 1 no folicles and nothing after stims so FSH is only part of the puzzle for me.

AFC ranged from 0 to 4 during baseline scan and average of 0-2 during stim phase on 1 occasion (2nd cycle) there were about 10-12 little ones developing during stim and I was so excited but there was 1 dominant and trigger was based on that 1. The others didn't grow quickly enough and oestrogen levels dodnt reflect that there was anything likely to be in them anyway.

On 1 cycle I had 2 folicles but oestrogen wasn't rising so likely they were empty folicles so cycle was abandoned.

Every cycle that anything was there, 3 cycles, my LH peaked to try and ovulate but the eggs weren't mature and I had to take meds to prevent ovulation.

Our focus was 1 good egg was a win. It seems so hard to be aiming for 1 egg from a cycle, especially when you stumble on some of the other forum posts. But for us it was 1 more egg than they said was possible.

I took DHEA and COQ10, and vitamin D, C, iron, folic acid. I read it starts with an egg but only took any supplements in agreement with my consultant. Some clinics I had consultations at do not agree with DHEA use.

We chose to batch embryos so that when we moved to transfer we had a 1 in 4 chance. But the 12 months it took to make 4 embryos was really hard. Like you guys my cycles didn't play ball, I had months where my period just disappeared. Months where nothing grew, FSH didn't come down, oestrogen dropped, folicles disappeared.

I think I have responded to everything but will go back and check. Xxx

Oh I didn't say what the other protocol was. I think it was an antagonist protocol. After back to back mild cycles where nothing happened we took a break and decided to change the protocol because may as well as mild wasnt working anymore. I had to wait for a naturally good FSH month which took a couple of months, then started with cetrotide injections and then stim daily. In this cycle I had 2 folicles from start to finish, 1 in each ovary.

I haven't had experience internationally but alot of people on the forums have so worth having a look at some of those chats too if you are considering it.

The only other thing I think I could have done earlier is a hycosy scan, I had this after all my stims and they found a polyp which needed removing. This could have been a factor affecting my fertility but I will never know for sure, as we moved onto transfer phase.

It feels like such a long time to wait when batching but for us if we had transferred and been unsuccessful we would have had to wait 2 clear cycles to start stims again. Based on the outcome of the first cycle we knew we needed to stay focused on stims until we got to 4 embryos. I wobbled alot and took a mental health break after the back to back unsuccessful stim cycles.

Im sending you all the positivity and my advice is ask all the questions, do your own research, keep talking to others on the forums ❤️

I just reread my message....my mild stim was clomid for the first 5 days then stim injections every other day..sorry for typo.