* Author Topic: Low AMH / High FSH Cycle Buddies - Part 6  (Read 124989 times)

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Offline Briss

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Low AMH / High FSH Cycle Buddies - Part 6
« Reply #230 on: 19/02/18, 09:32 »
Tily I think your 15/16mm is unlikely a cyst and most likely a follicle, the egg was probably not quite ready to detach or It was not collected properly.  Happens a lot. Considering there are questions about maturity of the dominant follicle possibly it was picked a day too early but it's hard to say cos the size looks perfect and estrogen was good.

Btw how many times did they flush your follicles? I noticed some clinics flush a lot and sometimes my eggs come out after second flush but some clinics just do it once.

I agree with Anna setting deadlines might put a lot more pressure on your mental health. I had a 45 year cut off point that was playing on my mind so I released myself from it.

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    Offline Helenbeau

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    « Reply #231 on: 19/02/18, 09:52 »
    LXP, sů sorry this cycle didnít work out for you. My thoughts are with you. I know how hard it is but Iím sure youíll find some positivity soon.

    Tily, so sad for you too. Iíve had nothing but bad luck recentky too and itís just poop. I absolutely know your pain and I can only imagine that your head is going ten to the dozen right now.

     My advice comes from a place that Iíve had to discover myself recently. Itís given me some relief and maybe it will you too. Maybe also itís a more positive outlook and positivity can feed positivity.
    So since last week Iíve started to feel like I canít keep beating myself up and putting myself through this. Iím ruining my quality of life. So Iím trying to change my thinking as I cannot go on torturing myself.i cannot change my body I can only change how I think I feel towards it.
    Iíve tried to stop looking for answers and to stop obsessing over every detail and Iím trying to accept that there are no answers. Trying to find answers for something so complex is making my brain go round and round in circles and therefore massively affecting my emotional health. I am trying to accept that for some women pregnancy is a given and itís easy and for others it is not and I am one of those women and I have nothing to feel ashamed of.
    I feel like Iím trying to force a square peg into a round hole so Iím trying to stop forcing it. I have to accept that my path is not what I would prefer but I canít keep fighting it I just need to carry on along it without analysing or forcing my way too much.
    Similarly If I start to think about DE I start analysing every detail it sends me into a spiral of worry and doubt. I start to think about the future the consequences, how I might feel etc etc. I mean natrually itís not something anyone expects to be faced with so of course itís a decision so complex again it sends your brain into a spin and youíre emotions along with it..
    But if I ask myself Do I want a child? My answer is yes. If I ask myself do you want this pain to stop? My answer is yes. So thinking nothing more than these two questions Iíve decided that DE is an option for me. If I start to analyse that decision then I will go crazy so Iím choosing not to analyse it, not to think about it too much and to just accept that it might be my path.
    I will try another OE cycle but that will be the last for me. I have to choose to be happy about that. I have to choose to accept that. Iíve found acceptance gives me more strength, itís helping my self esteem and itís some what relieving. I donít naturally feel that way. I have to stress that I am choosing it. I hope that makes sense

    Iím sending lots of love to everyone. We are all incredibly special women. We are all super high achievers fighting for exactly what we want however we decide to do it.

    Klik...thinking of you today. Good luck xxx
     

    Offline dorchestor2016

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    « Reply #232 on: 19/02/18, 10:08 »
    Tily - itís difficult to know exactly what the cause may have been..it seems the clinic has done a decentish job - as much as they could...
    I think this is more a fertilisation issue as the estrogen level is good for one mature egg- 22mm is also ok.
    If his DNA is good now it was probably good then in his frozen sample...
    Maybe Letrozole or mild gonal with IVF and fresh sperm is better for you....
    Now that you have all this experience -maybe you could look at batching locally with a Irish clinic, then DH wonít be as stressed by you travelling as much- not sure if this is possible?
    You need some time as and OE and DE is not some thing you can rush all in one year, all this is hard and complex and pressured enough - take some time to heal.

    Offline Mac78

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    « Reply #233 on: 19/02/18, 14:42 »
    Hi ladies,

    Just a quick one to say that my interview went well, at least I felt much more comfortable this time. Off course there was a question about the gap from my previous job until now,  but this time I explained very quick that it was due medical reasons and I  took the opportunity to work on personal projects such a my blog. Thank you ladies for all the advise :) I felt much more confident this time and now I need to patiently  wait to find out if I made to the second stage ^pray^

    Klik...Good luck today ^hugme^

    Helen; Acceptance has been my mantra lately. Your words were very encouraging and I am also re considering my position about DE, without overthink too much about it and focusing on other things.  I know the clock is ticking as I just turned 40 but I will no rush into right now as  I feel that if this is the path to go I do have a bit of extra time, just to be sure that this is for me.

    Offline Babyhopeful

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    « Reply #234 on: 19/02/18, 17:51 »
    Tily - Iím so sorry, I wish I could give you a big hug. I donít understand how follicles can be empty either, but I think it happens to me as Iím always one egg less than the number of follies. It could be as Briss says that the egg wasnít ready to detach or poor collection techniques.

    I understand where your DH is coming from and why ladies take a break from all of this. There is only so much heartache and disappointment we can take. I have drawn a similar line. I want to give it my best shot this year then take a break to consider DE. However, I know these lines can move, so I wonít be too hard on myself if I keep going longer or give up sooner.

    I went through a particularly low period last year. I couldnít stop crying about how unfair it all was. I would well up in work and spend weekends just crying. It really took a toll on my relationship with DH. He feels he needs to fix problems and this is just one problem he canít fix so he felt helpless and frustrated. We were both so worn down and miserable all the time. Similarly to helenbeau I just chose one day to let go of the pain. It has taken a lot of work to alter my mindset and I still get very low days, but generally I feel like my life is still good and Iím optimistic that I will be a parent one way or another.

    Mac78 - Iím so glad your interview went well!

    Sunshine122- I hope the pain has gone after your fall? I think ovulation has set the spotting off. Itís continuing though unfortunately, so I think thatís it for me this month. I really hope next month is better.

    Afm - Iím still waiting for my amh results! The clinic told me they would be in today and now Iíve been told possibly tomorrow. Iíve been working from home today, so I thought if I got upset it would be okay as no one can see me. Iím back in the office tomorrow so Iím worried now that Iíll end up getting upset in work!

    Offline tily

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #235 on: 19/02/18, 21:58 »
    Hi Ladies,

    It's of so much comfort that I'm not alone in this incredibly painful journey. Wouldn't wish it on anyone but the feelings are so unique that I think other people can never fully empathise unless they've had similar experiences.

    Babyhopeful: sorry your AMH results are taking so long. Try and protect yourself from getting bad news in the office. Whatever the AMH result, remember you are not defined by a number.

    Mac: well done on the interview and explaining the gap time. Hopefully Karma will reward you for being so good to your friend and get you through to the next level.

    Dorchester - thanks, I agree the care last week was very good. There's no natural ivf in Ireland, some clinics do it but it costs the same as fully stim i.e. Ä7,000 per cycle so my Lister package worked out much less than that.

    Anna - failed fertilisation is extremely painful. Your words are beautiful. I am a little traumatised by it all. It's just such a damning indictment of egg quality. It's taken me so many years to accept the lack of quantity but now age has kicked in. So so devastating and yes, it creates so much body negativity. Trying to accept ones body when it feels like it's doing the opposite to what we want it to do is hard. Your knowledge is really impressive by the way, your reading has paid off! I'd love to talk to you about elevated LH levels. My best cycle was a microdose where the agonist kept LH super low from baseline. My LH is around 10 from baseline and I wonder is that frying the eggs? I read some articles about high LH being the main reason the women with high FSH find it difficult to get pregnant as the chronically elevated levels release androgens which impair egg quality.

    Helen - I just love the way you've moved yourself into a better place and have started the journey of acceptance of your body and your fertility. You're right, quality of life is paramount. My DH constantly says that this us our journey and our path and whilst it's painful, he is right. Constantly comparing ourselves to others with better fertility isn't helpful. We are where we are and I guess once we accept that, it takes some of the power out of it.

    Klik - how did the hysteroscopy go? I passed Hammersmith hospital a few times in recent days and was thinking of you. You mentioned to me that Letrozole follicles should be much bigger before they are mature. Are there papers / research on this? It's a possibility I triggered early even though the lead was 22mm.

    Queenie - yes, you're right, it doesn't make any sense but I think it was just a bad egg, again.

    AFM, no news, went back into work today and my boss actually cried when I told her what happened. Two of my colleagues that I told welled up and gave me hugs, they are such nice people. Still in mild shock tbh, that's the second single egg collected that just didn't fertilise which is fairly indicative of poor egg quality. In addition to age, I probably can't deny that the endo might also be impacting egg quality. It was the first thing my endocrinologist said when I told her that the doctors in Greece discovered endo, I'd have been prepared to do 5-8 banking cycles if I could even get one embryo frozen per time but I'm just not making embryos.
    On a positive note, DH has agreed that we can do some fostering. It's something I've wanted to do, irrespective of whether treatment is ever successful. I'd like to try and turn something that has been so painful into an action that would improve the lives of other people.

    Hi to anyone I've missed. Xx

    Offline klik

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    « Reply #236 on: 19/02/18, 22:31 »
    Sorry, gals, this will be very incomplete--only a couple of personals and an update from me... I'll try to catch up in the next few days, but I'm sure a lot will slip by me...

    tily: I'm so sorry... Unfair doesn't begin to describe this. All your sacrifice... My guess as to what happened is simultaneously enraging and hopeful: I still think they triggered you too soon. Unless LH has started to think about surging (had it?), and even then an antagonist (cetrotide), perhaps even in double dose might have helped... Yes, Letrozole cycles do require larger follicle sizes, according to Cornell. In such cycles, they like follicles to be, ideally, at least 23mm before collecting, and yours was 22. (I haven't seen any papers, though, sorry...--just what Dr Davis told me...) So "borderline mature" makes perfect sense to me, and unfortunately the non-fertilisation also makes perfect sense (and your little one was just way too small for a Letrozole cycle). Even your E2 is "borderline mature" for a single follicle, though as we know the Letrozole needs to wear off completely before we can pay close attention to that number. In my personal experience, cycles that start with oestrogen priming and have either clomid or letrozole introduced are cycles where the follicle develops very slowly. Of course I don't know that this is what happened, but I think you just needed one more day, maybe even two. I think Lister mismanaged this. I think they scared you too much when they panicked about low E2. If they're going to offer a protocol, they need to understand it--it's not like this has never been done before. I'm sorry, I don't want to rubbish any particular clinic--all clinics can be shockingly stupid sometimes when it comes to protocols they're not used to. It's quite typical off fertility clinics, I think--I'm just furious that this had to happen to you, as if you didn't have enough of a mountain to climb already. Never mind all the suffering and cost: the clock keeps ticking, which makes every mistake very hard to forgive. So, I'm furious with Lister, though in that kind of "ain't that typical of fertility clinics?" sort of way... But I'm also hopeful for your eggs. I really don't think it's their fault... I just don't think they were ready quite yet.  The idea of fostering sounds amazing... I really hope you get to do that AND have your bio-baby. For now, though... I send you hugs... I'm so sorry...

    LXP: I'm so sorry about your BFN... When a cycle starts out so promisingly, the potential disappointment can be crushing... Be good and kind to yourself... You don't deserve this. Nobody does.

    Mac: Sorry, this will get all therapy-ish of me, but it does seem like your TTC attempts get obscured by everything else in your life... I think to some extent you're avoiding it, my dear. I really don't mean that as criticism--I doubt there is even one of us who doesn't have huge doubt and conflict about this process... especially given how uncertain the outcome is. So, this is something to think about... to what extent are you letting other things get in the way? Is assisted conception something you really want to even try? Sorry, this question may very well make you angry! But we do all have conflict, and we have to embrace it and give ourselves a mental hug--this stuff is so hard, and so painful... and then hopefully find a bit more peace with whatever really is in our hearts--whether or not that includes putting ourselves through this IVF hell. I mean, both choices stink. On a much better note, I am so, so glad to hear your interview went well! I hope you get the job, and that this puts you in a better place where there is hope and activity and creativity and good energy--maybe this is what you need for TTC, too! May this be the start of good things for you!

    Sunshine, Shady: still hoping for natural BFPs for you!

    Helen: you've done so much soul-searching... Giving up the illusion of control is one of the hardest parts of this (especially while trying to remain clued in and assertive)... Sounds like you've been doing a lot of work on this, and I really commend you... I send you hugs...

    Everyone else: huge hugs... and huge thanks to those who sent good wishes. Very rude of me not to send individual thanks, but I do want to go to bed early tonight... I just want to know, I appreciate every single one of those wishes, and I just don't want to risk forgetting to thank anyone!

    AFM: hysteroscopy went as well as possible, really. Mr Trew said they encountered exactly what the HSG showed--adhesions in that exact spot. He said they were extensive, but they were of the filmy type (thank goodness!). After resolving those, he took the hysteroscope further into the cavity and everything else looked normal and as it should be. He then put in this gel to avoid the walls sticking to each other again, and the gel should come out by itself. He is completely confident that a follow-up HSG and surgery are not needed, so I'm free to transfer next cycle (assuming CRGH agrees and I don't have a cyst). I put in a call to Dr Ozturk (who should hopefully call back tomorrow)--I want to ask him to change my FET protocol back to "natural" from "stimulated," as I'd love to see what my uterus does just with my natural hormones, after this surgery. If it gets to at least 8 I'll be ecstatic! I'm quite anxious about speaking to Dr Ozturk because I need to be straight with him and yet I don't want him to feel I'm accusing him of breaking my uterus with the D&C (or his colleague with the ensuing hysteroscopy). But hopefully we can talk this through and agree on next steps... and hopefully next steps will mean an FET in March... And then all anxieties relating to that will come flooding back in, but at least those anxieties are now familiar to me--they'll feel welcome by comparison! (I say that now--watch me be a wreck in a month or so...)

    Offline AdelineX

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    « Reply #237 on: 20/02/18, 00:49 »
    Hi, ladies, here I am, back again, trying not to lose track.

    Tily - there is a so-called `LH window' that involves a threshold and ceiling value of LH needed for proper follicle development. It is considered that a maximal value of 10 IU/l can be accepted in the follicular phase, as higher levels can be detrimental to follicular development and egg quality. Clinical tests showed that stimulations with lower doses of recombinant LH resulted in more eggs of better quality than stimulations with higher doses. Letrozole stimulations follow different patterns, as it has direct influence on the activity of the pituitary gland. Letrozole inhibits aromatase, which is an enzyme producing estrogen in the body. The result of estrogen suppression is an ample response from the pituitary gland, releasing more FSH and LH to stimulate the ovaries. Some clinicians argue that while the FSH discharge is beneficial for follicular growth, early exposure to high LH can be detrimental for egg quality. Did you test LH during stimulation? I know they sometimes add an antagonist if LH goes closer to 8 on day 6,  even if the protocol is not an antagonist one per se, but it depends on the clinic. As a general idea, I think these protocols that stimulate the pituitary gland to release endogenous FSH and LH may not be for everyone, hence my reluctance towards the microdose flare. They cannot estimate or control the magnitude of the FSH and LH release. A lot of endogenous FSH may be good, but not the same can be said about LH.
    I'm glad you sound positive, there is no choice really but to take small steps everyday and keep a positive frame of mind. It is immensely difficult. But we have no choice but to keep going, one way or another. Sending you big hugs!

    Later edit: congrats on your decision to foster, it is truly wonderful to open yourself to this experience. Your heart will lead the way...

    Klik - I am glad your hysteroscopy went well and you have transfer plans for next month. Sometimes drs focus less on the uterus and it it can be a huge challenge, as it is the organ that in fact sustains pregnancy. It is a major milestone in your journey and it's great you sorted it in due time.

    MAC- I'm glad your interview went well. I second Klik on her idea about considering the fact that you may have conflicting feelings about the process. Please don't forget that, although you need to take your time and do as you feel is right for you and DH, time is not on our side. It is a complex situation, but being honest to yourself about your true feelings is essential. I have a tendency to be in denial when things get really hard, so I'm not speaking from a `privileged` position. I hope I haven't upset you, but we are here to help one another.
     
    Helen - I love your perspective on things. Those were wise words, thank you. Indeed, you can only do so much in this awful situation. Life goes on with or without us being present in it, I also feel this awful process can annihilate all other good things in life, leaving us empty and purposeless. An active choice to shift the point of view sounds like a real option for now. Sending you my warmest thoughts. 

    Babyhopeful - your positive attitude is inspiring. Thank you.

    MA66 - I feel the same about trying DE first, if I somehow manage to accept that I'm done trying with OE. I know this sounds horrendous, but I have my own issues with abandonment, so although I think adoption is a wonderful chance for a family, I am far from considering it for us. Truth is I have a horrible relationship with my very traditional and conservative parents. I love them just because they are my parents and I do my best to be a good daughter, but we always have painful arguments that leave me drained and feeling like garbage. I was raised by my grandparents from 2 to 7 years old, so there is a big part missing in my relationship with them. We have so little in common. In fact, all we have in common is my very obvious physical resemblance to them. Our relationship has always been bad, as they got married and had me purely because everyone else in their generation got married and had children. I'll never understand why they sent me to the countryside to live with my grandparents, as they were factory workers, did not have careers to manage or complicated schedules to align. It is obvious they did not want me around  and this had a massive impact on our relationship- I grew up adoring my grandparents and feeling that my parents were in fact mere strangers. Rationally, I have no reason to get stuck on the genetic link. My parents and I are different species from different planets. But I do feel I need the biological reality of pregnancy and birth. I know I would love a child no matter how it came to me, but right now adoption is the most remote and inaccessible option I can think of. I'm ashamed I am so selfish but this is the truth.

    AFM- 10 days ago I had the dreaded appointment to check follicles and see if I could start stimulation. Although I had had 6 days of estrogen priming, the cyst was still present and we had to cancel. I had 3 follicles on my right ovary and a 24 mm cyst on my left one. No visible follicles on the left. I actually saw 2 drs, as my first dr. did not answer her phone for 2 days. When she finally called, she said she couldn't answer because she had been sick and couldn't speak. Well, last time I checked text messages had been invented. So I decided I cannot afford to have a dr that disappears when I'm due to start stimulation as I'm going to be monitored in my home country and go to Brno for EC. So I made some calls and got an appointment with another dr, who works at a bigger clinic and seems more available. He said the third follicle had an elongated shape so maybe we shouldn't count on it. He said he could puncture the cyst and go ahead with stimulation if estrogen is low, but I preferred to wait. My Czech dr. was back in office and confirmed we should wait until the cyst is gone. I hope this cycle is cyst free and I have at least 3 antrals so I can finally start stimulation. I will do estrogen priming again. Still undecided if I should go ahead with microdose flare or do a short antagonist. I asked my Reprofit dr. if, given that I have a short cycle and my 7 days priming ends on days 3-4 of the cycle, it would be of any use to have the flare so late in my cycle. She said I should start the agonist on day 2. What if I hadn't mentioned this? What would be the use of a flare on day 4? Everytime I emphasize something she should have asked, she adjusts the protocol. I am beyond tired of this incredibly frustrating manner of managing treatment. I cried a lot and took it really hard to be cancelled again. Got the DE speech, of course (new dr...), I was polite but firm and I stood my ground - no DE talk until all reasonable OE chances have been exhausted. 

    Sending lots of love to everyone.
     

    Offline Briss

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    « Reply #238 on: 20/02/18, 06:46 »
    Just a quick one to Klik, excellent news!! So happy it went well. Totally agree re natural FET and will be keeping everything crossed for your perfect lining to make a wonderful home for your beautiful embryo

    Offline LauraC81

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    « Reply #239 on: 20/02/18, 07:33 »
    Tily:  How are you?  I hope you have been looking after yourself and had some good chats with DH.  It must be tough with him putting an end date on things but it will just be his way of dealing with things, men process things so very differently to us, they need to have answers and if they can't solve a problem then they struggle, putting an end date on it is maybe his way of solving the problem as he won't be able to solve it any other way...that doesn't make it any easier for you though and perhaps you need to explain to him how much the thought of that hurts you right now.  As for finding it difficult to accept that you're in your position I think all of us on here can empathise wholeheartedly, we spend most of our lives being told not to get pregnant and how easy it is to make a 'mistake' that it never occurs to most of us that we might struggle to get pregnant when we want to!  What I've found hardest about the whole process is the lack of control, if I were able to conceive naturally I would be able to decide when that was whereas with this I'm being dictated by clinic timeslots and embryoligists availability etc. it's maddening!   Also the lack of understanding is frustrating...I was the same as had 7 follicles but only got 3 eggs, I still don't understand how 4 were empty and the doctor's seem to think you don't need an explanation, for me understanding helps me to cope so not understanding makes it all the harder.  Sounds like you have managed to turn it all into something hugely positive though, fostering is a great way to do something positive and you will make a huge difference to those children's lives!

    Queenie/Briss/Dorchester: Hi, hope you're well.

    Helenbeau:  Good advice & I agree we are all warriors!  It's a good job it's us women who have to go through this as not sure the men would cope ;)

    Mac78:  So glad your interview went well!  Well done, sounds like you handled it like a pro.  FX for second interview for you!


    Babyhopeful:  Waiting sucks!  Have the clinic said why the delay?? FX you get results today and they're good for you.

    Klik:  Glad the hysteroscopy went well and you have a plan of action!  Good luck with the next steps, sounds positive!

    Annakay:  So sorry to hear you had to cancel again.  It must be so frustrating.  Sending hugs.

    AFM the waiting game continues...these past couple of weeks have been so loooong!