AMH 30 but only 7 follicles?

[LittleSmall]

Hello! I’m age 39, all general female fertility tests came back OK and with AMH 30 pmol (above average for my age). We have male factor infertility and are having IVF with ICSI.

I only had 7 follicles at first scan and egg collection - (7 collected, 6 mature/injected, 5 fertilised, 4 top grade embryos at Day 3, 1 good/2 average blastocysts at Day 5).

So firstly, are there any explanations for a higher AMH but low follicle count?

And secondly, it appears that low AMH is a more common factor that affects fertility and is discussed here but does anyone have any experience of a more average AMH level and IVF/ICSI outcomes?

Thanks in advance!

[Twiglet2]

hey it doesn’t sound like you have a low follicle count it sounds like the average amount especially for your age, at least that’s what my clinic told me that average collection was about 8 eggs. Your drop off to blast sounds about average too or just above! Personally I’d be quite pleased with that number 🤗 I have higher amh about the same as yours and my 5 egg collections the past few years (age 40-42) have collected between 6-9 eggs with 1 or 2 blasts and the clinic said that’s exactly what they would expect to see.

When I was 37 we collected 13 eggs 10 mature 7 fertilised and made 6 blasts (one of which was my son) With the same number fertilised at 41 I only made one blast that round so it really about the quality of the eggs rather than the quantity and to make 3 blasts in one round at age 39 is great! 🤞🏽 xx

[LittleSmall in reply to Twiglet2]

Thank you so much for this reply!

It’s great to hear from someone with a similar AMH and also some experience of numbers for egg collection. That makes sense - that for age it is an expected amount. Our initial consultant stated that 10-15 eggs at collection is the ideal number and trying to remind myself that this is in general, and think she kept forgetting my age. Makes me realise that AMH isn’t necessarily that relevant once we are older perhaps? And quality will be the deciding factor. Keeping my fingers crossed for this upcoming FET transfer (our first fresh transfer was BFN) X

[XXKKXX]

Perhaps it depends on protocol. My amh was 62 I'm 38 and I collected only 7 eggs. 4 of which were mature and 2 made it to blast . They were 5cb and 3cc grades so very poor and unfreezable so we transferred both. one of those little embryos that we were given a low chance of pregnancy with is now a screaming 3 week old . I think its a roll of the dice and in my experience amh didn't seem to correlate with the amount of eggs produced but then I was on a lower dose which means me wonder if its protocol. Quality over quantity. Not that it made a difference to quantity in my case but perhaps outcome could have been worse

[LittleSmall in reply to XXKKXX]

Thank you for your reply!

So happy for your outcome

I keep hearing quality over quantity so this is what is reassuring me so far. And the AMH not correlating was confusing me in the back of my mind but nice to hear a similar(ish) experience. Like you, I wasn’t given a super high FSH dosage (originally was going to be 150 based on AMH but they upped it to 200 after baseline follicle scan). The drop off rate from collection to blastocyst has made me think that was the right dosage for me.

[DianeArnold Partner Nurse Fertility Network UK]

Hi. If your FSH is high, then perhaps you need a different stimulation medication. Good luck. Diane

[LittleSmall in reply to DianeArnold]

Hi Diane!

My natural FSH was 6IU/L and the dosage I was given was 200IUI (upped from an expected 150IUI after baseline follicle scan). We have a follow up appointment next week so will see if they advise any change to dosage - however I am wondering if the egg numbers for my age (39) might be right on this dose? Any experience or insight welcome

[Spicycurry]

It could be that fsh is slightly higher maybe due to protocol. If fsh is lower at baseline scan, more follicles will be available at start to grow evenly. A long protocol might be better as it turns everything off and every follicle grows from the same point.

[LittleSmall in reply to Spicycurry]

Thanks for your reply!

Can I ask what makes you think that FSH might be slightly higher? (Do you mean natural FSH or dosage?) sorry - still getting used to all the acronyms and signs

I had 7 follicles at baseline scan on Day 3, before stims, and then still had 7 at collection (6 mature/good for fertilisation)

[Spicycurry in reply to LittleSmall]

Do you know if you had all even follicles at baseline scan or were some bigger than others to start? I am 43 and for modified FET I do mild stims for lining so I also do oestrogen priming due to high fsh. Once I had a lead follicle which messed everything up. But obviously this is different for you. When I was 38, my fsh and amh were really good but things changed when I got close to 41.

[LittleSmall in reply to Spicycurry]

Thank you - that makes a bit more sense to me now! Think at the start they were all similar and then the midway scan (before collection date) there were 4 in front and the rest were closely behind, so not a lead one etc

I’m conscious that my blood tests/hormone levels will be changing as the months roll by so definitely something i will discuss in follow up appointment and moving forward. Thank you for taking the time to reply!

[Spicycurry]

Follicle stimulating hormone at baseline scan. Did you say it was 6? 6 is very good. It just might be that you were not on high enough medication or that you needed the long protocol.