Infertility

High AMH, Low Follicle Count

Hello!

I am wondering if anyone here has had a high AMH with a low follicle count and how their treatments have gone. 

I am 36.  When I had my pre-IVF testing, I was told to wait to do the AMH test until having been off birth control for 3 months.  I went ahead and had a follicle count ultrasound done about 6 weeks after having stopped the birth control.  (We will be doing PGD as we are both cystic fibrosis carriers, hence the birth control.)  At the time of this ultrasound, my doctor could only find 6-7 follicles.  6 weeks later when I had my AMH, it came back at 4.482 ng/mL. 

The doctor was very happy with the AMH result and said that perhaps we should have waited until I had been off birth control longer to do the initial ultrasound.  She then started my IVF (in vitro fertilization) cycle on a pretty high dose of meds.  After day 4 of my stims, my cycle was cancelled because my ultrasound showed that one follicle had become dominant.  There were two other "measureable follicles" and 9 "immeasurable follicles."

I am still waiting for info from our doctor on what may have caused this and what our plan will be.  That said, I am wondering if anyone out there has had this high AMH/low follicle count issue and what their treatment plan/results were.

Thanks!

Michelle

Re: High AMH, Low Follicle Count

  • So sorry about your cancelled cycle - those are tough to deal with. I don't have personal experience with this situation,  but my RE typically does estrogen priming to combat the dominant follicle problem.  You wait until you O, then go on estrogen. You'll get AF but you stay on the estrogen until you start stims so that your ovaries are suppressed. Then when you start stims, the idea is that all the follicles will grow together (you'll probably still end up with follicles in a couple of batches, but hopefully no lead follicle). Has your RE made any suggestions wrt changing up the protocol? 
    Me: 35 I DH: 38
    *TW loss and children mentioned*
    DD:2006 | Dx: Unexplained Secondary Infertility | DS: 2011

    TFAS since 2012

    Oct 16: Spontaneous BFP | m/c @ 9w1d (massive SCH) | D&C
    Apr 17: IUI #1 = BFN
    May 17: IUI #2 = BFN
    Jun 17: IUI #3 = Late BFP (18 DPO) | NMC 17Jul17 @ ~6w
    Aug 17: IUI #4 = Cancelled due to premature ovulation | TI = BFN
    Sep 17: IUI #5 = Cancelled due to overstimulation (10+ follies)
    Nov 17: IVF #1 = Cancelled due to non-IF related health issue | TI = BFN
    Dec 17: IVF #1 = Puregon 200, Menopur 75, Orgalutran, Suprefact trigger due to OHSS risk | 22R, 18M, 16F, 10B frozen  
    Feb 18: FET #1 (medicated) = BFN
    Mar 18: FET #2 (natural cycle) = CP (beta 1: 54; beta 2: 0)
    Apr 18: FET #3 (natural cycle) = cancelled due to missed ovulation
    Apr 18: FET #3 (natural cycle) = BFP! Beta 1: 201  Beta 2: 585 Beta 3: 3254 Beta 4: 9715 U/S 19May - one bean measuring on track with a HB of 125!
    EDD: 07Jan2019 Team Green
    My Rainbow Baby Boy born 03Jan2019 <3 

  • Hi tosh24!  Thanks for the quick reply. 

    I have not actually spoken to my doctor yet.  A nurse called when they cancelled the cycle last Wednesday.  She said the doctor would most likely call later that day however I never got a call.  She also said they have a meeting on Mondays where all the doctors discuss their cases together and that they would most likely come up with a plan for my next cycle then.  So, I am planning on calling them if I don't hear anything by early next week.  Is it normal to not receive a call from the doctor for a cancelled cycle?

    I was on birth control until a few days before I started my stims.  I know this had some purpose for my IVF cycle but I don't recall being told what the purpose was.  Do you think the birth control could have been for the same purpose as the "estrogen priming?"  Sorry if this is a dumb question....

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  • Yes, birth control is used to suppress the ovaries as well.  I have seen a number of ladies on this board who have not been suppressed enough on BC, though. You can ask your RE to try estrogen priming or Lupron after O. I have seen ladies not be fully suppressed on those either, but unfortunately it's trial and error to see what med/protocol your body responds to best.

    I had a cancelled IVF cycle in November and never heard from my RE. I was just supposed to call next CD 1 (but there weren't going to be any protocol changes). Since you might want to consider a protocol change, I would definitely call to follow up. GL!

    Me: 35 I DH: 38
    *TW loss and children mentioned*
    DD:2006 | Dx: Unexplained Secondary Infertility | DS: 2011

    TFAS since 2012

    Oct 16: Spontaneous BFP | m/c @ 9w1d (massive SCH) | D&C
    Apr 17: IUI #1 = BFN
    May 17: IUI #2 = BFN
    Jun 17: IUI #3 = Late BFP (18 DPO) | NMC 17Jul17 @ ~6w
    Aug 17: IUI #4 = Cancelled due to premature ovulation | TI = BFN
    Sep 17: IUI #5 = Cancelled due to overstimulation (10+ follies)
    Nov 17: IVF #1 = Cancelled due to non-IF related health issue | TI = BFN
    Dec 17: IVF #1 = Puregon 200, Menopur 75, Orgalutran, Suprefact trigger due to OHSS risk | 22R, 18M, 16F, 10B frozen  
    Feb 18: FET #1 (medicated) = BFN
    Mar 18: FET #2 (natural cycle) = CP (beta 1: 54; beta 2: 0)
    Apr 18: FET #3 (natural cycle) = cancelled due to missed ovulation
    Apr 18: FET #3 (natural cycle) = BFP! Beta 1: 201  Beta 2: 585 Beta 3: 3254 Beta 4: 9715 U/S 19May - one bean measuring on track with a HB of 125!
    EDD: 07Jan2019 Team Green
    My Rainbow Baby Boy born 03Jan2019 <3 

  • Oh look, bio tex is back and spamming the board
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