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!

Ahh yeah i would ask about it - espc if your having monitored cycles - think it just lets you time it properly and gives your body that extra push. Although I can say it doesnt matter too much as I didnt use it the cycle i fell.

Good luck! Keep me updated - feel free to ask if you have any more questions.

Thank you! x

Hi there! I had an AMH of 1.1pmol/l with 2 AFC and fell pregnant at 41 with follicle stimulation drugs and trigger shot. All on the NHS. Husband had a low sperm count too. At first we were refused treatment due to the impossibility but I appealed and they accepted us.

You don’t always need a trigger shot. If you have cycle monitoring and your follicles are growing ok and there’s a front runner for maturity they may let you lh surge yourself. If you are on high stims and follicles compete for growth they can time a trigger so you aren’t releasing multiple eggs and the cycle being at risk of cancellation.

I hope that gives you some hope. AMH and AFC are only indicators for ivf, they are less important with natural and assisted fertility. I’d be trying assisted as you are doing what I find a way around the funding.

impryl you take by itself alongside omega 3 but I think that’s all you can take with it. Read their website and email them with questions, more is not more when it comes to impryl as the ingredients are finely balanced and anything else can disrupt the effectiveness. Xx

Hi @Eiradu1 congratulations on your pregnancy and thank you so much for your message - you have no idea how this lifted my mood! Yes i called the clinic regarding the trigger shot and as you said, they told me that they’ll be monitoring my cycle and will give me trigger shot if needed. I will not need it if they are sure that i am ovulating/have ovulated. How long have you tried on stim drugs if you don’t mind me asking?

I'm on my first nhs round, originally 2.6amh but it went up when retested to 3.something Just inconsistency in testing I think. I'm in Scotland.

They thought they'd get four eggs, but they got three. All three fertilized. Still growing at day 3. Currently at transfer day waiting for a call with either bad news or to say to come in. Can't tell you how jumpy I am (I panicked at a paper bag falling thinking it was a dog jumping at me?!). But we never thought we'd get this far. We've had some very serious hiccups along the way.

I'm very sorry to hear you don't quality for nhs funding down there (we actually began at homerton but moved back to Scotland so we could buy a home for our hopeful family). All I can say is that it definitely shouldnt stop you trying. It's such a lot of money to go private, but if I'd known what I know now (that we actually did have a chance despite being told by one dr we basically didn't) I'd have payed and used my 2.5 years younger eggs to give them that extra chance.

Hello again, I hope I’ve replied directly to you, I’m not sure how this thing works!

I had follicle stims at 41 with my daughter and we got pregnant first time. The second time we tried them at 43 we got pregnant but lost the baby at 8 weeks. We are due to start another cycle once I’ve recovered from surgery. I just really like that everything is monitored and timed to stop any guess work. They usually trigger two eggs for me as multiples aren’t really a risk as the chances of fertilising is so slim, but they do cancel or go straight to harvest if your follicles respond and your AFC is decent. Please discuss your options rather than having a cycle simply cancelled. I’ve seen this happen on the peanut app and there are options.

I’m so pleased my story helped. I believe if you take your supps, eat a fertility friendly diet and avoid the main staples like cigarette, alcohol etc and manage your bmi, with the right support it will happen. It’s not over until menopause is established, it’s just a lot harder with age and you aren’t there yet! Xx

Please do let us know how it goes. Get hubby on that naughty plastic bag!! Xx

Heh @Eiradu1 i think it was an eye roll moment for him!

Well we got our transfer, and im so pleased to have got this far. Sadly two embryos have slowed down too much at 8 cells (I wish they’d just let them grow on to see) and we transferred our 4cc embryo this morning. It’s still developing, but slower than their top grades. I’m sad but also happy. I know chances are less but that chances are there.

Congratulations! Most successful stories include less than optimal conditions so I remain hopeful! Where there is opportunity there can be success. When can you test?

Hi @Eiradu1 thanks again for replying. Sorry I’m new to all this but when you say follicle stims - what does this mean? Were you put on letrozole or clomid? Sorry got confused when you mentioned harvesting of eggs - is it some form of ivf too?

I just started my first cycle monitoring with letrzole 2.5mg. I had a scan today (cycle day 3) and was told I only have 4 follicles. Last month i had 9 when I was having my workup done for my initial consult although that was done on day 14 of cycle. The nurse tried to reassure me today that 4 follicles is absolutely fine and I only need one egg and that afc varies from cycle to cyle. I still can’t help but feel a bit deflated with 4 follicles but will try to keep positive! I return next week for another scan to see if any starts to mature. Xx

Hi @Nosejug thank you for sharing! Can i ask how old are you now if you don’t mind? I’m so pleased you were able to transfer one - I wish you the very best of luck!! We’re trying letrozole for 3 mos and if unsuccessful we move on to IVF. I hope we get our BFPs soon xx

Aw me too @Pep1952 and yeah of course, I'm 38, I was 36 when we started investigations. I was on protocol 9 for icsi ivf (I can't believe it's past tense now!) and although I hope you don't have to use it, it really hasn't been bad at all! It's lovely being supported by a medical staff of your side, especially after so much waiting, and supporting you through your emotions too.

Thanks @Eiradu1 ! It's helpful and lovely reading your story of success. Testing on the 2nd August 🌞

Follicle stims are what you are having, I just have the injectable version not oral. I only had one follicle on my first set of scans and then others woke up. You don’t want a ton of follicles maturing as they will cancel your cycle. You want a front runner. In our natural cycle that’s what happens. I got pregnant on that first cycle and got to healthy birth. I’m also a lot older than you so the chances were very tiny. It can happen!!

egg harvesting is when they take your eggs for fertilising outside of the body. On an ivf cycle you have stimulation drugs to mature as many eggs as possible for them to be harvested. On an ovulation induction or IUI cycle you only want one or two max. If you get two your chances of non identical twins increases under some circumstances.

Aww the 2nd August is soon! It will be here before you know it. I love that your egg gets mature where it belongs and I’m sending positive thoughts to you. I’m sure the wait will be difficult but time will pass. Take it easy and spend time doing things that make oxytocin 🙏🏼

Hi @Eiradu1 thanks for explaining, that makes sense. I’m on a low dose of letrozole but fingers crossed it’ll work for us!

@Nosejug 2nd Aug… i’ll be thinking of you!

Thanks @Eiradu1 and @Pep1952 !xx

Hi all i’m CD10 today and just had my 2nd scan (1st scan was CD3 to check for any cysts etc and that was fine). I have a dominant follicle at 17mm. However my endometrial lining is only 5.7mm, the clinic wants it at least 7mm. I was started on vagifem 10mcg twice daily, i had my first dose in the clinic. Nurse said we should BD tonight, do a LH opk test, and I come back tomorrow for another scan. Feeling a bit sad about the lining. I wonder if it’s too late for vagifem to work as I feel like i may ovulate soon (i usually do at cd13-15). However, I am also grateful that at least they found an issue which hopefully is fixeable. @Optimistic66 can i pls ask how thick your lining was when you were successful as I know we’re both on letrozole 2.5mg for unexplained fertility xx

5.7 is very close to 7, and from what you’ve said it sounds like there’s time for it to grow. I’ll add that I have a friend who’s lining was very thin ( more so than yours) and even though they couldn’t in the end getting it to minimum, her clinic thought she should at least get to try a transfer. Her child was born a short while ago.

And obviously it’s with a pinch of salt, but it was suggested to me that eating lots of pineapple (I’ve been leaving the core in) is good for lining. Who knows, but it’s nice to feel like there’s something to try to help.

Hi @Nosejug happy to report that I just had my repeat scan today and my lining grew to 8.8mm! So pleased!

So I am to continue vagifem until I test for pregnancy (2 weeks tomorrow). I was also asked to do a trigger shot today then BD tomorrow. And then cyclogest from Friday. I was not asked to come for a progesterone blood test and forgot to ask the nurse about that - shall I push for that?? Xx

@Pep1952 that's great!

Re: blood test, I'm afraid I don't know. I was getting regular blood tests (for ivf icsi) towards the end along with scans... but I'm hazy about what they were for? I was just told they were checking my hormones were where they should be, so maybe that was progesterone. I imagine someone else will be better answering.

But yeaaaa on the lining :D one less thing to worry about :)

Thank you @Nosejug , I’ll drop the clinic an email there’s no harm in asking! And wishing you the best of luck for your test on Friday. Not long to go now!

Just popping in to wish you all the great tomorrow @Nosejug xx

Aw @Pep1952 and @Eiradu1 you're both very kind for remembering. If I'm honest I don't really think it's worked. I feel like I'd know, but I feel like I'm due a period. It will be good to get the news either way and move on from there. Trying to see positives whatever happens 🌞

that’s such a great mindset! I had zero symptoms with my daughter, I just felt like I was going to get my period and got a faint line in a FRER 14dpo. TTC baby number 2 ive felt dreadful and it’s been negative, then our recent pregnancy I felt great and BFP. You just never know. X

Bad news for us sadly :(

@Nosejug I am so sorry to hear about that :( have you thought about what you’re doing next yet or will you take a break for now? Sending you virtual hugs x