Low AMH/High FSH Cycle Buddies - Part 8

[Briss]

How many days did it take for your estrogen to get over 100? Do you remember on what day you had egg collection? I just recall in the past collecting after day 20 rarely produced any positive outcome and this looks like its going to be a very long follicular phase.

[FertilityFriends]

[queenie123]

Yes I agree - My collection was never beyond day 16-18 even on a slow cycle (unless I had primed or downregged or done EOD stims - then it was sometimes longer) - it was always more predictable if the clinic allowed my body to do the first 5 days or so, when I would start the stims on a low E2 cycle depended which clinic I was with.   

If you stim now what you are doing is not allowing your body to 'choose' which egg is best and you may end up forcing a follicle which isn't really the point of a natural cycle. - That being said it 'could' work - if there is an egg there is hope. 

There isn't a lot of evidence based practice going on with natural and natural modifyed cycles - a lot of it is down to personal experience and clinical judgement. 

What is your clinic's viewpoint?   
If you/they want to continue with the stims from scratch -
Why don't you just have scan and bloods done again in 3 days time and see if there is a change, there may be growth?.

[Briss]

Thanks queenie that's so useful! If I understand correctly you are saying there is a difference in follicle recruitment depending on when you start stims? I recall with Create i would start stims on day 6 on natural modified.  My issue is that I don't think i grow follicles anymore so without any stims there might not be anything.  I'm also doubtful I have natural follicle recruitment. I might be wrong but what I am observing is nothing like the cycles i used to have. What I have is not even a cycle but a random follicles turning into cysts with fluctuating estrogen/LH and no progesterone.  One of the docs in munich actually suggested natural but i dismissed it thinking nothing (except cysts) will grow without stims. On scan i observe large cysts like 2cm or tiny follicles like 2-4 mm but i don't actually see the growth anymore.  I'm so confused.

[queenie123]

Yeah - I was wondering that - it makes sense. 

I think many of us here have dysfunctional LH and need help with maturation - but sounds like you need help getting of the starting blocks.

Create will actually do it later than d5/6 depending on your E2. 

Why don't you have scans and bloods done again on Monday.  -  with an E2 that low, you might want to consider just FSH until the E2 gets a bit higher and the follicle is recruited.

[dorchestor2016]

Hi all
hope you are all ok

Briss: Sounds like you need a fresh clean cycle start
Have u considered BCP?  however might over surpress -  but I think one week/10 days  should be ok

With regards to Create St. Paul’s protocol which might be similar to Serum's as they start fsh when e2 is higher..
Just had a collection last Monday at Create with a 15mm right scan before collection
No egg and triggered with a 14mm follicle
E2 was 640 and LH 14 on Sunday

DAY 5   FRI      
LH    12.5      
E2   78      
RIGHT   8MM      
LEFT   6MM      
LINING    4.7MM      
         
DAY 8   MOND      
LH    14.9      
E2   135      
RIGHT   7      
LEFT   0      
LINING    3.9      
         
DAY 10   WED      
LH    12.7      
E2   215      
RIGHT   8      
LEFT   9      
LINING    5.2      
BEMFOLA    150      
LINING    6.6      
         
DAY 11   THURS      
LH    14 (RISING AFTER STARTING STIMMS)
BEMFOLA 150   
They had admin communication issues and didn't CALL ME to START CETROTIDE!
   
DAY 12   FRI       
LH    23      
E2   370            
RIGHT   8mm      
LEFT   11mm      
LINING    6.6mm      
BEMFOLA    150      
CETROTIDE 0.5   DOUBLE DOSE    2PM & 10PM
LINING    6.6   

AS THEY COULDN'T FIT IN MY SCAN ON SUNDAY THEY CALLED ME IN ON SATURDAY AND ONLY DID BLOODS SUNDAY

DAY 13   SATURDAY        
LH    12.5   (COME DOWN WITH DOUBLE DOSE)   
E2   420      
Lining: 6.5mm
RIGHT FOLLICLE: 11MM - middle good blood flow
LEFT FOLLICLE: 14MM - very good blood flow       
         
DAY 14: SUNDAY
LH 14.1
E2: 641
NO SCAN - OPK HOME URINE STICK POSITIVE
TRIGGERED AT 7PM WITH ONE DOSE OF 250
collection afternoon of next day!

DAY 14   MONDAY       
FOLLICLE    15 MM BEFORE EGG COLLECTION 1.30PM       
NO EGG COLLECTED
maybe immature or stuck to walls or trigger didn't work properly?

They wait for you to recruit the follicle and then when the e2 is over 200 they start stimms
I do agree with this plan to start later...
When follicle is naturally recruited! However my cycle this time got a bit screwed up 

Mouse: it’s best to start when your body is ready .... this protocol works for you so don't give up

Queenie - would you consider Argc ?
They take on patients for natural preg and monitor until 3 months
I would also look at the best nhs hospital - Hammersmith is very good one of the best!
I agree about finding the correct NHs consultant who will monitor all the way many shift from private to NHS

Afm:
Is it possible to have a follicle and e2 levels rise but no eggs?
Would a day 21 prog help?

Briss any suggestions as I know you may have had similar cycles like mine as shown above -
did you try double cetrotide ? did this help you carry on stimulation until its more mature?
LH RISING QUICKLY - my biggest HURDLE
ARGC give double and 5 times Cetrotide if needed :-(
however even getting double was a mission here...
Have a follow up tomorrow need some help planning next cycle...

[Briss]

Sorry for yet another selfish post but its all such a mess,  I got a peak on both my monitors so LH must have jumped. Its quite amazing in itself as I haven't seen a natural LH surge detected in over 6 months. My LH was high to begin with but my estrogen was still below 100 3 days ago and I doubt it could have jumped to 1500+ by now so there unlikely to be a proper follicle/egg. Could it just be my LH playing up or monitors got confused.  Maybe I shouldn't even use monitors anymore with my cycles as they are, I actually got a high reading when my estrogen was well below 100. 9 days of stimms and I'm getting nowhere.

[queenie123]

Are you still stimming?
Go and have a blood test,  LH and E2 and Prog - that will tell you what is going on.

It might be just that your E2 is v low and therefore your LH is high.  Or it could be that one of the follicles has 'run away' and your prematurely peaking.

But yes, I agree monitors do not replace bloods and only work if you are quite predictable. 

I hope it is OK - let us know how the bloods go!

[Briss]

Thanks Queenie,  am off to do bloods (so greatful for pathlab!). Do you think if my estrogen is still low like below 300 and LH is super high I can still go on stimming? I haven't been doing any cetrotide , just 150 pergoveris.  Munich just asked for bloods but didn't tell me to do cetrotide today,  I wonder if I should?

On the other hand it does feel a little like premature ovulation as I am getting tonns of ewcm which I only get around ovulation with high estrogen. Maybe my body just triggers whatever I have without waiting for proper egg maturation cos it doesn't have faith in my ability to produce good eggs.

[dorchestor2016]

I see what you mean Briss
Pathlabs will release blood today to u
They are good I use them
At least then u will see 

Mira fert testing at home have launched E2 testing
It’s £130 for gadget With a discount code
And then 50 a month for sticks

I have had this happen to me
LH triggered early due to high oestrogen and mucus

[Briss]

have rather disappointing results, my LH went up to 72 but estrogen remains super low 235, progestrone 1.5 ng/ml which to me translates into ovulation is triggered but somehow without estrogen/follicle/egg. How can that be? I did a scan and it's terrible, nothing except for obvious cysts and small follicles. nothing that would remotely looked like a dominant or ovulating follicle. not surprising considering the estrogen levels. but then why my body triggered LH? I do not even think taking cetrotide would help as with such low estrogen levels nothing would have grown on cetrotide. I have to admit this looks like I am forcefully squeezing something that's empty I cant produce a follicle even on stims. I was hoping that the presence of small follicles was encouraging as they might grow but they do not.