Ovarian reserve advice

[beanybops]

Hi everyone

Looking for some advice please. I found out last month I was ovulating after having blood tests. I was all happy this box was ticked until I saw the gynaecologist today.

I had an ultrasound and he said he thinks my ovarian reserve is on the low side (6-7 and I am 35). Was does this mean? I was so overwhelmed today I didn’t ask all the important questions. We were primarily focussed on talking about my endo and adhesions probs, and I have a lap and dye booked for 4th Nov.

He said that he would be recommending IvF straight away had I not had any other complications to explore further.

Am I doing the right thing have the laparoscopy 1st, not just going straight for IVF?

I’m so upset and confused, sorry to bend your ears I just would love some advice/personal experiences.

Tina x

[Lizzielizzielizzie]

Depending on what problems there are with your ovaries from the endo, you could maybe consider having egg collection before laparoscopy and then having any resulting embryos frozen and put back in your womb once the laparoscopy is done?

Also, you could get more information by paying privately (around £70) to have a test of your AMH- this hormone test is another way of finding out your likely ovarian reserve. Any reputable fertility clinic should be willing to do that for you, and your normal doctor should be able to do an FSH test- with this one the lower the number the better (preferably below ten) as an indicator of ovarian reserve.

[Lizzielizzielizzie in reply to Lizzielizzielizzie]

But having read that I have seen that your lap is 4th nov which is very soon, you wouldn’t get to ivf any quicker so go for it!

[beanybops]

Thank you for replying. I’ve gone through my medical insurance which is why it’s so quick! I am having the AMH blood test next Wednesday.

Can I ask what is a good number for ovarian reserve? Is 6-7 very low?

Thanks in advance

[Hidden]

Hi

Definitely have the laparoscopy first. It's the gold standard of investigations and most people don't get offered that till much later down the line and after ivf. It can discover or rule out so much. Amh is a better indicator than the scan and the ideal figure depends on your age.

I'm 39 and mine is very low but although I don't produce loads of eggs the ones I do produce are great quality and that's what matters so try not to worry about it x

[beanybops in reply to Hidden]

Thank you for responding. Reassuring to hear I’ve made the right decision booking the lap.

He seemed to express a degree of urgency with IVF which worried me a bit... but hoping reserve doesn’t decrease over a matter of weeks?!

Hopefully mine will be good quality too 😊

Thanks again x

[Hidden in reply to beanybops]

No. It decreases over several months or a year but not a few weeks. They're prob just conscious that you have a better chance at 35 and under. X

[Ash2016]

Hey beanybops, if you were told this after an internal scan it sounds like the dr is talking about your antral follicle count. This is when they count the follicles on your ovaries during your cycle to see how many there are, one of which will be become the dominant one and be released at ovulation. I think 12 is viewed as 'normal'. I had a scan a couple of weeks ago and had 10. I had my amh retested and it was 6.3 (I'm 35) so it's on the low side for your age. It's worth having an amh blood test if you're worried and I'd go for the laparoscopy too so you have as much info as possible xxx

[beanybops in reply to Ash2016]

Thank you. It was an internal scan so yes, antral follicle count it must have been. He said the blood test would verify his count as he may be wrong. He did tell me 12-13 is normal.

Glad you agree with the laparoscopy route. I was initially concerned as I’ve had a few over the years and I was concerned about creating even more adhesions, however my no1 priority is having a baby and I think it will help me understand exactly where I am xx

[emmab178]

Hi. I had an ovary and tube Removed due to endo and it took ages for my hormones to stabilise out at which time I was on the ivf waiting list. I chose not to have a further lap with a bgse specialist as I didn’t feel I had time (I was 37 with amh of 7-8).

Amh gives an idea of quantity of eggs but not quality.

I got 5 eggs at egg collection, only 3 mature but all went to blast . Pregnant at 34 weeks with the top quality one and one in the freezer. And I got that result with a 5cm endo mass remaining with endo around my ureter, bowel stuck to uterus and right ovary stuck to uterus ligaments.

If this is your first lap please please ensure it’s with a reputable surgeon. Mine in Hampshire presented himself as an expert but he is not bgse accredited. He was supposed to remove my 7cm mass but two months later a ultrasound showed a 5cm mass remaining but he told me he got it all. He also said a hysterectomy and hrt would cure the endo!

Because it was a private lap I have no comebAck on him as I paid to have to tube and ovary removed and that’s what he did. No proper discharge notes or staging of my endo.

A large amount of general gynaes are presenting themselves as endo experts however they need to be bgse accredited surgeons to ensure they have had the correct training to preform surgery. If you are paying privately there are at least 5 very good endo bgse surgeons with excellent reputations around the country. For my next lap only one of those will be doing the surgery.

Theres a fb page endorevisited uk support and education group where you can name surgeons and get opinion on them. I’d recommend asking on there about your surgeon before getting that (I assume) diagnostic lap on your endo. A good endo surgeon can easily do the dye check as part of the diagnostic lap but can do so much more if required.

Are you self funding ivf or going through the nhs? If nhs then get on the waiting list ASAP ie pre-lap and get the ball rolling as it can take a long time.

[beanybops in reply to emmab178]

Thanks for replying Emma. So pleased for you that IVF was successful

This isn’t my 1st lap, prob about my 6th unfortunately. Admittedly tho, my 1st with this surgeon as my gynaecologist sadly passed away last year. I feel fairly confident in him as he is well known in Eastbourne and he is the director of the fertility centre here. Albeit I shall give that Facebook page a visit, thank you.

I am going to go NHS (should I qualify) so most definitely will take your advice on getting on the list. Is that through my GP can I ask? Or the gynaecologist?

Thank you x

[emmab178 in reply to beanybops]

Through the gp. Check which ccg (gps postcode not your home address postcode) you are in and their guidelines for funding. I don’t think endo classes as a known fertility issue but they will usually have restrictions on funding for age, bmi and how long you’ve been trying. Bit of a postcode lottery to how many attempts you get.

Fertility fairness website has a good excel sheet with the different ccg criteria. For instance we live in hants and the age limit is 34! Our gp is in west Surrey and their limit is 39.

Hope the lap goes well. I’ve always had the opinion that the endo drs can easily pick up the fertility side whereas fertility gynaes don’t have the endo skills. 6 Laps though, you must be an expert

[beanybops in reply to emmab178]

Thank you for all the info. I have just checked and should I qualify, Sussex provides 2 free cycles.

I really appreciate the time you have taken to respond x

[emmab178 in reply to beanybops]

No problem hope it all goes well x