Hi I'm new- jumping into IVF & confused low AFC but normal/high AMH?

bionerdsteph · May 2017

Hi all! I've been lurking for a few weeks while my husband & I were trying to decide whether to do IVF or not and we've decided to go for it. A bit of our background then a question. I was diagnosed with cancer at 27 in 2008 & went through treatment including chemo, so now I'm 36 and have been "no evidence of disease" for almost 9 years. My husband has a known super low sperm count & was previously told IVF/ICSI was his only option so we haven't really tried to get pregnant. We're jumping into IVF without having gone through IUI or previous testing on me. We have a tentativeJune/early July IVF cycle setup. The Dr is pretty down about me having gone through chemo and what that means for my egg reserve & quality- I wasn't expecting him to be excited but he said I have about half the chance of IVF working than someone my age/health/stats usually does. So I'm reeling a bit from that and then my testing results are confusing. He did a AFC and there were only 7. My AMH is actually high/normal at 4.8ng/ml and definitely no obvious PCOS/ issues in general. My FSH also seems decent at 3.8uUI/ml. My AFC was on day 5 of my cycle- could that have caused it to seem lower? Why would my AFC be low when my AMH & FSH are good? If anyone has a similar experience chemo or low AFC/normal AMH I'd low to know what your take on it is.

KLake42 · May 2017

I don't have any experience with what you're reporting, but I just want to say that it's always good to hear of folks who have been in Camp NED for a number of years. I have two friends battling ovarian cancer.

I would expect that there are just a lot of unknowns for you, as to how the chemo impacted your egg quality, and I wish there was more information out there. I have another friend who has had no evidence of disease after fighting leukemia in her 20s, and she recently had a baby (mid-30s). There's no reason to not be hopeful.

notamyrtle · May 2017

Hey, I just wanted to say that I've had the exact same issue! My AMH was 4.7 (at least a year ago) but my AFCs have been as low as 9 (twice). One month I had an AFC of 9, and then literally the next month I had 13 in my L ovary alone. I'm like, how could i have more in one ovary than I had in both ovaries combined the previous month?

I'm not sure why this discrepancy. There could be many reasons. Ultrasound can be quite user-dependent and subjective. Also, you may just have follies that are really small but 'wake up' with stimulation. And there is some level of month to month variability, but I'm not sure that's as big a factor as the other two reasons I mentioned.

bionerdsteph · May 2017

Thank you! I do have a few friends that have had kids post chemo but none that I know of via IVF and past the age of 35. Hopeful my good AMH & FSH levels mean more than the low AFC! Im hoping/thinking the Dr gave us worst case chances.

cashewchicken · May 2017

AFC of 7 is within average for your age. I was told by my RE that the average AFC count for women in mid-thirties undergoing infertility treatment was 5-10. As pp said, u/s is also quite user-dependent, so I wouldn't worry too much at this point.

2MomsHoping · May 2017

This may be a long shot but prior to seeing your doctor have you been on birth control for any reason? I know some people take them just for regularity or acne. I get over repressed and when I was on it they my AFC was only 4, went off it for a month and it went up to 19. Sounds like you have more complications but just wanted to throw it out there in case it happens to apply to you.

Irisheyes81 · May 2017

Welcome and good luck! You're already a warrior.

bionerdsteph · May 2017

Nope no bcp for 10+ years, I had an IUD (copper not hormone) for a long time but that was removed over a year ago- 1 benefit of super low sperm count means no bc needed!