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Fertility Network UK
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Low AMH peeps and 2nd IVF cycle- how did results differ from first round?

Hi all, am considering our next options and wondering if your chances of success/ producing eggs are lower on second (or more) rounds of IVF if you have a low AMH? Am sort of worried that I may have used up eggs on my last round?! My AMH was 3.4. Also, should I have my AMH levels retested to see if they've changed before I start a new round?

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I had my levels retested but not deliberately. I was going to different clinics and one retested my amh. I was over a year since I last had it tested and had gone from 10 to 6.something. It probably would’ve been less stressful not to know! I’ve had three cycles and my response to stims was v similar on all three despite the change in protocols and drug levels. I got 6 eggs 1st cycle, 8 on 2nd and 7 on 3rd. There was 12 months between cycles 1 and 3. I think you should be fine and will probably get similar results depending on drugs etc. good luck x

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Thanks for your reply. Do you mind me asking what protocols you were on for each cycle and how you found them? I did long protocol for my first round, didn't find it too bad tbh apart from uncomfortable bloating, but got 6 eggs, 4 fertilised and 2 made it to blastocysts. I was pleased with that as wasn't sure if get any. Just wondering what the clinic will recommend for my next cycle xx

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Sure. Cycles 1 and 3 were short protocol cycles and cycle two was long. I had my best fertilisation rate on cycle 3 which was my lowest dose of stims. I was on clomid and 150 bemfola for that one. The embryo quality on my second cycle was the worst which was also the cycle I was on highest stims which I think is definitely linked. I had different drugs every cycle. My embryo quality was always poor and we never got any blasts so was keen to try something new but if your first protocol worked well for you and you are comfortable with it, don’t feel you have to change it. I guess see what the dr says. Good luck x

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Hi, my AMH even lower than that 0.38 and I am only 30yrs. My first ivf only 3 eggs but not mature and fail to fertilize. And my second ivf only 1 eggs also immature. Both cycles had 2 same meds and only one different. 1st only 8days and 2nd 10 days.

Before 1st cycle didn’t take any prenatal or DHEA or vitamins. Before 2nd cycle take DHEA, prenatal and vit d : 2 months prior.

Hope it’s helps you.

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Thank you. I've been wondering about DHEA. One consultant I saw suggested it, then when I got to the IVF clinic, that consultant sort of said there's not enough research on it so I stopped. Where are you at with your journey now? It's all so hard isn't it and everyone's journeys are so different xx

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Yup. A lot of people suggested it and some do have seen the effects of taking it. Now I had enough of going thru ivf. Can’t use my own eggs so I’m looking for egg donor. It’s not an easy path. Devastated for not being able to use my own eggs.

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Hi

On highest doses of stimulation drugs I produced one follicle one egg and one embryo. But was a negative. The second round we were advised to go with modified natural cycle due to low egg reserves. I was taking much lower meds and ended up with 5 eggs and 4 embryos.

Maybe worth asking about modified natural cycle? It’s supposed to be better for egg quality too.

Also my clinic seem to go more on Antral follicle count at day 0 which changes each month rather than AMH.

Wishing you the best x

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That's really interesting to read, so thank you for sharing. Did you personally do anything different on your two cycles as in supplements or lifestyle/diet? I have a follow up appt with my clinic on Monday so am just trying to prepare myself with queries and questions to ask them! X

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Hi

I didn’t do anything different with diet lifestyle between these 2 cycles. It was at the same clinic taking same medications but instead of top dose of 600 I took 75 for the first few days.

I was on different immunes protocol for both cycles however not sure if that would have affected things.

Best of luck with Monday. I think it’s great to get as much info as you can beforehand. Take care xx

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Hi!

In the first cycle I got 6 eggs.

For the second my AMH had lowered and 1. Went to a new clinic. 2. I took DHEA for two months and 3. The new clinic changed my medication (It was muchas easier for me with the new medication). Got 10 eggs!

Best of luck xxx

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Piggybacking on this post sorry Stars and Sunbeams

6 to 10 eggs is brilliant. If you don’t mind me asking, what meds did they change you from and to?

I’ve just asked if they would change my meds and they said no it would be the same.

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Sure, happy if I can be of help.

First cycle I had Synarel (the nasal spray) for downregulation and Gonal F for stimmulation. Second cycle I was just on the contraceptive pill for two weeks (shorter, less symptoms, and I think It helped because in my basal scan I had my normal follicles, just tiny and dormant, instead of nothing at all like in the first cycle with the spray) and then Menopur (Gonal F is produced totally in vitro, while Menopur has a natural origin -urine of menopausic women- and doctors told me that sometimes the response is better to the naturally sourced one).

I really think change of drugs in my case really made a difference, It is true that I was also changing clinic and went abroad.

Also, It could be that the egg quality was better. Of the six from first cycle we ended up with only one good embryo (BFN). Second time we had 3 and the 3 were PGSed and were normal. The first has given me a BFP, although now I am scared with some spotting in the 6th week...

Best of luck!! Xxx

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Thanks for that, I’m had menopur too so I guess that’s why they won’t change it.

Spotting can be perfectly normal try not to worry too much (easier said than done I know)

xxx

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Thanks hun xxx

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Thanks for the info both. I was on Menopur for my first cycle and tbh, everything seemed to run like clockwork. I had bloating and headaches but I could deal with that easier than the 2ww! I'm wondering what they'll suggest for the next round of IVF. I'm interested in contraceptive pill instead of down regging and also the options of a more natural cycle. X

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Keeping my fingers crossed that your BFP stays a BFP xxxx

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Thanks! Everything crossed for you too! Hopefully the clinic will come up with some ideas for the next one xxx

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Hello.

My first cycle was cancelled due to a poor response. I was devastated. For our next try I took letrozole tablets and stayed on a low dose of the stims and I got 12 eggs! 7 mature and 5 fertilised. Ended up with 3 good quality blastocysts. I couldn’t believe it! (My bloods yesterday showed I’m pregnant but levels so low it’s very likely not viable. But I hope I’ll have more luck next time.)

Have a read about letrozole - some clinics recommend for poor responders because it tricks the brain into thinking your estrogen levels are lower than they are and you produce more natural FSH as a result.

I also took DHEA for two months before.

I would say focus on quality rather than quantity though - you just need one good embryo! I found the Zita West IVF diet book really helpful, and ‘It Starts With the Egg’.

I hope you find a protocol that works for you. Good luck! X

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I will keep my fingers crossed that your BFP stays BFP xxx

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That’s a brilliant result. Would you mind telling me what clinic you are with? Would be interested to hear more!

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Thank you for that. I've not heard of Letrozole so will have a read. I'm interested in DHEA but have had mixed medical opinions on it! I've just bought 'It starts with the egg' for my next read 😊

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