* Author Topic: Low AMH / High FSH Cycle Buddies - Part 6  (Read 125181 times)

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Offline Lulu2017

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Low AMH / High FSH Cycle Buddies - Part 6
« Reply #280 on: 1/03/18, 18:27 »
Hi ladies, Thank you SO much for such a quick and considered reply, I am so, so appreciative.

In answer to your questions... (thank you SO much for taking the time)

I've not had a decent answer to what they think about why only one has fertilised in our first two cycles - they've said it could be sperm, or could be egg. They don't know. We've used ICSI both times yes (need to as my husband has poor results across the board - count, morphology, everything is frankly terrible!) It's been frustrating in that we've had no real insight into what may be causing it and I was keen to at least find out if it was sperm or egg. So I did my own research into low fertilisation and came across AOA (artificial ocotyte activation) which is available in the UK but a stronger version of it is available in Belgium. It is primarily to overcome sperm issues but has been shown to help egg issues too but to a much lesser degree (I've have got lots more info on this if anyone is interested). Thought it may help to see if it's sperm or egg issue at least and thought it worth a try so we are cycling with a clinic in Ghent, Belgium.

On my first two cycles I had no bloods taken during stimms (we were at Guy's and is just how they do it) so unfortunately don't know my oestrogen levels were on those , if it's any use it was 4963 mpol on day 8 of stimms on the cycle we just stopped

And when I triggered my follicles were as follows:

Cycle 1: one at 19, one at 18, one at 16, three at about 12. On that cycle they collected 5 mature but three matured in the lab)

Cycle 2: one at 25 (think we lost that one), one at 23, one at 20, 3 at about 12/13

On my latest - They recommended I cancelled although I haven't got loads of eggs previously my follicles have at least been closer together in terms of size. This last cycle I had two race ahead very quickly (one was at 23 and one was at 20 by day 8 of stimms whilst others were 7 MAX). So they recommended trying next month. I'm not sure if that was the right decision but as we are paying now (last two were luckily nhs), I thought maybe we could get a couple more next month.

Your thoughts are unbelievable helpful - thank you so much. I'm a bit annoyed I didn't arm myself with this knowledge before the call I had with the doctor today (as the clinic is in Belgium it was over the phone) but I was also expecting her to have a slightly stronger plan of action for me - however it felt more like She would just do whatever I would most prefer which doesn't give me a great deal of confidence

So sorry to write such a huge essay that's all about me. I'm reading back on this thread a lot and getting a sense of everyone stories so I can help a lot more or at least be here for an ear and a sounding board. Thanks again for taking the time, it is so appreciated xxx

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    Offline klik

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #281 on: 1/03/18, 20:13 »
    Hey, katkat! Yeah, an immaculate conception might have been difficult... Re. LH, I think a surge is defined by an increase, rather than a level. In particular, if your LH increases by about 50% from its baseline for that particular cycle, you need an antagonist. But that does mean blood tests every day from when your lead is getting close to being mature, so it can get expensive. I never used an antagonist in my natural cycle IVFs (only indometacin). At Cornell they always used an antagonist, as did CRGH 5 years ago when I did full stims. For these 3 recent mild-stim cycles at CRGH, though, we didn't use an antagonist for the first two. The third one, they didn't take an LH measurement until my lead was already 16, so we didn't have a baseline to compare it with and I used an antagonist just to be on the safe side... Real bummer about your timing... I'm hoping you get to have EC and ET this cycle despite your work commitments--as your AF is late, it's possible your follicles have already grown a bit anyway. If so, I'll hopefully be about a week behind you on the transfer!

    Lulu: wow, if my oestrogen was that high with two mature, wild horses couldn't stop me from retrieving--it's a great oestrogen for 2 mature! I think you definitely need to prime with something--oestrogen is my personal favourite (100mcg patch, changed every other day, starting a week before AF--at AF, stop changing patches but only remove the last patch on the day you start stims; don't worry if it falls off, though), though norethisterone or BCP are also good contenders. I think you need to get your ovaries sleepy in the luteal phase of the previous cycle so you have a chance of getting all your follicles to grow together. Clomid is then particularly good, apparently, at encouraging those follicles to grow. So yeah, I'd totally try the oestrogen priming + Clomid + mild injectables protocol in your place... So you'd be cycling at a new place?! Hopefully they're better at ICSI than Guy's, though I would have though Guy's would have a good lab... Anyway, you'll be using artificial oocyte activation--what is that?! I've never heard of it! Hopefully that will help with the fertilisation rates and with, finally, getting a good embryo!

    Offline ShadyWheat

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #282 on: 2/03/18, 09:54 »
    Hi lovely ladies - hope you are all staying warm and toasty in this crazy weather! I was supposed to go to Bristol for a girls weekend but can't get there with the snow.

    Blue, so very sorry to hear about your bereavement. I'm not surprised that you didn't feel motivated to stick with healthy eating etc, it's tough at the best of times, let alone when you go through something like that. I'm glad that you're finding the thread supportive though as you gather your thoughts for next steps.

    Lulu - welcome! Really sorry to hear about your three cycles so far and that your clinic are not giving you more advice about protocols. It's so hard to find a good answer as everyone's body responds differently, but sadly many clinics are very unimaginative when it comes to DOR and continue to advise high doses. I second Klik's advice, I would definitely try a lower stimms protocol, preferably with oestrogen priming if your Belgian clinic will let you do it. I have seen much better results on a lower stimms protocol, and also better fertilisation rates than with high dose. I would also be encouraged by your fab oestrogen levels last time - that's a really good sign! I would also have thought Guys would have better service and a good lab..... wishing you the best of luck on your next cycle! x

    Klik - when is your AF due? I bet you are raring to go but I know what you mean about feeling tired. I'm totally preparing myself for disappointment/cycle cancellation as I can't afford to get emotionally invested this time.

    KatKat, sorry to hear that timings are not going to work out with work - that is so frustrating, especially when you are going to be away for the next few months. However, one thing that this journey has shown me is that timings never are as predicted with regard to AF and ovulation, so there may still be hope this month!

    AFM, so AF is 2 days late, typically when I'm sooooo impatient to get started and have been feeling symptoms of PMT for nearly 2 weeks now! Cramping is really bad so it must arrive soon, hopefully before tomorrow so that I can try and go for my first scan before going to Loughborough on Tuesday. Klik I'm 98-99% sure I'm not pregnant though!

    I also want to ask your advice ladies..... so I received fab news this morning that I got offered a wonderful sounding job in Cambridge! I haven't received the official offer yet, but I have a ballpark figure in mind at which I think I'd take it..... but I just don't know if I should. I cannot completely figure out how I will cycle at the Lister and work in Cambridge if I do need to do more collections. Plus I would feel pretty crappy if I transferred this month, miraculously got pregnant and then disappeared 6 months after starting (completely assuming I wouldn't be able to start work with them until June as I think existing work would make me work out my notice). It's a small rare disease start up and I think they are completely about trying to find the right people to be on the team.... and the people were so lovely when I met them last week and it sounds like a really motivating atmosphere to work in that disease space and they're just closing on a massive amount of series A funding and expanding the team. However, they did also emphasise in the interview that they are very family friendly and all about work/life balance and that I could work from home sometimes as they have other people who are based in different countries even, so potentially it could work..... why is life never simple????? Obviously I need to discuss fully with DH, but I've been so miserable at my existing job that I literally cannot bear it anymore, I will also feel rubbish about my boss, because he has been massively supportive about the whole IVF thing - I'll feel a bit like I screwed him over....

    Offline klik

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #283 on: 2/03/18, 11:02 »
    Shady: my AF would be due around the 8th... lol, you know me so well! I'll hold out hope for your 1-2% chance of a natural pregnancy... but if not, I hope your AF does arrive between today and tomorrow, as presaged by your cramps... Re. the new job, ditch the guilt and take it! You're a lovely person for worrying about how your current boss will feel and how the new place will feel if you need to take maternity leave quite soon, but, really, just do it! He'll get over it, they will cope, everyone will understand you're doing the best for you. Please, get out of your hell and go to the new place, which seems lovely and understanding and--if I'm reading it correctly--flexible enough that you would be able to cycle at Lister and work from home when needed... I'm so glad you've got this in your pipeline! I hope it's the start of wonderful new things for you!

    Offline Helenbeau

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #284 on: 2/03/18, 13:02 »
    Just a quick one because Iím in India and internet isnít great.
    Shady... take the job! You cannot predict the future. Keep in the now. Ask yourself do you hate your old job? Would you love a new job? Are you excited about this new job opportunity? Donít allow anything about babies, bosses, pregnancy, ivf, guilt etc get in the way. The decision will become impossible if you throw every single scenario into the equation. Keep it simple and trust that the future will be bright no matter what! Good luck xxx

    Offline Lulu2017

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #285 on: 2/03/18, 13:19 »
    Thanks so much for your very helpful response, can't tell you how helpful and reassuring I have found them. After feeling quite alone after lack of info from my clinic I feel much better

    The clinic are recommending I use birth control pill (Microgynon) for two weeks before stimms (starting on day 1 of my period) is this a similar to estrogen priming - would you mind explaining what the difference is.

    And sorry one (whoops two - just thought of another)  question from me 1) when you say 'low dose' what kind of numbers have worked? My clinic want to start me on 300 menopur. 2) in terms of clinic do you take this alongside stimms, I'm going to ask my clinic about this too but Interested in your thoughts

    AOA isn't hugely available in the UK but can apparently help some sperm deficiencies so we were keen to give it a shot, here is a bit of a blurb. Do anyone please let me know if you're interested and I can send more info

    'In order for successful fertilisation, your sperm must release a specific functioning enzyme called Phospholipase C zeta (PLCζ) when it enters the egg. This induces waves of calcium oscillations across the egg to Ďactivate ití, allowing fertilisation to occur.

    A deficient or abnormal PLCζ may be the cause of failed or low fertilisation. This can be overcome in some situations using a calcium ionophore solution to activate the egg artificially.'

    Shady - I agree with the ladies here, take the job! I know the feeling, I've stayed in my current job and been completely miserable because I thought waiting it out whilst TTC was the sensible thing to do. I have actually just yesterday made the decision I am going to leave though - enough is enough for me and I need to feel other areas of my life are moving on. I think this job sounds wonderful, and I'm sure the change will be great for you.

    Kilk, thanks so much for taking all the time you have to help, in very appreciative. I've read back a bit, I'm sorry to hear about your last FET, do you know when you'll try again?

    Big hi to everyone else, hope you're all doing ok xxx



    Offline katkat2014

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #286 on: 2/03/18, 15:16 »
    Shady take the job. You're missing out on so many things due to ivf that I think you shouldn't miss out on this opportunity. Had I not changed from my hated stressful Job 4 years ago then I would be stressed and miserable because of my work AND not pregnant. Now I am still not a mother but at least i am no longer stressed and miserable due to my work,  I love my job.

    Offline Sunshine122

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #287 on: 2/03/18, 18:13 »
    Shady, i agree with the other ladies about taking the job, the worst thing is having regrets and this new job sounds like an oppurtunity not to miss. Go for it!!

    Lulu, totally agree with the other ladies re trying low stims, I had 3 cycles at high dose stims with low number/poor quality eggs and only ever have 1 fertilise, despite good sperm. Well then I moved to mild and I got 5 eggs and 4 fertilised, with a dose of 150 bemfola switching to 225 menopur from day 5. Estrogen priming i think you would only take the pill after ovulation for a week or so.

    Afm, just waiting for AF. I only ever have a 11 day luteal phase that even cyclogest/lubion has never been able to extend, this is the first month ever that Iíve been able to extend it with cyclogest despite a few cramps when AF was due,  it has been a blessing as we have been snowed in for most of the week and would have struggled to get to Create. Have stopped the cyclogest for a few days now so also just waiting for AF. Wonder if I have a cyst now. Xx

    Offline Cramer

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #288 on: 3/03/18, 00:45 »
    Hello ladies, hope youíre all staying warm

    Lulu: There is nothing I can add to these ladies comments, than wishing you luck.  Which centre are you with?
    KatKAt: I understand the work/fertility balance saga.  Fingers crossed your timings work
    Klik: wishing you all the best for your transfer, the break is nice huh?  Glad to hear the operation went well
    Shady: Big congrats on the offer!! Cambridge is the new scientific hub, add the ability to work in rare disease and sounds like a great opportunity. If you can add a few working from home days, you can make this work.  I had the same feeling when I was recently offered a promo (and more hours and stress!) however I realised there is so much in our journey that we cant control, but job satisfaction and careers is something we do have a control over
    Helenbeau: so very jealous of your trip to Goa.  When DH and I were there for Christmas (his family is originally from there) we actually said there was a market in Ďholidayí ivf, as it would be great to head to somewhere warm for the last few days of stimulation and transfer.  Timing could be hard, but relaxing would have such a positive impact Ė enjoy!
    Susie: interesting take on the EJ timing.  Interesting as started another IUI cycle (new clinic CRGH so they want us to do this before IVF) and they said the same thing, to not EJ in BD while stimming, I was blunt saying, clearly with stims and fertility treatments you guys cant get me pregnant, so there is no risk for me! They said well then think about the risk of multiís and I had to laugh.  Congrats on the 20 week scan, exciting times
    Tily: So sorry to read about your last cycle.  Iíll give an update below, but I feel like Ive just replicated yours but was able to use your learnings.  Hope youíve figured out the next steps

    Hi to everyone else!
    So amongst all the travel, I thought I would do a baseline scan and AF just to check in, as it had been months.  My AF still remained low at 3 but my FSH had dropped to 15.  First time in a very long time.  Not sure if its diet, going back to exercising, or not thinking about it all! This chat really helped as I had  Iíve never really looked at LH before, but when you had highlighted it Tily  I reviewed my last few stimulated trials and it was on the higher side, this cycle it began a lot lower at 5.9.  As expected my oestrogen was low as I was letrazole and only 1 AF really responded to stimulants.  I considered your situation and I made sure the clinic let me go for a few extra days as I needed to let my oestrogen rise again.  Today I got my AF to 20 and oestrogen to 629, still not ideal but LH is starting to surge, so looks like IUI is tomorrow.  Then I fly out to Paris on Monday until Wednesday and then Thursday to New York.  So lets just see not really holding hope with 1 AF,  but it did really show how valuable this chat group is as a hands on resource Ė so thanks!

    Keep warm 

    Offline LauraC81

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    Low AMH / High FSH Cycle Buddies - Part 6
    « Reply #289 on: 3/03/18, 10:11 »
    Hi Ladies,

    Sorry for the lack of messages over the last week or so.  I got struck down with gastroenteritis last Friday and a weekend of hell followed!  Cue then a busy week at work (not helped by all the snow) and today is the first time I'm getting a chance to catch up - this is such a busy thread to follow too!

    Annakay: I'm so sorry to hear you feel ridiculous.  You've had such bad luck, I wish I could give you an answer how to improve things...sending hugs  ^hugme^

    MA66:  I know it was a while ago you were asking about selenium now but I am just going to eat a handful of brazil nuts each day I think, would be interested to hear what you decided to do though.

    Katkat2014:  Sorry I can't help with your DHEA question, I was advised not to take it by my doctor.  Glad AF appeared finally although sucks regards EC.  I feel your stress regards the not knowing until the last minute, as a control freak the lack of predictability of this process really gets to me!

    Babyhopeful:  Glad your AMH results weren't too bad - what were they if you don't mind me asking?  I would be really interested to see what they said in your planning session as I too am a poor responder with what the doctor called low AMH but apparently isn't that low compared to lots (10.6).

    Klik:  Sorry you had to repeat yourself with your doctor, communications are not always great are they?!  Good luck with your cycle, I too am feeling scarily optimistic this time round, I think it's because I'm doing a lot more in way of supplements etc. to help so can't help but feel something has to make a difference!

    Mac78:  How you doing?

    Shadywheat:  Still on downreg until 12th at least when I get first scan and decision on move to stims.  Hope AF arrives soon and FX for a nice thick lining too!  As for your job I would say take it, as you know you cannot predict what will happen with your cycle and there is never a good time to do these things, you cannot put your life on hold for it and, it sounds like it will make you a lot happier which can only be a good thing!  If your boss has been as supportive as you say he will totally understand.

    Susie76:  That is really interesting about the sperm although I never believe a word written in the DM  ;D feel sorry for your partner though!  Do they not have locks on the doors?!  Great news about your scan, it's good to have some hope on this thread!

    Bluedolphin:  Sorry to hear about your bereavement, hope you're managing to get back into it, any idea when you might start again?

    Helenbeau:  Good work on booking a holiday!  Sometimes a bit of relaxation is better than any medicine!

    Queenie123:  How you doing?

    Tily:  Interesting article, unfortunately, as we need PGD, I can't try naturally :(

    Lulu2017:  I'm sorry I can't offer any advice as I'm so new to this but good luck and I hope you find something that works for you!

    Sunshine122:  FX AF appears for you soon!  Hope you don't have a cyst.

    Cramer:  Wow you're so busy, I don't know how you have time/headspace for cycling with all that on your plate!  Good luck!

    AFM:  I started downreg (Buserelin) last Sunday so almost a week in now.  So far injections have been a little easier than last time although they didn't give me enough needles so I had to get some from the GP which are twice the size and make me bleed a lot  :-[ ah well, could be worse!  Roll on 12th March for my first scan.  Oh and one quick question...AF is due tomorrow but I don't 'feel' like I usually do the day before, is it possible the Buserelin is suppressing symptoms or am I just overthinking things?  Love & hugs to all xx