* Author Topic: Low AMH of 1.4 I'm only just 33! Clinic planning to double stim dose this time  (Read 3067 times)

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Offline 2708belle

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Hi everyone,

I'm in a bit of a panic. We had an ICSI cycle abandoned in February as I was found to have polyps in my uterus. Little blighters weren't there before I started treatment. Thankfully they've now been removed. Also, I didn't respond well to the stims (Menopur) and only had 3 decent follies which the Dr decided weren't numerous enough to remove. Now I've just been told my AMH is only 1.4. I was only 33 last week! Shock is an understatement  :'( I keep reading about others on here being panicked about having AMH's of 4 and being told by their clinics they can't be treated or have a very low chance of success. My clinic has given me very little information apart from 'don't believe everything you read on the internet' and have opted for me (I say for me as no other options discussed) to just double my Menopur this time around. I just hope I have enough eggs in there for me to have a successful cycle. And I hope my reserve isn't used up by using such a large dose this time.

Please can I get some reassurance by anyone else who is/or has been in a similar situation? I am planning to talk to the clinic when I go next week too.

Thanks! xxx

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    Offline Maisyz

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    My amh was about 1.6 when first tested. When retested it was closer to 3 (can't recall exactly). I have had four cycles, the last of which was the most successful in terms of embryo numbers (3). On this cycle I was on a combination of Gonal F and Menopur, not sure if that helped but may have done. Previously had cycles on just Menopur which always went OK and got me to transfer, had one bad cycle on pure Gonal which was cancelled v early. Might be worth asking about combinations of drugs maybe. Good luck

    Maisy

    Offline BettyMax

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    Hi there
    I can't offer much advice but only that it seems to be very variable! Last year we only got 3 eggs, got a BFP and had a miscarriage. This time they doubled my drugs and today I found there were no eggs and I only had 2 follicles anyway. They want to check my AMH which must be low as like you, I am 33.
    What I have found out:
    -Double the dose does not always increase the eggs and is unlikely to double them.
    -Think about your protocol in terms of long/short as this can affect stimulation.
    -Take DHEA for egg quality. The jury seems to be out on whether AMH is linked to quality and / or quantity.
    -I have read that ladies with endometriosis who have it lasered might find their egg reserve is lowered. I'm not sure if this is true.

    Sorry I can't offer a positive  story, just my experience. Good luck!

    Offline dandygirl

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    Hi ladies, just to add in my story...

    I was 38 when first tested for amh and it was low at under 1, we live in N. Ireland and because of the low amh we were actually refused our cycle on the NHS (we were advised by NHS consultant to go for DE). Through conversations with various couples at a support group we found out about GCRM in glasgow and to cut a long story short ended up having one cycle with them in Sept/Oct 2011. They were very upfront at our consulation about our chances (around 1%) of becoming pregnant with my eggs but we had decided to give it one shot. In fairness to GCRM when they explained what protocol we were going 2 be on, they could explain exactly why this was suitable for our situation. They also suggested a 3 month course of DHEA to hopefully have an effect on egg quality. We were on a flare protocol using gonal f. We ended up with 4 folicles, 3 mature eggs, all 3 fertilised, we had the 2 best transferred on day 3. Unfortunately none to freeze but ended up pregnant and now have a bouncing 9month old!

    We made the decision at the end of last year to give it one more shot (AGAIN!) for a sibing and so consulted with GCRM again at christmas time and started DHEA again for 3 months. We were again on the fiare protocol but the timing of the drugs was slightly different to last time... to be honest I didn't hold out much hope that we'd even get as good a result as last time but to my (and DH) surprise we ended up with 6 eggs! (one was very large and considered abnormal so that one was ruled out straight away) but the other 5 fertilised... 3 were of such good quality on day 3 that the clinic decided to push them to blast, and we ended up with 2 perfect blasts on day 5. one was transferred and one is in the freezer! we're now in our 2ww and even if we don't get a positive result from this or the snow baby, I know that the clinic have done everything in their power to give us the best chance possible...

    I know that this has been a long post but its just to give some background info... in our experience the clinic could show us why the protocol was suitable for us, everything was done to maximise egg QUALITY (not quantity) and to be honest when reading a lot of the posts on other threads its a bit hard to read the posts where ladies are getting 15+ eggs and end up with snow babies but remember for us it should always be about egg quality and any clinic should be striving to give you the best chance of quality mature egg(s).

    best of luck to all you ladies and remember it only takes one egg!

     ^reiki^ ^reiki^ ^reiki^ ^reiki^ ^reiki^

    dandygirl

    Offline Sweetpea123

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    Hi,

    I'll just add in too as i've just had 3 consultations with clinics that will treat low amh, the one thing they all advised is that age is on our side even with low amh. i had positive consultations with all. none of the clinics mentioned donor eggs, and they all believe you cannot go by just one cycle. i had a consultation in the midlands which led me to have consultations in london as i was rejected by them saying my chance is less that 5%. i'm glad i went for other opinions. last year i had an abandoned cycle on lp, then the 2nd i was on the max dose of menopur. with low amh they advise do sp - no dr!

    this time round i'm going to be on sp. i was on lp last year before my amh was tested and i got 12 eggs. this time even if we get fewer eggs but better quality i will be happy. i have been taken a lot of supplements for 6 months now. we are looking to start next month.

    in jan i thought it was all doom and gloom but at the moment i'm not feeling too bad but taking each day as it comes!

    xx

    Offline LisaL29

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    Hi all

    I was curious about amh level.  When I got tested by a private clinic last week, (which we will be switching to if my next frozen fails) he said my amh was either 6.5 or 65, i wasn't paying attention as I had other worries in my mind and I underestimated the importance of this blood test.  Now I'm curious.  He said it was high and said I would more than likely have ohss again (I did at last cycle of ivf). He referred to another patients being 115?  Or was I really not paying attention?  He said he would reduce my drugs and monitor me closely and increase the drugs half way through if they weren't coming along but he more than likely anticipated I'd collect 20 eggs again.  So I'm wondering is it more than likely my level is 65 or is that just unheard off.?  And does hyperstimulation reduce egg quality?  I do have pcos.  Would that cause a level of 6.5 or 65?

    I'm taking that a low amh is not great but surely a high amh is not great either if it causes more eggs with reduced quality?  Can you do anything for the level either way?

    Thanks
    Lisa

    Offline Sweetpea123

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    Hi,

    I think you would be looking at a level of 65, as 6.5 is low amh an I think this is indicative of pcos from what I understand, and they would need to monitor u carefully for ohss.

    I know there are things to try to improve low amh but not sure on high amh you may be best asking on pcos board?! Sorry I can't help any further cx

    Offline 2708belle

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    Hi everyone, thanks for sharing your experiences. I'm going to look into DHEA and ask my clinic about it as they haven't mentioned it at all but I've read lots of positive things about it recently.

    Interesting that my AMH was okay prior to my lap/endo removal. Perhaps that has affected my reserve?

    I feel sad now that I had 3 decent sized follicles which the Dr felt weren't worth removing. As mentioned above, it's quality rather than quantity! We'll see how this round goes. Fingers crossed I'll get a few decent follies this time. And yes, it only takes one! :)

    Dandygirl - thanks for sharing your story. It's great to read about lovely positive outcomes. Congratulations and I hope all goes well with your 2ww xx

    Thanks everyone, you've given me hope and some great advice xxx

    Offline BettyMax

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    interesting that you mention the lap/endo removal. I have been wondering about this as I have read that laparoscopic lasering does affect AMH levels. My left ovary was lasered in Feb and didn't produce any eggs at all this time. My right was heavily treated in 2011 and has never produced anything during IVF. they never tell you this though do they!?