AMH of 3.5 (36 y/o)

[Pep1952]

Hi all,
I got a call from my fertility clinic at Guy’s today, unfortunately my AMH is 3.5 and will not qualify for NHS IVF funding. This all came as a shock because my cycles are regular like clockwork and I ovulate every month. My FSH is normal (forgot to ask the exact number) so I will be scheduled for an ultrasound to count the follicles and also check my tubes. I am obviously devastated and was crying all morning. I am 36 y/o and was told that i can still conceive naturally (DH’s sperm results all good), but that my chances for successful IVF is diminished significantly compared to others who have AMH within normal range. We are scheduled to speak to the dr but I would appreciate advice from women who were on the same boat please. We can afford to do IVF privately but it won’t be comfortable if that makes sense. We only have just enough in savings. We’re not sure if we should keep trying for the rest of the year and re-assess in January but worried it’ll all be too late but then. Equally, also worried we will be spending monies on IVF when my chances aren’t great to begin with. Just confused right now tbh!

Hello ☺️ Sorry you’ve had that news today. That’s rubbish that your area won’t let you have IVF with AMH that level - mine never mentioned that. My AMH was 3.9 and I had my first cycle of IVF in May. I only had 4 eggs on the scan (which aligned with my AMH) and in the end got 3 eggs retrieved. Miraculously one of those made it to day 5 and I fell pregnant from it. There is definitely a chance it will work for you! You’re younger than me, your eggs will likely be better than mine too. Yes, it might take longer for you than most people to get an embryo that works, but it’s possible! I say do it. ❤️

Ps. Of the groups I’m on on here, those of us who had low egg numbers and poor chances for IVF have all conceived. Sometimes with the lower egg numbers there’s better quality because all those lovely hormones don’t have to be shared across lots of eggs. Have faith xx

@HopefulllHolly just stumbled upon your message and just wanted to say thank you. I needed to read something saying just that as I have become quite fixated on my numbers (14 follicles on baseline but only 8 have grown) and I’ve been so sad and worried. Thank you for the hope x

@MerryBrickHelper I know it’s really easy to compare numbers (especially when you see people getting upwards of 20). But a lot of clinics only aim for maximum of 12 because it can affect quality. It is 100% quality over quantity. I cried for hours after my scan where they only saw 4 but it all worked out. I really thought people were just pacifying me by saying it’s quality over quantity and it only takes one, but it’s very much true. Pour that energy worrying about numbers in to trying to be hopeful, eating healthily and taking care of your wellbeing ☺️ It’ll work out xx

Thank you so much @HopefulllHolly that’s really encouraging. We are scheduled for a hycosy next week, will try naturally for 3 months and then go down the IVF route with managed expectations. We’re considering the multi package but will be guided by the doctor. My DH’s sperm analysis all good so we are staying positive.

Good luck to you too @MerryBrickHelper xx

Good luck @Pep1952 ☺️ my friend fell pregnant after HyCosy after being told it was medically impossible for her to get pregnant naturally. Hope it all goes well for you!

Hey @Pep1952 - could you try ovulation induction instead? I fell on my second round of letrozole. I believe age doesnt come into play, or alternatively i paid privately at Kings fertility and it cost approx £1000 a cycle but you get much more for your buck. My AMH was 6 so slightly higher than yours but still low. [

Hi @Optimistic66 we’re seeing the consultant at the Lister clinic next week and will ask about this. Thank you and congrats on your success with letrozole!

What's the thread for this, I'm in the same boat!

We’re all pregnant now so it’s one for post BFP. But have faith ☺️

I had my transfer last week. Out of 7 eggs, all 7 eggs made it to blasts but they transferred one 4BB and the rest they left until day 6 and then discarded because they were low quality! I test on Friday and feel like it’s not worked and I’m gutted we don’t have a Frostie and will need to start again!

Thanks @MerryBrickHelper for updating us! I wish you the best of luck and all fingers are crossed for you! Manifesting a BFP for you on Friday!! Xx

@Pep1952 did you find out your exact FSH and AFC? You may be able to challenge the funding decision if both are ok. Usually it's two out of three of AMH/ FSH/ AFC which need to be in NHS range.

Do you know the exact criteria laid out by your local health trust?

Hi @sirensong my FSH is ok (9.1) but unfortunately SW London criteria is strict on AMH which should be above 5.4. Very frustrating indeed! When i had hycosy, the dr said i had 5 follicles on the right and 4 on the left but he counted it very quickly, I think it’s because he wasn’t planning on doing that it’s just that i asked. I think 9 is ok though for my AMH??

@Pep1952 how frustrating. Some people get around this by registering with a GP in a different trust area with more favourable policies - some accept out of area registrations: https://www.nhs.uk/nhs-services/gps/registering-with-a-gp-outside-your-area/

https://www.gov.uk/government/publications/nhs-funded-ivf-in-england

Good luck either way.

Thanks @sirensong , the only thing is we really like our GP! We will be seeing a consultant in Lister clinic this week and might use the Access/Assured programme if we’re going the IVF route. Still hoping we can still manage to get pregnant naturally but know clock is ticking!

Hi everyone, just came back from our appointment with Lister clinic. The consultant recommended we do cycle monitoring so I will call the clinic on the first day of my next period to book my first ultrasound. He said they will do ultrasound monitoring to ensure all is ok and behaving as expected. He also prescribed letrozole once a day for 5 days which I will start on d2 of next cycle, and cyclogest suppository twice a day to start after my next ovulation. He was not in a rush to do IVF although of course gave us this option. He also said he didn’t think my AMH will drastically drop in 3mos. So we plan to continue trying naturally for 3 months and then do IVF. Fingers crossed we conceive soon!

Hi,

I don’t know if this is any help to you but my AMH is 2.7 pmol and my AFC is 9. My fertility nurse suggested Impryl to improve egg quality and there’s studies it improves outcomes for women with lower AMH. Originally it was to improve sperm but then there has been great outcomes for women too. It's pretty pricey but I’ve heard good things, especially before trying with IVF. I am booked in for a hycosy next month and then we way be thinking about IVF as next step. I hope everything goes well for you x

Thanks @Kp1345 . I asked the consultant if there is anything DH can take to improve our chances (his SA is normal) and he suggested Impryl so DH has started taking it and Vit d also. I’m currently taking coq10 and pregnacare. Now considering to add impryl too! I’ll read the ingredients. Thank you. We have the same AFC, had my hycosy done 2 weeks ago. It looks like we are on the same stage of this journey. Good luck to us. We will get our BFP soon. xx

So my fertility nurse said to take it instead of everything else. So I just take that and vitamin D. Wishing you all the luck!

@Kp1345 it has some of the same ingredients with pregnacare so when i finish my pregnacare supply i might switch to that!

Hi @Optimistic66 i’m starting letrozole on my next cycle, plus cylogest post ovulation. I was reading different threads here and some were given trigger injection but I wasn’t. Were you? We’re trying naturally so not IUI. I wonder if i should email the clinic to ask why I wasn’t given a trigger injection.

Hey, are you having a monitored cycle? where you go in every few days for a scan? or is it just DTD all over the period and at all home ovulation sticks?

So i was given trigger and used first cycle but was unsuccessful. I was told by the clinic to go home and use. However second cycle I was told to trigger when i get a peak on OPK but never got a peak so didn’t use it as i didn’t think i had ovulated yet. When i went to my next scan i had ovulated already myself and this is the cycle i fell pregnant.

I believe the trigger just forces your body to ovulate at a certain point and you can time it well. However in my case the cycle without trigger was the successful one.

Keeping my fingers crossed for you! How many rounds are you getting? xx

Hi @Optimistic66 . I was told it will be a monitored cycle so I was instructed to call the clinic on the first day of my full flow period so that the nurse can book me for a scan. I'm not sure if there will be blood tests too (what was your experience?). The consultant said I may have my first ultrasound scan on day 10 of my cycle but that the nurse will let me know. Trigger injection was never mentioned during the consultation but it may be because I told the doctor that I ovulate as per OPK testing. I'll ask the nurse when I first go for scan.

DH and I agreed we'll try 3 cycles on letrozole. Dr seem to suggest can try for around 6 months but I'll be turning 37 early next year so really hoping I conceive before then.

What letrozole dose did they start you on? Did they give it to you for PCOS? I don't have PCOS but more of unexplained fertility. Dr said my AMH level is not a reason for infertility. Did you also use cyclogest pessaries? Is this your first baby? Sorry for all the questions!!

I had monitored cycle too - so first cycle was CD10, then CD 12, then CD14 - where i was told to trigger so then didn need any further scans that cycle. I didnt have any day 21 blood test as if you do monited cycle - ovulation is confirmed through scans anyway.

Ive not personally heard of NHS offering trigger, most people I know who get the trigger shot are going privately. So wonder if its more because its another thing you pay for?

Most I know do let for 6 months and quite a few I knew had success on round 3 or 4. Fingers crossed for you that it works in the first round!!

I started on 2.5mg and stayed on that dose as I successfully ovulated. I dont have PCOS and also my consultant said the same that Low AMH doesnt mean inability to get pregnant - it just means less eggs left in your reserve. As long as you have eggs - can still get pregnant. Low AMH mainly affect IVF, where i believe you are likely to only get a few eggs per round vs those with higher AMH.

Thanks @Optimistic66! I am with a private clinic too (Lister in London) but the consultant never mentioned a trigger shot at all. Just learned about it on threads here. I will ask about it when I phone the nurses to book my first scan. I’m just waiting for AF to show up which should be any day now (have been cramping for the past few days).

I hope all’s well w your pregnancy x