Dramatic drop in AMH

[Dogpark]

I tested my AMH in November 2018 and it came back at 11.5 pmol/l. I then had a cycle that resulted in 10 eggs and 5 blastocysts. This month, I had another cycle that resulted in 4 eggs and nothing to freeze. I retested my AMH privately and it came back at 3.3 pmol/l. Has anyone ever had such a dramatic drop in AMH in 6-8 months?

My consultant recommends that I keep on doing aggressive FSH drug stimulation with growth hormone for my next round, however, in light of these results, should I switch to Mild-IVF?

Thank you all for your advice and support!

[DianeArnold Partner Nurse Fertility Network UK]

Hi Dogpark. I must admit, I think I would prefer mild IVF. It would be more gentle on your ovaries, using eggs that "want" to come out, rather than are forced out. My thoughts of course. One that you need to talk over thoroughly with your specialist. Good luck! Diane

[Cooking-Queen20]

Hi Dogpark,

I am in a similar boat. Stimulated to the hilt as my AMH is below 5 but from my last cycle and AMH test last October 2018 a couple of months ago it had dropped by 2.

I am at the limit to be honest and actually questioning whether they are telling me to go ahead with no hope or whether there is a chance.

Approach it by having no regrets is my advice.

Good luck!

[Dogpark in reply to Cooking-Queen20]

Thanks @elena123 did you see this change being reflected in your AFC and number of eggs collected as well? Hang in there. It's true that I'm sure whether we are properly advised here.

[Cooking-Queen20 in reply to Dogpark]

I won’t know until the next round which will start imminently.

My consultant has already spoken of DE as a consideration moving forward and is using terms such as “accepting the risk” of the next cycle.

Sometimes there is no rhyme or reason to our quest!

Best of luck to you.

[Prayingforafamily]

Just wondered about your 5 blastocysts from your first round? Did you transfer these?

[Dogpark in reply to Prayingforafamily]

Thanks for asking. I transferred 2 and it was a BFN. I still have 3 frozen, plus I just learned that my second round yielded one more blastocyst (on day 6), so now, I have 4 frozen. I think that, at 42, I would realistically need a lot more embryos to stand a chance, e.g. 10 more perhaps.

[Prayingforafamily in reply to Dogpark]

I am 40 I have 4 blasts waiting but don’t feel I can go through another egg collection. Are yours good quality? It’s so hard making the right decision isn’t it x

[Dogpark in reply to Prayingforafamily]

I had 2 top quality blasts and 2 average. I read some stats that at 40 you need around 8 embryos for 1 of them to be chromosomally normal. I would do another round while you still produce eggs.

[Prayingforafamily]

We can’t really afford another round and also the cost of possible FETs after. Are you getting them PGS tested. ? X

[Dogpark in reply to Prayingforafamily]

I am not going to PGS them for several reasons:

1-I only have 2 FETs worth of embryos and I don't anticipate generating a lot more embryos from now on

2-I am hesitant to PGS already frozen embryo because there is an additional risk of damaging these embryos by thawing and refreezing them

3-PGS has a known margin of error (about 5-12%), perhaps it makes sense to do it when you have lots of embryos, but again, with only a few, you do risk losing your one good embryo

It's an individual decision, I can see how it could make sense in your case and I certainly considered it myself.

[Dogpark in reply to Dogpark]

Also, once your embryos are frozen, you have all the time in the world to save money to transfer them later, might be something to consider.