TTC/CYSTS/LOW AMH

[scotlandttc]

Hi,

I’m hoping to find people who have been in the same situation as me. I have query adendoymosis, dermoid cysts 5cm on my right ovary and a low AMH of 9pmmol! I’ve been told time is not on my side and i should consider private IVF. NHS IVF won’t accept me until i have the cysts remove however i’ve also been told that if i take the surgery it will affect my AMH and egg quality further. Has anyone else been in this position? I don’t know what to do for the best. I do have an appointment at a private fertility clinic for a 2nd opinion

Hi,

Just jumping on to say that I also had a 5cm dermoid cyst on my left ovary and my amh was something like 5pmol. However, I did have an ok afc count (approx 10-15) such that effectively my amh and afc count were out of kilter.

The NHS told me they would do ivf with or without the cyst, and that it was up to me. I had private healthcare at the time and was strongly advised to remove the cyst. The reasons were that (a) the cyst could continue to grow and obstruct (for example it can cause ovary torsion especially after ivf) which could impact any future pregnancy (and particularly pregnancies if I wanted to have more than 1 child), (b) that with a cyst that size it would eventually have to be removed in any event so it made sense to do so pre any ivf/pregnancies.

I was told that removal of the cyst could lower my amh further. I did a lot of research at the time and it is inconclusive on whether removal negatively impacts fertility - it does seem to lower amh but it is not clear whether removal reduces egg quality. What I would say is that if a dermoid cyst is largely impacting an ovary, it is likely to affect healthy follicle growth regardless of whether the cyst is there or whether it is removed.

I had mine removed and never tested my amh again - I went straight into ivf. What I found was that the removal of the cyst on my left ovary left very little ovarian tissue on that side and the follicles on that side never properly responded to ivf medication (I.e. there were fewer follicles and the ones that did grow did not reach optimal size for egg retrieval)
so in my case, all of my eggs from ivf were from the right hand side. But the quality of those eggs seemed unaffected as I had a successful round of ivf following my op when I was 34, and then again when I was 37 for my second child.

not sure any of that was helpful as every situation is so unique to your circumstances. But I should think that getting eggs from your left ovary is your best bet and doing so asap will give you your best chance of success - I really do think that age is the biggest factor in ivf outcomes x