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.

@smashedbanana Sorry for the late reply. It's been a busy week in the lead up to Christmas!

Our next step is deciding whether to start ivf in January or whether to give my body chance to respond to the changes I've made (supplements, type of diet and acupuncture) so that it's in the best possible state before starting ivf. Apparently, it takes 3 months to see improvements in egg quality. But then I'm conscious of the clock ticking! What do you think? I'd we didn't start right away, we'd try naturally in the interim.

@SPR40 what was your approach in that regard?

@smashedbanana Have you got any further with Bourn with starting the clokid route? The other thing I have heard about us duostim cycles, which are aimed at women with low ovarian reserve. I'm going to look into it a bit more. Have you looked at that? Xx

I also thought it was worth mentioning that I got FSH tested this month on Day 2, and it was 2.9. The lowest it has EVER been. Even when I had it measured 10 years ago, it was about 12 at it's lowest.

It could be a lucky fluke, but I wonder if it's due to the changes I've made in my diet, including supplements, and the acupuncture. Happy to share what I'm doing if you want to know xx

@SPR40 Thanks so much for taking the time to explain what process you followed. I'm sure that was very demanding mentally. All of this takes its toll as, I don't know about you, but I literally cannot switch off from it, and that's without having started on the drugs, the scans etc, etc. That's amazing that you persevered and got the result you wanted. I'll do whatever it takes too, and if I'm lucky enough, it will all be so worth it in the end.

Your story certainly gives me so much hope. It shows me that, against all odds and whatever the doctors may say about chances, there is still hope. The fact that I've missed periods and not ovulated some cycles this year has really worried me, but you've shown that our oldies can still do what they need to do. And they only need to do it once with a good one!

Thank you xx

@GingerRCD that's amazing on your FSH!! Yes please give me all the details, what an improvement!
Can I ask, do your FSH tested on NHS each time? I'm not sure my GP would keep testing it so would have to pay each time through the fertility clinic.

I did speak to Create this week, they're happy to do a consultation based on the Bourn Hall sperm tests but would need to have a scan redone in Loughton clinic. Unfortunately they don't accept Access Fertility funding so ended up speaking to Lister (after a recommendation on here) and felt really impressed with the lady I spoke to (got through to the actual clinic rather than "call centre" type person) and have a consultation pencilled in on Wednesday with doctor Kemball. I'll let you know how it goes but I told her our test results and she didn't seem bothered at all and said they specialised in women with low AMH

Did you speak to Lister at all?

My partner has gone off the idea of ivf abroad, especially as we likely need multiple rounds it would be too much back & forth so think that's off the cards for now.

If I were you I'd start treatment in January - it sounds like your supplements etc are already having a very positive effect. I'm impatient though so wouldn't want to wait. Have you decided yet on the 3/6 months batching?

@GingerRCD forgot to say, Bourn Hall happy for me to take clomid (although it was never mentioned until I asked) but I need a consultation first and can't have until January.
I am speaking to Lister in the meantime to get a second opinion

@GingerRCD @smashedbanana

Hiya I started treatment as soon as I could but I'd waited a long time in general as I had put off testing to try naturally, for pride reasons (which feels so silly on reflection) my hubbi and I have been together 21 years so that was a lot of evidence there was something a miss but because I ovulate every month I wasn't that concerned and felt it would happen when it was meant to happen.

By the time I pulled my finger out and got tested then got my results and how challenging we knew it was going to be I was desperate to start immediately to get any eggs that I could. Then covid hit and i lost another year in the NHS waiting, then another almost year in NHS treatment which ess the worst time of my life. Then we took back control and went private.

That was me personally as I knew I would get information from the cycles, folicle counts, blood test results and medical assistance to get the best result from each cycle etc whereas naturally I wouldn't know and felt I had done that for years and nothing so there was no point. After seeing how my body reacted (or didnt) to the meds and understanding that even in the most unlikely chance my body created a viable egg without intervention, the early ovulation meant it was immature anyway and wouldn't have a chance to fertilise. So genuinely it would have been almost impossible naturally for us. Especially when I consider all the back to back cycles I had where nothing grew at all and that was with medical intervention and meds.

It will be a personal decision for you though I'm just sharing my reasons x

Re duostim I've heard lots of good things on the forum for people with low AFC I only found out about it later in my treatment from the forums, but if I had needed to stim again I would have tried duostim as I always had little folices late into the cycle after the dominant had progressed, so a 2nd stim in the same cycle might have been beneficial.

X

Ps re the takes 3 months to impact egg quality, my cycles where nothing grew were from my 3rd month onwards. I think the question is...how would you know if the quality of eggs is a factor that needs improving. I was working on the basis my egg reserve was low so needed to get every egg possible from each month. My protocol was 2 cycles the 1 rest month to not overestimate, I also had Christmas close down timing so I had 2 months rest which was excruciating mentally thrn when we came back had all those crap cycles, which were so dire my consultant said not to have the rest month so we could just keep trying, then took another break for body reset and mental wellbeing and that ended up dragging on as my period disappeared. So yes it is mentally exhausting and I am sending you all the positivity and strength ❤️ xxxx

Morning @smashedbanana. Good luck for your appointment today. Hope it goes well, let me know.

In terms of diet, I've been eating more fats and protein, and trying to reduce carbs (which isn't easy, so when i do have them, i try to gave things like wholegrain brown rice, quinoa etc). So, for breakfast, I'm eating things like Avocado on rye bread with eggs and seeds or salmon frittata and spinach. Lunches, I'm having thinks like caesar salad with chicken and bacon, hearty soups, kale and avocado salad etc. Dinners, I'm adding more protein and fat again to things like stir fry (e.g. steak/chicken and cashews), casseroles, etc. I'm not a fan of fish, butbive been making myself have two portions of salmon a week - I've found making Thai fishcakes a good way to stomach it. I'm trying to snack on things like Brazil nuts, hummus and carrots. If I have dairy, it's full fat. Happy to share recipes if anything of interest.

I've also stopped drinking alcohol altogether, not that I was a heavy drinker before. I limit myself to one coffee a day.

Supplements-wise, I've been taking Proceive conception and Proceive omega. I've recently added in DHEA, CoQ10, D3, Vit C.

I've also had 3 sessions of acupuncture si far. Personally, I would really recommend trying this with a reputable fertility acupuncturist. They are very knowledgeable and helpful advise you on diet and other blood tests to do based on a pre-assessment. For example, she told me that my TSH was nothing the favourable range for fertility (my GP never has!!) and I've now managed to get a prescription through Create (will start taking this tomorrow). She also advised me to put on a bit of weight, as favourable BMI is 20-25 and mine is 19.4. Again, something a GP has never told me in the 9 months of going back and forth!

@smashedbanana With regards the blood tests...basically just be persistent with your GP (and see a different one at the same practice if necessary). I was just insistent that I wanted to monitor them and one doctor said I could get them checked again the next month if I wanted. Now, I just call up and say that the doctor recommended I get them tested every month! Sorry to say, but I think you have to play the system a bit to get what you want out of it... I think they don't really want to spend the money on this issue, especially with "older women" like us, and we get fobbed off. I was told my hormone levels were all normal, but they weren't normal for fertility, just for general health and proving I wasn't menopausal. I wasn't prepared to just accept that and I keep going back and getting the tests.

@smashedbanana That sounds sensible to consider using Lister. I think going back and forth abroad would really take its toll and add another layer of stress/complexity to this.

I haven't spoken to Lister. My friend went to the London one (I don't think she had AMH issues, but had not conceived in 2 years of trying naturally) and got pregnant first time.

I'm waiting to hear if Create do duostim. If they don't, I'm going to call Cambridge IVF, as they offer it. Would suggest asking Lister about it, as it's specifically targeted at women with very low AMH. Basically, they do stims and collect eggs around your "typical" ovulation date, and a few days later do a second round of stims and egg collection. I didn't realise, but we have eggs that come to the fore later in the cycle, before our periods, that just get wasted when we get our period. So, the idea is it utilises those eggs and cuts down time to conceiving.

@smashedbanana Sorry for the long messages, but wanted to give you all the information. Xx

@GingerRCD hello. Sorry for the late reply. I tried to forget about TTC over Christmas and just focus on my daughter and having a nice time - I do actually feel so much better for a break from it all and have been sleeping better too. I spoke to CRGH today, on @SPR40 recco, as they were offering free consultations until 5th Jan and postponed Lister. They basically said not to bother with IVF as the chances of conceiving as apparently the same with the results I have. He told me IUI might give me slightly more chance... better odds than ivf anyway. This isn't something I've even thought about so going to look into it.
Anyway, wanted to check how you were getting on? :) xx

• chances of conceiving naturally are the same as ivf

Hi @smashedbanana

I'm so sorry for my late reply. I struggled with all of this over Christmas and have been feeling pretty low about it all. Its not helped as it feels like I've been bombarded by pregnancy/birth announcements Dec-Jan, which is a time of year I struggle with as we had a traumatic loss in 2022 (of a baby that was due December 2022).

Have you made a decision as to what you're doing? We've got a consultation with Cambridge IVF on 30th Jan to find out about duostim. Then I'm hoping to go ahead with them or CREATE iny February cycle. I'm getting so impatient now!

Xx

Hi @smashedbanana Hope you're OK. How's everything going?

I've decided to go ahead with Create. Our first round should start in the next 2 weeks. Going into London tomorrow to do our virology tests, so the ball is rolling.

Thinking of you and hope you're doing well x

Hi @GingerRCD so nice to hear you're starting treatment!! That's so great. Why did you decide to go with Create after all and what is your treatment plan? I'd love to know!
I'm not getting on too well over here - I have been very strict with the wheatgrass and taking DHEA & melatonin since beginning of December. I got my FSH results last week and it's actually gone up :( which means Clomid isn't even an option for me now....
i did message Create on Monday to get an invite to one of their webinars but not heard back.
I'm meant to be ovulating today but no signs yet and I fear it's going to be another 2/3 month cycle.
I feel soooo fed up with it all. I would love to move past this and accept it's not going to happen but there's so many success stories online that I'm clinging to!
Sorry to be all doom & gloom!!!
Please keep me up to date on your journey- I'm wishing you every success! Xx

Hey @smashedbanana
Thanks for your message. I decided to go with Create because of the fact that they do the natural modified ivf. Cambridge ivf didn't think duostim would benefit me, and they only offer conventional ivf, so you'd have to take all the drugs (and pay for them!) even though they wouldn't be necessary for someone like me. I'd rather have the reduced drug protocol and have more rounds of trying to retrieve eggs.

How are you? I hope your cycle has got back into some form of routine. I find it hard that my cycle is not reliable any more. I used to be like clockwork so it's disconcerting when it's unreliable and when you have anovulatory cycles.

I'm in the TWW at the moment. My period is due Friday so that's what will set the clock ticking for the start of ivf.

Did you manage to speak to create in the end? Xx

@GingerRCD How are you? Sorry I haven't replied for a few weeks, nothing really to report here, feeling a bit hopeless... I keep thinking about ivf in Greece but it would be quite disruptive to our lives (work/daughter at nursery) and also I know of someone who had treatment at the same clinic last month and it didn't go well... I'm in 2 minds...
i hope you're having a good experience with Create, what stage are you at now? Are you travelling into London for appointments? Xxx

Hi @GingerRCD just checking in. How are you? I wanted to update the thread to say I followed your advice and managed to get FSH down to 5.9 this month!! Previous lowest was 16 so feel really pleased. I am trying Letrozole next month (although clinic didn't seem to think it would help much!), I don't think we want to pursue ivf now but I'm still holding onto hope of conceiving. Hope you're getting on well with Create - are you doing 6 cycles as originally recommended? Xx

Hey @smashedbanana so lovely to hear from you! Sorry I've been quiet on here. My first cycle of ivf was cancelled after two scans (and no drugs), as my dominant follicle was a funny shape and my hormones weren't playing ball. I got a bit down about it all, thinking that it's never going to be the right time as my hormones aren't perfect due to my age and DOR. I kind of let the diet and supplements etc fall by the wayside the last few weeks because I felt like what was the point in it all when my situation is so bad. Ugh!

But, it's a new cycle and I'm trying to be positive again! I think we have to be kind to ourselves when we have these lows sometimes - it's hard! So, my update is that this cycle is going ahead and I had my first injection last night. I have another scan and bloods tomorrow, but fingers crossed it continues this time!

That's amazing about your FSH - well done you! That's given me a boost to get back to it with the diet! That's great that you're going to start letrozole. Is that with a private clinic? I was really considering ovulation induction, too. I don't see why it wouldn't be as effective with women with DOR. I think the timing is the real key. Wishing you lots of luck - keep me informed! Xx

@smashedbanana I'm doing the 6 cycles. The cancelled cycle doesn't count as one of them (but we've had to pay £500 for the pleasure!) X

Hey, just to update you, I had my first egg retrieval today. I knew I only had the one dominant follicle and they managed to collect an egg from it. Praying that we get an embryo from it. The natural modified cycle only starts on Day 6, so it's focused on stimulating the dominant follicle your body has naturally selected.x

No embryo this time, sadly. Ugh. It's such a lot, feel a bit numb. X

@GingerRCD

Oh no. I'm so sorry. I can imagine how that feels, it must be so hard.
Ivf / TTC in general is a rollercoaster of hope and then despair isn't it.
Did they give you much feedback on why or just unlucky? I hope you can have a lovely few days off work over Easter and relax after what sounds like a very stressful few weeks.
I'm still waiting to start Letrozole, I had a crazy short 21 day cycle last month and my paperwork wasn't ready on CD2 so they advised I start next month instead, after 3 years trying to conceive what's another month hey?
I'll keep you updated.
On side not, have you been pleased with Create so far? How did they handle the news today?
Xxxx

@GingerRCD how are things? Xx
About to start Letrozole early next week, will keep you updated but the clinic have advised it's unlikely to work... wishing you lots of luck for this round, are you still taking all the supplements? Xx