40 Low AMH

[starmoon167]

Looking for suggestions, any direction is appreciated. Please share your experience and the clinic / hospital you were treated at and if the outcome was successful / unsuccessful.

I’m 40 with low AMH. I’ve had 2 failed stim cycles and one fresh embryo transfer resulting in a negative pregnancy test. Was treated by the NHS. Now looking into clinics which are specifically geared to those who fall within my bracket.

Thanks in advance.

Hi starmoon
I am in exactly the same situation. I am 41 with very low AMH.
With 2 failed cycles. There were both natural modified cycles, which means minimal stimulation. I did both cycles in Greece. i Also had PRP procedure.

Currently I am looking into NAD & DHEA

What do you plan for the future?

Hi @Laura2345cc ,

Sorry to hear.

I have no idea.. there’s a possibility of trying again. At the moment, I’m feeling pretty down. Need to snap out of this if I am to have another cycle. Meeting our consultant this week to discuss next steps.

I’ve heard lots of positive things about DHEA. But I don’t know enough about which is good to use. I’ve been taking CoQ10 and having acupuncture.

Will you try again? Do you suggest having a few months break between cycles?

Hi @starmoon167 , what do you mean by failed stimulation rounds - your ovaries didn't respond so the rounds were adandoned?

Regarding DHEA, it is sometimes used by women with DOR. Get your testosterone/ androgen levels checked. Increasing those can sometimes also increase AMH.

Duostim is also a potential avenue for those with DOR.

Hi @sirensong ,

Correct, the first two rounds my ovaries didn’t respond well, so they were terminated. Protocol was then changed to remove Gonal F and only use Menopur and I had a much better response.

Thanks - I will get those levels checked.

Have you had success using DHEA?

Thank you for your answer.

Sorry to hear you feel down. It's an awful feeling, as it comes with the realisation that we may never be successful. But from what I know, for more difficult cases it can take several attempts.

Strangely, I am feeling ok. I felt down after the first cycle. Because I underwent Fresh transfer and then waiting for two weeks. It's awful to imagine your are pregnant for 2 weeks and then you are not.
But now I change the strategy and I believe is much better. After the first cycle I decided I will not do any transfer until I obtain at least 2-3 blasts and then transfer them all at once. In Greece you can transfer up to 4 embryos, for my age group. I believe this is better, both emotionally, financially and other points of view, given you have to use some medications post transfer, and for example progesterone inhibits folliculogenesis, therefore this would delay the next cycle.

In the first cycle, the doctor took the decision to transfer my embryo at day 3, which I believe for a women over 40 is not a good idea, if there is only one embryo. From 2 points of view:

1. For a women over 40, many embryo will never make it to blast stage(Day 5 or Day 6). If you only have one embryo, then there are very slim chances to make it. If you have few of them, then is a different situation. This is exactly what happened the second time in my case: my embryo was growing very well to day 4 and then stopped. If I would have done the transfer at day 3 then I would have wait two weeks, while taking unnecessary medications.
2. Blastocyst stage are more like to implant. It's at blastocyst stage when an embryo is capable of implantation. Also there is a certain window of time when the uterus is ready to receive the embryo

Having said that, I am aware there are clinics with good success at day 3, or even at day 2. But this is not a good strategy if you are over 40 and you only have one embryo at a time.

So, to increase the chances, I will collect 2-3 blasts first. This means I may need to do several IVF's cycles, just to obtain 2-3 blasts.
However, as for now, I wasn't even able to produce not even one blast!

What is your case? How was your last cycle?

@starmoon167 I haven't tried DHEA because I have the opposite problem - over response to stimulation and then dire attrition (despite not having PCOS).
However I've noticed others in a similar boat to you reporting it helping.

@starmoon167sorry to hear that. I would suggest Create Fertility as they specialise in the older age bracket and those with low amh. I had 3 ECs for embryo banking at 37/38 and on the 3rd FET (was a double transfer) had DC - amh was around 4 pmol. Could be worth a consultation to explore options, a lot is personal preference and whether you agree/get on with clinics approach

Hi Laura,

Understood your thoughts and thanks for sharing detail.

In my case, the last cycle, I had one Blast graded 2BB and one which didn’t quite make it to the blast stage, but was showing good development. The hospital recommended transferring both, which we agreed. Two weeks after all the meds, we had an unfortunate outcome. I was told to stop meds, and have had my withdrawal bleed which very different to my period, much heavier. I have a consultation this week to discuss next steps.

I still feel all the hormones pumped into me are lingering, causing this feeling.

Hi @sirensong,

I will look into this. I’m taking a highly absorbable multi-vit, vitamin d, omega 3,CoQ10 and magnesium for your information.

Thank you @Sunflower360. I will checkout Create.

At least you had a good blast!
I think this is reason for hope! Don't be disheartened yet!
You have a chance! Bank 2-3 good blasts and you will make it!

May I ask if you had any other procedures, apart from IVF itself.

Hi @Laura2345cc,

Thanks for your kind words.

I didn’t have any other procedures. I took a multivitamin, vitamin d, magnesium, CoQ10 and omega 3. I also increased protein with each meal. I did acupuncture and intermittent reflexology.