Low AMH/High FSH Cycle Buddies - Part 8

[katkat2014]

Rocket, Queenie, sunshine and MSJ, thank you so so much for your wishes! If it can happen to me then it can happen to anyone!! Lots of love k x

[FertilityFriends]

[Briss]

 Hello ladies, I hope everyone is doing well and coping with the current situation. It’s been a while. I stayed away from TTC trying to focus on my new job but it’s not going well. I thought it was going to feel liberating not to have to plan EC/ET every month. I think I lost something during my TTC years when I prioritised TTC over my career or maybe I am generally tired and cant quite bounce back, I just do not have it in me to cope with the pressures of work in the City. I am feeling stressed and disappointed in myself that I did not perform as well as I hoped and I did not give it my absolute best.  And I am still longing for a sibling for my daughter.

Kat, I am SO SO SO happy for you, words cannot describe it! You are an inspiration for perseverance and hope.

Rocket, how are you and little Bethany?

Queenie, how are you holding up? I also thought about London clinics, I mean I practically can walk to Create but I just have so little trust in them. I’d have considered Create for natural IVF but as things stand it’s no longer an option. As for stims I only ever had embryos and even BFP with Munich. As much as I am tempted to give it a go with Create (rather than just waste the time waiting) I just feel I would end up feeling even more disappointed and poorer. They did not want me to continue with my own eggs 6 years ago, what are they going to say now when I am definitely in peri M situation. I am thinking of writing to Munich to see how things are. Looks like the scanning places are still working and I am sure I could find a local bloods venue. Theoretically if Germany is open I can still fly and stay until ET and then quarantine in London for 2 weeks while working from home. I think the first step is antibody test. I had a very nasty pneumonia in early January (before covid testing began). Took me 3 months to stop coughing. Am really hoping it was it but there is no way to be sure. We have been completely cocooned at home with no access to the outside world except for food/post deliveries since early March. I ventured to the post office the other day and was surprised to see that nobody is wearing masks. I do not even know what’s going on in London. I stopped watching news in mid April just cant take so much disappointment.

MSJ, how are you? I personally do not believe in hidden C, I also tested positive but it means nothing. I usually have a scan with dr Jurkovic every now and then to see what’s what. Last year I had persistent pain in my ovary but he could not find anything. It went away after 8 months or so but I might do another scan with him before cycling again. I trust him cos he could tell me more about my ovaries from a scan then a doctor at a st Mary’s hospital after doing a lap. I was able to see him a few times via GP referral but on private insurance. You can ask your GP but I doubt they can refer to him (which is a shame cos my lap was paid for by nhs and everybody would have been better off just sending me for a scan with Dr Jurkovic). With regards to some other underlying infection – it’s totally possible. You cant test for everything. DH and I just went ahead and took antibiotics at the same time. We do that from time to time . clinics and Russia and Greece routinely prescribe antibiotics before IVF. It also worked for a quite a few couples I know who got pregnant naturally after AB even though they had no symptoms of any infection. I think you can still try to get a scan or MRI on an nhs cos your symptoms relate to miscarriage and potentially it can be dangerous (I do not think it is but this could be your line to build a case for referral).  It’s funny you mentioned your DH making spicy meals, I have the same situation at home, my DH adds some nasty triple hot stuff on everything I cook which completely ruins it in my mind and when he cooks he does not realise it’s too hot for a normal person to eat. But we do have more pressing things to argue about like his beer consumption levels …

Mac, I cant even imagine what 6 embryos in the freezer feels like! It must be thrilling. it’s always so good to reach the ET stage! I hope your embryo is doing well and making a comfortable home. Best of luck!

Babyhopeful, how are you doing? Have you ended up doing the split dose of stims with half in the morning and half in the evening? It sounds very interesting actually.

Sunshine, How are you doing?

Saltysea, are you still with Lister? Are you able to cycle?

Afm, I no longer have a cycle. I cant even use my monitor. I have no idea when and if my next period is coming, it could be 12 days or 40, proper AF or some sort of spotting. I almost never have 2ww / high progesterone symptoms and my estrogen/sex drive levels are just random. And I am still only 43. I am hoping that this might be to do with having back to back stim cycles last year but of course it is more likely to do with the M thing   But I feel like I am probably hitting the middle age crisis as well.

Still, I find myself thinking more and more about trying again. Unfortunately I can no longer do natural IVF but I might still have one or two stim cycles in me. My monthly trips to Munich/Brno seem almost nostalgic now. I recall struggling at one point holding on to full time high pressure job while constantly planning my EC/ET trips and working from hotels and cafes while trying to ignore pains after EC. What fun (I mean it does seem so compared to being imprisoned in your own house with no possibility of flying anywhere without being stuck in a 2 week quarantine). I did think about doing IVF in London but frankly I do not trust local clinics. I never had any luck with them (granted I only tried two). If anything the current crisis revealed the difference in medical care in Germany and UK. So I’d have to wait until they open the borders.

[Briss]

ladies, how are you all doing? is anyone cycling?

I finally got the strength to do bloods/scans to see what I am dealing with. It was rather depressing as my cycle was over 40 days and progesterone was still close to zero so no signs of ovulation. Surprisingly there were still some follicles on the scan so my hope was renewed. Munich suggested triggering as my dominant follicle was over 15mm so that we could start my cycle. and it worked! just checked my progesterone and 7 days after trigger it's 48 so solid post ovulation level. I also have signs of progestrone (like breast tender etc) that i did not really see this year at all. I am thinking that maybe i have LH issue in a way that even though i have follicles and estrogen is high i have no natural LH surge for some reason and as a result no progesterone. I do not know if that theory has any merit though. anyway, at the moment i am trying to source elonva in london with a scanned copy of german prescription which is proving tricky.

one random observation, as i was stuck in what seemed like perpetual follicular phase (and do not get me wrong i am not complaining my reward was visually constant increased estrogen and ovulation level sex drive which unlike normal 2-4 days lasted 1.5 month!) I noticed how easy it was for me to eat less and lose weight. I got so used to it that when suddenly after trigger my progesterone went up and my appetite returned it was hard to ignore. my usual follicular phase is quite short (11 days) so I never actually noticed that difference. it's not just estrogen/sex drive it's also how much I feel hungry and how easy/hard it is for me to eat less. not having ovulation and progestrone means staying slim becomes easier. just looking for the bright side in everything

[onelastchance]

Hi to everyone,
I hope you are all keeping well during these difficult times.
Just a quick reply as I haven't been on here for a while, I wanted to find out more about what your doing Briss, I feel in the same boat.
I'm in Scotland and couldn't find a clinic to even look at me seriously so I have just been trying naturally as they all insist the problem is with me.
I think you said a while ago that you thought your cycles were out of sink with egg release and I felt the same way.
I then had a really heavy period during lockdown so I started taking Turmeric capsules, just the minimum dose to help with this and now it's like I have just lost all track of my period. I had a light period in May, well light for me anyway, no period for June, and then just last week I had what could only be described as spotting but not even that much. I've not done a pregnancy test as I have no symptoms and can't face the negative test yet, I was about to when the spotting started. With my DS I felt so ill and even though it was ivf I knew from the beginning it had worked, I felt completely different.
Which clinic are you with and how are you getting tests/scans done?
I'm sure you have said this before and I will look through the posts when I have time, I just wanted to respond, A) to let you know that you're not alone, I thought I could come to terms with only having one child but it really is breaking my heart and B) because it has given me some hope and comfort to know I might still have at least one good egg left somewhere?
Thanks

[Briss]

Hi Onelastchance, thanks for responding. it was beginning to feel very lonely. I still do not know what I am doing but I am just responding to the drive somewhere within me however irrational. I had a very traumatic experience a year ago which I did not share here and honestly I cant bare to even think about it but looking back it was probably the turning point. I had a few days of immense stress last July and ever since then I have not had any normal cycles. It could be the result of this trauma that affected my hormones and threw my, otherwise, fragile system in complete disarray. I have little hope of recovering my natural cycle so I will be relying on meds going forward. Disappointingly I was not able to source elonva in London so I cannot even start my next cycle. I am considering flying to Munich to do scans and buy meds but I did not realise that easyjet is no longer flying to Munich so flights are going to be expensive and very limited. In the past I waited until CD 1 before booking flights and then flew to Munich on CD 2 to get protocol, buy meds and start them all in one day and return to London the same day – seems like an impossibly difficult task in the current circumstances. 

We have sperm issue so that prevents me from relying on TTC naturally. We still do (no one cancelled miracles) but we never had a natural BFP with DH so ICSI is the only way for us.

When I look at my cycle I do not rely on its length I always look for symptoms/tests etc to determine whether I am in a follicular phase or luteal phase and go from there. Period is not that relevant either for me because it does not necessarily correspond to the beginning of the follicular phase. I know it’s confusing. I spent years carefully observing my cycle so I know it very well and that’s why I see how badly things are messed up right now. Even then I can roughly determine whether or not I have LH surge/ovulation and it appears that I no longer able to have this shift naturally. But if I trigger at the right time my body still responds and ovulates so that’s something I suppose.

I work primarily with two clinics Reprofit in Brno and BBN in Munich. Mostly because historically I did only natural IVF and these clinics looked very favourably.

I do my scans at ultrasound direct in London and they have plenty of slots that can be booked at short notice but they are not cheap 135 per scan. I used to do my bloods at Pathlab in bond street but now I moved from central London so I am not sure yet where I am going to have my bloods done. Local places take at least a day to provide the results which does not really work for IVF. I may end up traveling to Bond street for bloods (not ideal as one wants to avoid public transport)

All pregnancies feel different so if you have no sperm issues I’d definitely test now so you know what you are dealing with. Even in my case where the chances on natural pregnancy are nil I still test just to be sure. But maybe easy for me to say I have grown immune to negative results after years of constant disappointment. 

[dorchestor2016]

Hi All
Any help please?
Had egg collection today
Follicle was empty the granules and cumulus crops were there
Follicle was 17mm
Lining 9mm
LH 20 and e2 600 at trigger Wednesday evening
Any advise ??

[Briss]

Hi Dorchestor, I'm very sorry they were not able to get your egg this time. Unfortunately it happens.  Happened to me many times. I'm pretty sure with your estrogen levels there must have been an egg somewhere but its not always possible to collect it. I really hope your next attempt will be a success!

Afm, my cycle lasted 57 days ... I'm sure it would have been longer if it wasn't for the trigger. The good thing is I got solid 13 days LP . But after two months my period is super painful,  so bad that I actually recalled my labour pains and at my weakest moment I even doubted I could go through that again but the best thing about memory is that it fades have started stimming with pergoveris as I couldn't find elonva in London.

[dorchestor2016]

Thanks Briss

Should I have had the collection on Thursday ?
I am trying to figure out what happened

Tuesday Follicle 15
e2 was 610
LH 20
Wednesday Morning e2 590 Follicle 16
LH 24
Trigger 9.30 pm
I had a LH surge before the trigger on my OPK in the evening? Which I didn’t have Wednesday morning.

I am blaming myself that the collection should have been Thursday
as they gave me this option...

There was fluid in the scan before collection on Friday
Follicle 17mm
And the follicle was stil there
Do U think we just missed it?
Or was it stuck?
The cells were there

Should trigger be done before the Oestrogen drop? Which happened Wednesday morning.

Do I still have eggs? Did u still have eggs after this?

My cycles have also become irregular since the last few months... Noristhisterone restarted the cycle...

They are saying it was probably a immature / poor egg which released quickly..
However e2 was good and so was the blood flow to the follicle...
Does this happen every time? Should I give up?

[Briss]

Hi Dorchester, you normally need around 35-36 hours between trigger and egg collection having said that it’s no guarantee to collecting the egg. In the past I always needed to collect the egg as early in the morning as possible regardless of the timing of the trigger. Anything after 9 am was risky of losing the egg. These days I just have no idea any more. You are always running either the risk of losing the egg or collecting an immature egg. Getting the timing  right in between these two is an art. In the past I had several scans in the morning before collection and the collection was moved to the afternoon as my doc had a feeling the egg could still be immature but again sometimes we get the egg and it’s mature but sometimes we do not.

I think I misread your estrogen levels it was e2 600 (I took it to read 2,600 rather than 600). 600 is quite low actually so it’s possible the egg quality was just too poor. The fact that so close to ovulation your estrogen levels did not change in 24h is also not a good sign. The closer you get to ovulation the higher the speed of follicle growth and estrogen levels tend to jump up. yours did not. Either it was way too early and the 15mm thing was not the dominant follicle (although this is unlikely in your case because your natural LH surge started so the timing must have been about right) or the egg was just too poor.

If your estrogen levels were much higher than 600 before Tuesday  - that’s a sign that the trigger was too late. The estrogen drop is usually significant (not in your case, 590 – 610 is not a drop, I’d see it as the same level but moving from 800-900 on Monday to 600 on Tuesday I’d consider a drop attributable to ovulation).

Fluid is also an indication that ovulation must have started before the collection but again it might have been still possible to catch the egg. Sometimes I was literally minutes late to collect you just can never be absolutely certain on this.  If you still have small follicles you can try again, why not?

Best of luck!

[dorchestor2016]

Thanks Briss I was torturing myself going mad about this blaming myself
That I should have had collection on Thursday I felt my body started surging before the trigger

Before stims on day 5-7 my Baseline LH was 8
However after 3 days  stims of 150 FSh it rose  to 20
Then started cetrotide
So it makes me think controlling my LH will allow me to let the follicle
grow further
As my e2 can rise to 700-800 in longer cycles
Is 600 not ok for one follicle?

I had two smaller follicles 
They said I can start my next cycle in two weeks
If they did Lp stims they would grow...

I had a 3 month break between my cycles last months
When they scanned there  were Two 18mm Follicles with a 7mm lining 
However bloods were baseline (Cycles messes up)
Does that mean they were empty follicles? 

However in January I had a 32 day 21 progesterone
Maybe I don’t ovulate every month..