Advice please.... What a difference 2 years makes

[OlsonM]

2 years ago we had just had our 2nd failed ICSI treatment for “unexplained fertility”

I asked for an AMH as my clinic never did it initially. In 2017 my AMH was 25.55 which I’m told is good/high fertility potential and my antral follicle count was 22 (apparently)

Even with those figures and the highest dose of meds we only got 8 eggs round one (5 mature) and 6 round 2 (4 mature). Both times we were left with 1 mediocre quality ambryo - these didn’t implant each time

After weeks of admin issues with the clinic I’ve finally got my updated 2019 results as we were contemplating round 3

AMH level is 13.49 and antral follicle count is 12. This means both results have practically halved (I’m 34). Consultant has written in the letter that this basically means they would expect less eggs retrieved- even though they were low last time and my results looked much better

Genetic testing for us both came back normal too - as with every other test we’ve ever had.

Just don’t know what to do - consultant is doing a telephone consult with us on 21st but I just don’t know what to ask anymore. Feels like I’ve googled everything I can possibly google

[DianeArnold Partner Nurse Fertility Network UK]

Hi OlsonM. Sorry to hear this, but your current results are only just under what is considered as “normal”. I think that perhaps you need to try a different protocol so as to not switch your ovaries off too much. A short or mild protocol could be what you need. Hopefully they will have learned enough about you to be able to adapt a cycle more suited to you. Good luck! Diane

[OlsonM in reply to DianeArnold]

Thank you. 2nd cycle was a short cycle but highest meds dosage. Such a lot of money to get wrong again x

[Bistbee]

God sounds like you’ve had a right faff just navigating the admin minefield to get good of the basic information you’re entitled to! And i’m so sorry you’ve had this news from your latest tests, it seems nuts that the figures could have basically halved in the space of 2 years.

For what it’s worth, my tests have come back roughly around what yours were in 2017 and we only had 5 eggs on round 1, with 2 average quality embryos (1 transferred 1 frozen) and then only 1 okish embryo from cycle 2 where we had 8 eggs - so that was a total slap in the face to get more eggs but less embryos - there really doesn’t seem any rhyme or reason to it but just that your 2017 results aren’t dissimilar to what we’ve had so far.

Is it worth asking about different types of stims medication as I think some are better than other depending on your AMH levels and so it might make sense to try something different this time around.

Really hope you get some answers from your doctor x

[OlsonM in reply to Bistbee]

Thank you

Sorry to hear your also having treatment.

admin was always the worst part of the clinic. Whether it’s picking up the phone when you call, returning calls after voicemails are left or post going missing etc etc

I’ve heard a lot about the mild/natural ivf but it’s never been mentioned to me specifically by the clinic or a consultant

I find it hard to believe less drugs will give a better outcome seeing as though I had higher drugs and less eggs when I had much better looking results

Feels like I’m banging my head against a wall x

[CatCee in reply to OlsonM]

I’m 39 and had pretty low AMH. I had a poor response to the long cycle (2 eggs, 1 poor quality embryo) and only very slightly better on the short cycle the first time (3 eggs, 1 slightly better embryo). We had a conversation about egg donation but thought we’d give it one more go. The second short cycle they upped the dosage only very slightly as I was already nearly at the top and I had a completely different result (9 eggs, 2 good 5 day blastocysts, 1 perfect quality hatching blastocyst). So things could be completely different the next go round! Hang in there!

[OlsonM in reply to CatCee]

Thank you, that’s a really positive story to hear. Thanks for replying - well done you xx

[Bexta6060]

Your AMH isnt too bad, I know its easy for me to say, but hang in there. Mine went from 22 to 8 in 4 years (im 36) and here I am 24 weeks pregnant. They may change you to a short or flare protocol this time. Best of luck to you x

[OlsonM in reply to Bexta6060]

Thank you and congratulations!

Do you think that will make the difference given I’ve done both the short and long previous?x

[Bexta6060 in reply to OlsonM]

Its still a bit of an art and down to luck sometimes I think. Ive done a long when i was at AMH 22 and was successful. Then 2 flare protocols when I was down to AMH 8, first was a disaster, then FET from the second flare worked.

[OlsonM in reply to Bexta6060]

It’s always such a gamble. So much money xx

[Hidden]

Hey OlsonM have you ever had a BFP? Or have the embryos failed to implant? Have you considered doing an ERA test? Endometrial receptivity array test? It will confirm what day your uterus will be most receptive to a transfer. My AMH was 8 when I started this process 3.5 years ago. I'm now 38 and 19 weeks today! Good luck with your next steps.x

[OlsonM in reply to Hidden]

No, never in 5 and a half years had a BFP. Never even heard of an ERA - why do they not tell us about these things? Will mention it when we have the consultation, thank you and congratulations xx

[dreams28]

Hi. At the end of the day they are just numbers aslong as they are not very low which yours are not. I had my first ivf baby with an amh of 15.. 6 eggs collected 5 mature , 3 made it to good quality blastos, aged 36. Then second baby with amh of 9 I had7 eggs collected 6 mature, 3 made it to good blasto's. This was 2 month before i turned 40. Drs may put you on higher dose of stims. I had my treatments abroad. Good luck and dont strees your amh is still ok.

[OlsonM in reply to dreams28]

I had the highest dose last time so they can’t give me any higher. She mentioned a lower dose but that just seems backwards to me. I agree though and sometimes think they are just numbers - so many people still have babies with lower numbers, thank you x

[dreams28 in reply to OlsonM]

My second round i combined 2 stim drugs. Gonal f, and then added menapur on day 5. Its just something you can discuss with you dr. Gonal f apparantly goves quantity and menapur gives quality. X

[OlsonM in reply to dreams28]

Yeah I had that exact combo last time xx

[dreams28 in reply to OlsonM]

Each round our bodies react different i believe. I had 4 rounds in total and thought i respinded different. All the best. You will get there xx

[OlsonM in reply to dreams28]

Thank you xx

[LKT1]

Hi OlsonM

Here to offer some positive news. Your results were better than mine at age 32 I had Amh of 9. I had one good quality embryo for transfer and now I’m 15 weeks pregnant. Remember it can only take one xxx

[OlsonM in reply to LKT1]

Congratulations that’s brilliant news

Thank you xxxx

[Countrymouse56]

My AMH was a lot lower than yours at 2.3 and my AFC was 3. I had short protocol low dose stims and now I’m 25 weeks pregnant. Stay positive. Your results are great compared to mine. Good luck ✨xx

[OlsonM in reply to Countrymouse56]

Thank you! Congratulations xx