Low Amh, failed cycles, Any advice?

[Clementinedam]

Hello,

I have been diagnosed with low ovarian reserve in december. ( 37 years, Amh= 0.1 and FSH =24 and AFC=7). I went throught a first long cycle with gonal 375 and got 3 eggs retrieved but without ICSI they didn't fertilized, started a second cycle this month with puregon 300 with antagonist, I just had one follicule growing very slowly and decided to stop the treatment as I thought that it didn't made sense to pay for egg collection with a medicated unique follicule. My long term plan is to now go through numerous MNC cycles with ICSI (up to 12). This message is a bit a message in a bottle to collect informed advice from women who have been through similar situation and are able to slightly anticipate the outcome or have any advice to improve it. I am not quite ready to give up but needs to advance in this difficult and long path as informed as possible. I took DHEA between the first and second cycle which didn't seems to help at all. My AFC plundered from 7 to 3 with testosterone level going high. I am worried that the next cycle will show no follicules at all! Is there a chance that the AFC improve? I have heard consultants saying that it comes and goes by waves??? I am still worried about drinking as little coffee as one cup every 3 days and half glass of wine every week, eating bread or any sweet food, plastic, perfumes, etc. But should I? I am taking many vitamines including ubiquinol and alpha lipoic acid, Vitamine C, D and E, omega 3, etc But should I? I have done well staying joyfull and optimistic about life and keeping an healthy level of energy and low stress but my blood circulation has been difficult to maintain throught the winter with cold hands and foot. Thanks for all your feedback! I need them at this hinge moment! Best. Clem

[Hidden]

Hi I'msame boat as you. I've done 2 iuis (was lucky enough second time and have a son) I've since did 2 failed ivf dhea acupuncture diet the lot! Im now on my egg donation treatment. I feel I've learned too little too late. On my egg donation I've had a biochemical pregnancy and a miscarriage. Currently waiting for first can on current pregnancy. I felt I didn't know about chromosome testing till it was too late. If you move onto a egg donation programe they can guarantee you 5 eggs on day 5 blastocyst. I made the mistake of not chromosome testing as this is tells you pre transfer whether your embryo is viable hence my past miscarriage. If I could do my treatment again knowing how rubbish my eggs were I would have went straight to egg donation and done the chromosome testing. I'm just hoping all ok this time round. There is hope for us with rubbish eggs it's just a long journey to get there!

[Clementinedam in reply to Hidden]

Thanks for sharing your story and for the advice regarding chromosone testing. Wishing you all the best with your pregnancy. It seems that you have taken the right decisions and are onyour way. xxx

[Hidden]

You are so good trying so much I hope you get your dream. My amh is .5 I was advised to straight to DE. I was told although I may produce eggs the quality would not be good and we would have very little to no chance of success. I have always wondered what if so will be watching your story. Good luck xxx

[Clementinedam in reply to Hidden]

Thanks! I will keep you informed. Part of me thinks that I should safe my energy and cost for the donor egg battle. I have spoken to many women who regretted not to have gone straight to egg donors. I don't think that I am doing the right thing but my husband is adament we should try hard with MNC. To be continued..

[Hidden in reply to Hidden]

Be good to see how you get on. I really struggled with donor eggs however my husband said it is me potentially growing, sharing my blood, my blood would run through the baby and I would potentially give birth to it so a lot of it me. You are 5 years younger than me so go for it lovely and I have everything crossed you prove the doctors wrong. Keep me up to date. Good luck xxxx

[Clementinedam in reply to Hidden]

Thanks! I believe the nurturing aspect is so much more important than the genetical one in a family! My sister had donor eggs and she has no regret and wouldn't change her children for anything in the world. I will keep you posted but expect to be in the same position as you in couple year. We are not alone and the most important is to stay focused, healthy and have a good life. Good luck to you too, I really do hope that you all find our ways.

[EmmaWills]

Clementinedam, I am experiencing the same casualty as you. I have a low ovarian reserve, and my AFC didn't get affected form any of the fertility treatments. If you have low AMH and low AFC (antral follicles)then the diagnosis is clear that you have low ovarian reserve too. The good amount o AFC indicates good ovarian reserve. There is a misconception that if the AMH is poor then the OR will be poor however the truth is that the increase in AMH won't increase the ovarian reserve. Because the AMH is an indicator of ovarian function. Therefore, it's not easy to increase the AFC or ovarian reserve. However, taking a well-balanced diet, and with medication will increase the quality of the eggs but won't increase the OR. Moreover, it is said that it takes one decent egg to do the job. I know the fear is real during IVF, just try to work on the possibilities that will allow you to make IVF a success. Wish you load of baby dust!!

[JessR]

Hi- I had low AMH too. It’s so hard when the numbers are so low. In the end I found a “mild ivf” approach worked so much better than taking loads of stims. It was much gentler on me and we got the same number in the end. I also took DHEA for 12 weeks for my last two cycles and I think it made a big difference but of course you can’t know for sure. We were so close to giving up and had ruled out DE so we have it one last try (7), and it worked! He’s 9 months old this week and truly feels like a miracle. Hang on in there- it only takes one- and you’ll know when you need to do something different. It’s really hard though. Sending you lots of luck.

[Clementinedam in reply to JessR]

Thanks so much for your encouraging words and a huge congratulation for the perseverance and the wonderful achievements. Wishing you all the best for you and your little one! Thanks for the tips on DHEA, I might give it a second chance in 5 cycles or so. This pathway expect to be one of the most difficult in my life and I really appreciate the support from women that can understand it. Have a beautiful day!

[emu2016]

I have similar to you... high FSH. Low AMH and low AFC. Less than 2% chance of conceiving with my own eggs but I still tried. Got three eggs, none fertilised. We’d already been told Donor Egg IVF was probably the best route, but I had to try with my own eggs. Which I partially regret but I know I’d have always asked.

I don’t know if it comes in waves. One woman I know has two donor egg children and turned 40 and fell pregnant naturally. How does that work?! Amazing!

Our first donor egg ivf was a BFP. But at 7 week scan there was nothing there. I’m just a few days in to our next cycle. It’s a big decision. And a hard one. But I think at some point you just know which way you’ll go. Sounds like you’re very strong! x

[Clementinedam in reply to emu2016]

Thanks for your message and wishing you lost of courage and luck for your next cycle. Have a nice sunny weekend with Mr Emu!

[EmmaWills]

Clementinedam, I am experiencing the same casualty as you. I have a low ovarian reserve, and my AFC didn't get affected form any of the fertility treatments. If you have low AMH and low AFC (antral follicles)then the diagnosis is clear that you have low ovarian reserve too. The good amount o AFC indicates good ovarian reserve. There is a misconception that if the AMH is poor then the OR will be poor however the truth is that the increase in AMH won't increase the ovarian reserve. Because the AMH is an indicator of ovarian function. Therefore, it's not easy to increase the AFC or ovarian reserve. However, taking a well-balanced diet, and with medication will increase the quality of the eggs but won't increase the OR. Moreover, it is said that it takes one decent egg to do the job. I know the fear is real during IVF, just try to work on the possibilities that will allow you to make IVF a success. Wish you load of baby dust!!

[Clementinedam in reply to EmmaWills]

Thanks Emma, for these precisions. Are you also in MNC cycles? How many? Did you collected some eggs? Wishing you the best and most importantly, stay happy! Spring is here and the long winter is behind.

[EmmaWills in reply to Clementinedam]

Nah, we are not, because the doctor said it's not worth a try. As I have a low ovarian reserve. We are looking for other options. I am afraid, we may have to go for donor eggs. Yet considering surrogacy. Weighing options right now...

Thanks for your kind wishes!!

[Clementinedam]

No luck for my first MNC cycle. Follicule grew easily and well but no egg retrieved. ;( On the bright side the intervention was super lightweight and done without any medications. It last 20 min and was done directly, a bit painful for 30 secondes and that was it. I feel I can bare with it for many times so will keep trying. Is the absence of egg just being unlucky or a sign that even if I have follicules, I don't have eggs anymore? Is there anything one can do to make sure the egg doesn't stick to the follicule membrane before egg collection? I am becoming more and more technical and mechanical here!

[ClarabGlasgow]

Hi sorry to hear this, sounds like you are trying so hard! I read a book recently called inconceivable, the lady had very high fsh & managed to get it down through diet etc. How are your progesterone levels? Just cos I think cold hands etc can be a symptom. I’m kind of clutching st straws a bit same as you low amh & trying everything to improve my chances. Have they told you this is the reason for your fertility issues or anything else at play? Stay optimistic & good luck x

[ClarabGlasgow in reply to ClarabGlasgow]

Ps what’s an mnc cycle ? X

[Clementinedam in reply to ClarabGlasgow]

Hi Clara. Thanks for your message. MNc is a modified/managed natural cycle. That means that the clinic gives you the minimal medication and aims only for one follicule. This is an alternative for low responder to hormone stimulation, of course it is a more tedious and slow process as you can only retreive one egg for every cycle. I will flag the progesterone concern to my consultant. I gave up all shamanistic diets and just stick to healthy = minimum sugar and glucides , no alcohol and coffee, for the rest life goes on! Thanks.

[Clementinedam]

Hello. I have been reading some academical papers which I would also like my consultants to read. (I am unsure about their pro-active exploration on the subject...)

I found this recent paper particularly interesting, it summarise well all the possible medication and adjuvants one might consider for DOR IVF cycle.

ncbi.nlm.nih.gov/pmc/articl...