AMH Level decreasing

[mommaicsi]

I am potentially eligible for NHS funding for IVF/ICSI due to my husband's very low sperm count. My AMH level was 30.11 pmol/L (reference range 3.71 - 85) last year, and it is now 27.82 pmol/L (reference range 2.5 - 84.5).

Previously, my local fertility centre indicated that an AMH of 30.11 might put me at risk of OHSS, and I would be placed on a short protocol. With my current AMH level of 27.82, has my risk of OHSS increased or decreased? I am 30 years old with a healthy BMI. I have asked the fertility consultant but waiting for a reply.

Will be choosing between Wessex Fertility (Freya Centre) and Complete Fertility Southampton/Chandler’s Ford.

27.82 is a very good AMH level, so yes you may be at increased risk of OHSS. Best of luck with your fertility journey

Thank you so much @2mumlife
I hope you are keeping well

I don't know if you've started your cycle yet but if you haven't, I would recommend requesting they don't give you the Ovitrelle trigger.

I had similar AMH to you and got OHSS multiple times with Ovitrelle.

My most recent cycle they switched to Buserelin and I had no issues at all.

I was shocked that what felt like such a big problem had such a simple solution (I switched clinics for my most recent cycle and my consultant knew straight away that Ovitrelle was the problem).

They might try to give you it because it's the most effective/ easiest for them, but for me it was definitely the cause of OHSS.

We are male factor as well and my fertility is normal, I'm in my 30's, so could be a similar situation.

Thank you so much for sharing your experience. That’s really helpful to know! I haven’t started my cycle yet, but I’ll definitely ask about switching from Ovitrelle to Buserelin, especially considering your experience with OHSS. It’s comforting to hear that something as simple as changing the trigger made such a big difference for you.

Out of curiosity, which clinic did you switch to for your most recent cycle? It sounds like your new consultant was really on top of things!

I’m hoping I’ll get more of a say in my requests too, especially since I haven’t started my cycle yet. Are you going through the NHS or privately? Also, how much time did you need to take off work during the process? I’m trying to plan ahead!

@mommaicsi We switched to the Lister - private - and I honestly can't recommend them enough, although I don't know if they see NHS patients. We had two rounds of NHS ICSI, and then loads of donor IUI at Agora, and they were pretty bad all round (I've started a whole other thread about them lol).

This isn't to say that private is any better than NHS - I truly don't think it is - I think it's about the clinic you go to. The Agora see both NHS and private patients and they are just as bad either way.

I had to travel in to the Lister on the train but it was worth the time and expense. For me it meant a day off work every time I needed a scan. But if you go somewhere local, you won't need that much - scans don't take too long really but you need them every couple of days during the stims.

It's hard to say how much time off you'll need because it depends how you respond. I only actually took 2 days off work in the end but that's because I'm part time and a lot of the appointments fell on my non working days. You might need a recovery day after egg collection - I wasn't quite ready to go back the day after.

Overall for me it hasn't been too bad with time off work.

Good luck with it all.

My AMH was measured as 34.9 in May and I had my first IVF cycle late July/early August so I assume it was pretty similar still. I was on a low dose of stims and responded really well. I did have the Ovitrelle trigger shot (I did ask if that was okay to have that one as I had 24 follicles and they said that would be fine) and didn't get OHSS thankfully, maybe I was lucky. But then equally I didn't have a transfer as none of my 19 mature eggs fertilised unfortunately (very rare, hoping it was extremely bad luck). I know a transfer and pregnancy can make OHSS worse.

Edit: not sure it helped but I drank plenty of water, had lucozade sports drinks for a few days after egg collection, and had gentle walks most days. I was quite bloated and constipated but it was manageable.