Low AMH Level

adc0417 · November 2017

@JamieH2000 so happy to know your cycle is coming along well with 3 follies and nice thickening of lining. When do you go back for monitoring?

@emmasemm good to hear from you. It might not be a bad idea to explore different reasons for the mishap.

AFM, I just did my 7th day of stimming and will be going for US and bloodwork tmrw. I was doing 75 of menopur and 150 for the last 2 days. Today is the first time this cycle, I’m feeling nauseous after my shot.

Hopeful_mom · November 2017

@Adc0417 hoping u have a great US! No nausea now you've got plenty of time for that

@JamieH2000 that's a great lining check I feel like mine wasn't much higher then 8/9 when I did my FET. We're on our way chica, u got this lady!!!

@emmasemm it's so interesting all the different rules. My place allowed dhea I think all of US does mine won't do hgh while other places do. I have high hopes for you!! just wish we all didn't have to work so hard through this process!!
I'm pretty confused as well my last cycle I really was in a lot of pain and I doctor expressed 0HSS as well which really seems ludicrous but what Do I kno. I pray I can continue being inspirational as I'm scared all the time. Tomorrow is the big testing day so praying hard all will be ok!!
The fact that your family has Endo it's interesting that your doctor didn't look further into it...ugh I'm frustrated for you, I kno that 2 wks of hope all too well!!! Hang in there it's coming lady!!

adc0417 · November 2017

So, went for my US this morning and still nothing significant. I know I have a longer cycle normally and am a slow responder, but still getting nervous. DH is very supportive and asking me to not stress, but it’s hard not to.

JamieH2000 · November 2017

@adc0417- I go back tomorrow morning, so hoping my lining is at least 7+. How many days of stims are you on? I have seen ladies start slow and still have a good cycle, so I really hope that is your case! Have you tried a full stim IVF protocol before? Sorry if you already told us that!

@hopeful_mom- thanks girl! I am trying to stay optimistic I will get there. Just would be nice if it would just go easy for once! hope you are feeling better!!

adc0417 · November 2017

@JamieH2000 I had done 7 days of stimming with 5 days of 75 menopur and 2 days of 150. I had started a cycle last month with clomid, gonal f and menopur and was cancelled on CD 11 since I wasn’t responding. I’m not responding this cycle as of yet.

Isthisthereallife · November 2017

Hi Ladies!!! Lurking here...been a while since I've been on the boards but just needed to drop in and say hello to Hopeful_mom real quick!! I'll send you a PM! And JamieH2000- I'll be texting you in like 5 minutes!! Hope you're all doing well and good luck to everyone!

adc0417 · November 2017

So, I’m having some light bleeding. Could it be from menopur? I’m now on 225 menopur

JamieH2000 · November 2017

@adc0417- I have not had bleeding during stims, including menopur.. but I would def check with your nurse. I really hope this cycle turns around for you!

Hopeful_mom · November 2017

adc0417 said:

So, I’m having some light bleeding. Could it be from menopur? I’m now on 225 menopur

Hmmmmm I've never bled during stemming definitely call ur RE!

adc0417 · December 2017

Thanks ladies!! So, I spoke to my nurse and she said that some spotting consisting of brown blood is ok, as long as it’s not not heavy red blood.

hopefuljj · December 2017

@adc0417 hey lady, I have had brown bleeding on sims, twice. So now i sort of expect it for me. It could have something to do with hormone levels rising or falling in some way. I'm crossing my fingers that you start responding soon!!!

@jamieH2000 sending lots of thickening vibes for your uterus!!!!! I told my RE that I wanted to go up on my meds and she was totally cool with it so now i'm on 150 menopur and 300 follistim. That was all you

AFM I got the green light to start Stims again yesterday so i'm cautiously proceeding after 11 days of Estrogen Priming. We shall see if i make it to retrieval this time. I totally screwed up my meds by mixing the menopur with 2cc of saline instead of 1 cc last night, but tonight I got it all right. Phew. doing HGH in the AM but it really is such a small dose.
I think i'm going to try to figure out making my signature finally ;-) to keep track of all these cycles. this is IVF 4.5

adc0417 · December 2017

@hopefuljj thank you and good luck to you!! Hope this cycle brings some positive results.

@JamieH2000 how are you doing?

JamieH2000 · December 2017

@hopefuljj- So excited you can start again since you have been waiting to long!! I'm glad your trying higher stims just to see if it helps you get a few more! Hopefully worst case, you get the same amount as before but just spent a little more

Praying so hard for you to get some more so you can finally get to a transfer!

@adc0417- glad they aren't concerned and you can keep going! When do you go back next?

AFM- the tech this morning was the one who doesn't give me tons a info. Sounds like one lining measurement was above 9mm at least, so hopefully the rest were at least 8 something. Just waiting anxiously for the nurse to call with instructions. Really hoping tonight is trigger night since I am tired of going in! Last night was rough as our donor coordinator emailed that our donor was recently diagnosed with ADD and anxiety. I freaked out a little since ADD is very highly related to genetics, so now I am worried about the risk to our children. Based on what I read, it sounds like 30-50% risk of a child having ADD if a parent does. I mean nothing I can do now about it since I wouldn't just want to throw out the embryos and start over... but hoping if she wasn't diagnosed until uppers 20's, its not really a severe issue for her or anything. But just more bad news and stress I didn't need right now...

tosh24 · December 2017

***Lurking***

@JamieH2000 I lurk on this thread from time to time as I have a low AMH level for my age, however, I've never participated. I'm so sorry that you have yet another unexpected turn in your journey. I have some experience with ADD/ADHD and I just wanted to help to quell some of your anxiety if you were open to it. I'm going to put it in a spoiler box, and *TW* that a child is mentioned.

I have an 11yo DD who was diagnosed with ADHD at 8yo. Some of the signs we noticed were some challenges she was having with reading and writing, focus (esp. during homework time), and her frustration level when she would have to transition from one place/activity to another. We had her evaluated and once we got the diagnosis, we modified our approach with her at home and obviously worked with the school to accommodate her needs. She is now thriving. Her IQ testing was either at the normal level or above average, depending on the skill being tested. She is an A/B student. She now loves school and does really well. She has big university goals and talks about her intended career all the time. Her ADHD has given her the energy to pursue her dreams (way more energy than I had at her age lol!). She is a smart, beautiful girl, and while it requires a bit more effort on everyone's part, she is succeeding and I have no doubt that she will be able to achieve everything she wants in life. She is currently not medicated. I won't pretend that people with ADD/ADHD do not face challenges, but I want to let you know that they are not impossible to overcome and that having ADD/ADHD does not mean that a person cannot have a happy, successful life. And remember that intellect is separate from ADHD. There are loads of scientists, doctors, etc. with ADHD. I used to babysit a boy with ADD and he is now an engineer. My friend's husband is a lawyer and he has ADHD. I did so much research and read so many books and articles when DD was diagnosed, and there are a TON of successful people with ADD/ADHD. Here's a short list:
Jim Carrey
Michael Phelps
Jamie Oliver
Sir Richard Branson (!)
Justin Timberlake
Ty Pennington
Ryan Gosling
Ingvar Kamprad (founder of IKEA)
Adam Levine
Anyway, I just wanted to share and hopefully slow down some of the spinning that your head must be doing after receiving the news. BTW, my DD has an anxiety disorder as well (GAD) and like I said above, she is more than fine. Good luck with your transfer - I wish you all the best!

JamieH2000 · December 2017

@tosh24- I cannot say a big enough THANK YOU for sharing your story. It honestly makes me feel soooo much better to hear from someone with a personal experience with ADD. Your daughter sounds simply amazing and I am so happy she is thriving. You are so kind to take the time to share so much detail. I am so hopeful that even if we do end up dealing with this diagnosis, it will be ok and our child will turn out just great. I really hope you have success soon! Definitely stick around with us in Low AMH if you want

So I just got the call.. and lining is 10.6!! We are triggering tonight and then confirming ovulation with bw on monday. If that is good, transfer is next friday! This is getting real!!

Hopeful_mom · December 2017

@tosh24 I conquer with @jaimeh2000 great post thx for sharing!! And jamie awesome news let's get this party started!!!

@hopefuljj great news hoping and praying this is your cycle lady!!

@adc0417 glad things are normal and it's nothing to worry about!!

dreamscapes_ · December 2017

Hello! I was referred here from the IF testing/treatment thread over on TTGP. I was recently found to have low AMH (but apparently my other numbers are normal). My AMH is 0.31, and I'm seeing an RE on Tuesday morning. We've only been trying for two months, but the doctor I saw wanted me to see the RE based on my age and result.

@JamieH2000 My husband has ADD, and while it can be trying sometimes, we work with it. He was diagnosed when he was about 8 or 10. Good luck with everything next week!

hopefuljj · December 2017

@JamieH2000 yay for trigger!!!!!!!!! This is happening!!!! I’m sorry for the stressful news about the donor. My husband has ADD as do 2 of my closest and best girl friends. It’s something they all bond over that I will never completely understand. They are all very successful adults but of course have had some challenges along the way, but haven’t we all? Being married to someone with ADD certainly comes with some challenges but it also makes them very amazing people in other ways. If we are ever successful I’ve always wondered if our child would have it too.
Anyway, so so excited for you to get this show on the road!!

Hopeful_mom · December 2017

@dreamscapes_ I'm on my mobile so my apologies if you have a signature and I just don't see it. I love the fact that your Dr is being proactive and having you see an RE. Do u mind me asking how old you are?
Hearing you have AMH it's scary and it's hard because you don't have all of this information that explains it. I know when I was diagnosed with that I guess about two years ago I didn't find much about it and this thread was definitely a lifesaver for me.
At first my RE thought that the results of My AMH were wrong and she ran another test that is more accurate and still came back the same way .30. I will say after a year of vitamin supplements Coq10, dhea, vitamin D and it actually went up to .4 so I was happy about that. My RE originally didn't think that taking extra vitamins would help but you do get to the point that you want to try everything.
It's great that you just started trying I was trying a full year before Seeking help. It's great you're just getting started I don't even think you should feel jaded or worried because it just means that you may not have as Many years to still produce as many eggs as other women TTC. What's your AFC and FSH?

adc0417 · December 2017

@JamieH2000 can’t believe there’s a sad new twist to this now, but I do agree that a lot of successful ppl out there have ADHD. Have faith it’ll all be ok. Excited about you triggering tonight!!!
My next monitoring appt is on Sunday. Really praying something’s brewing inside.

@dreamscapes_ you definitely are at the right place! I know I definitely feel more at home on this thread, since our cycles tend to run a little differently than other ppl.

emmasemm · December 2017

@jamieh2000 Your story is like a movie plot line. And now we’re at the point when everyone says, “hey come on, that’s just too many things, no way this can all happen in real life to one person - just bring on the happy ending”. So yay for triggering and can’t wait to hear your happy ending!

@tosh24 totally awesome of you to share like you have. And especially after the rough weeks you’ve had with the cancelled cycle. Hope your results came back clear to move ahead.

@adc0417 Fx you see some good growth on Sunday. Even if it’s not many I hope you can keep moving forward this time.

@hopefuljj I’m really hoping you can make it through this whole cycle! With eleven days priming things will be slow to start but I’m sending your eggs lots of grow vibes!

@hopeful_mom hope peanut is snuggling away happy inside!

@dreamscapes welcome and glad you have come over to join us here. Sorry, this will probably be a long post so I will spoiler it. It shouldn’t contain any triggers for anyone.

You definitely need to know your day 3 FSH Level and your AFC as those two things combined with your AMH will give you an idea how you will respond to IVF meds. But only an idea! In general we low AMH ladies also have lower AFCs and this means that even when we take the IVF meds we don’t get 20-30 follicles grow like most patients - we get lower numbers - 1 to 10 is the kind of range we’re talking. Even in young women with all bloods in the right ranges, the drop off rate from number of follicles, eggs retrieved, to mature, to fertilized, to making it to day 3 and then day 5 is quite high - typically 20-40% of follicles result in day 5 blasts. We also tend to have a noticeable rate of empty follicles too - ie they grow but at ER they find no egg inside.

If you have the money or insurance coverage (and emotional endurance - don’t underestimate that part!) what many ladies do is multiple retrieval cycles, each time freezing whatever is viable on day 5 each cycle. So for a person with normal AMH they might be able to freeze 4-8 day 5 blasts from one ER, we might need 7 or 8 ERs to get the same number of blasts.

And that’s before you start thinking of PGS testing... but I’ll leave that for another day.

When you have “enough” frozen blasts then it’s time to move to FETs. We have our very own success story from this approach on this thread - @hopeful_mom - if you read her history in the spoiler you’re hopefully as encouraged as me that this can work!!!

Sometimes particular protocols don’t seem to work so well for us. But it’s very much trial and error. So just because one doesn’t work it doesn’t mean you shouldn’t try another. What you need is an RE who deals with DOR every day and sees us as an exciting puzzle to solve - not one who thinks we will ruin his stats.

Some REs don’t suggest IVF for us as they think it’s a waste of money if we only get one or two eggs from a cycle - but I have found we learnt a lot more about my egg quality by doing the ERs. Also even if we only get 2 eggs in a cycle, that’s another egg we get that would have been lost naturally (as every month we lose many more eggs than the one that is released and IVF tries to “catch” more of those instead of losing them - in very simple terms). But medicated IUIs might be an option if insurance or money is a limiting factor, as long as you would be ok with multiples, though the risk is lower for us than average patients.

If during your ERs you find really poor egg quality (along with low quantity) or due to money or time constraints that’s when REs usually start talking about donor egg (DE). If your DH is with you in the appointment, maybe good to prep him in advance so he isn’t blindsided. Donor egg is a really personal decision. I’ve got huge admiration for the ladies who decide donor egg is their path - @jamieh2000 is my hero for this (especially as even donor has not been straightforward for her so far!). The further I get through my journey and the more people I come across the More at home I also feel with it. (I have a different issue that it’s not legal where I live, so that adds a whole different dimension in our decision making process)

Other than that wishing you good luck on Tuesday and we are here to help you decipher your meeting after!

AFM WTF appointment is on Friday. Imight have a few questions on detail of protocols for one or two over the weekend as I’m emailing my RE my ideas in advance!

JamieH2000 · December 2017

@hopeful_mom- thanks! Its crazy to think that if this works (dare I even to hope again) that today, I am technically 13 days pregnant since a 5 day transfer makes you 19 days pregnant lol. We need to be bump buddies (actual real bumps, not just on here) after being online buddies for 1.5 years now!

@dreamscapes_ - Welcome! I echo was the other ladies said. This thread is great and manages to stay pretty active even though we are all at different places and there is usually lots of waiting between cycles somehow. I feel very hopeful for you because of this article that came out recently:
https://www.nytimes.com/2017/10/16/health/fertility-test-ovarian-reserve.html
Bascially, low AMH doesn't mean you can get pregnant.. it just means you won't be a good responder to IVF likely. While we are all here doing IVF with low AMH, its likely that low AMH is not our only problem. For me, while my AMH was low for me age, I was able to get a decent # of eggs once we got the right protocol (see my siggy), but we couldn't get many to day 5 and they wouldn't stick. So my issue is likely egg quality, more than quantity. So I am really hoping that your quality is good and you can hopefully have success naturally even!! Thanks for sharing about your husband! The more I hear about people with ADD/ADHD and how managable it is, it really helps me feel better about this new risk factor.

@hopefulljj- Thanks for sharing your story too! I wouldn't have been to concerned about the donor update, except for I'm pretty sure my husband has some mild ADD as well (he struggles with reading a full page, easily distracted, forgets where things are and why he went into a room). He is also smart and successful as an engineer who graduates with his MBA in a week... so I guess if the worst I have to deal with is alot of reminding him (or our child) to not forget stuff... so be it. I am soooo excited for your cycle! I'm gonna need daily updates chica!!

@adc0417- Thinking of you tomorrow and really hoping they are growing! Since this is a mini stim cycle, they will proceed with ER for even one egg right?

@emmasemm- I love your description of my situation.. I often feel the same! Like hasn't there been enough plot twists at this point? You are such a good contributor with your detailed explanations for everyone, and so knowledgable!! Thanks for your kind words about me doing ED too.. I hope you never have to consider that path, but hopefully I have helped everyone understand it better. Its not easy or cheap, but there are some pro's for sure. I never thought I would get to the point where I was ready to move on, but after 3 failures and unable to start a 4th try for month, I just realize I was ready to be a mom, even if it wasn't my genetics. Now I am excited that I *hopefully* have enough embryos for 2 children, since I have always wanted at least two. Anyways, I am still so hopeful you will get this to work with your OE and your dedicated research and RE! Happy to answer any questions, if I can, before your appt on Fri!

Well ladies.. we triggered last night! the IM shot wasn't nearly as bad as the IM pio. I start crinone sunday night and monday morning, so my bw has to be good when we check progesterone on Monday I think. So hopefully no surprises there. DH and I continue to debate 1 vs. 2... but our consents currently say 2, so we have to get new notarized consents if we want to change that. Obviously scared of the risks... but we FINALLY have a good lining for transfer so I want the best shot possible...

LSatturo126 · December 2017

@JamieH2000 sending you the stickiest thoughts ever! Best of luck! I know two may sound like a lot to handle if it sticks but God gives you what you can handle. You got this!!!

mtpbadger · December 2017

@jamieh2000 yay! Glad things are finally moving along! Wishing you the best of luck. If your gut is saying two, go for it. You know the risks but plenty of people have twins and if your doctor is saying it’s up to you, I’d say go for it!

Kp214 · December 2017

@JamieH2000 so excited for you! Good luck!

capps42613 · December 2017

@JamieH2000 sending you super, sticky vibes!! *TW* Since we only had 2 embabies fertilize & grow we transferred both on day 3. I told myself that God wouldn't give us what we couldn't handle. Which is probably why only 1 stuck lol Good luck!

JamieH2000 · December 2017

Wow, thanks for all the Love ladies!! You are the best and have such a great advice. For now, we are planning to stick with two and pray that at least one sticks and if two do, well then just pray for a smooth pregnancy and easy babies haha!

Kp214 · December 2017

@JamieH2000 you might also consider the possibility that one may split so you end up with triplets. It has happened to a woman on here.

adc0417 · December 2017

Sending you lots of baby dust your way @JamieH2000 whatever # it ends up being, it’ll be a blessing from God.

So, I now have 7 follies but nothing measurable yet and plus my lining is still pretty thin. Waiting for the estrogen levels, hopefully that went up. Little nervous.

emmasemm · December 2017

@adc0417 7 is great, Fx for your estrogen levels rising. When is your next monitoring appointment?

dreamscapes_ · December 2017

FX for you, @JamieH2000!

dreamscapes_ · December 2017

@Hopeful_mom I do have a sig, but it's just our ages and wedding date at the moment. My DH and I are both 33. This thread definitely seems helpful, but I'm still figuring out some of the shorthand and acronyms, lol. I don't know yet what my AFC is, as my OBGYN didn't do a check for that. My FSH (in luteal phase) was a 5.0, which is right in the middle of the ranges that they sent me. So we shall see what happens.

@adc0417 Thank you! We're just cautious about everything right now. A bunch of the people we've mentioned this to have kept jumping straight to adoption, which is just too expensive for us to even consider right now.

@emmasemm I don't yet know what those numbers are, but I'm sure the RE will probably want to run them. We do have some insurance coverage, but I don't know yet how far it'll stretch. I'm hoping to get something started this next cycle because our deductible is met for the year and it'll reset on the 1st. Once we pay our deductible, we split costs 50/50 with our insurance until we reach our out of pocket limit, at which point they take over until their lifetime cap on fertility services. So... Yeah, I don't know how much movement we'll be able to get on it, but we shall see. I do know that donor eggs are not an option for us due to cost, since I don't believe insurance covers them. So we'll just have to see what happens for now. Also, what's a WTF appointment?

@JamieH2000 Thank you! We're just going to have to see what happens. I do ovulate naturally sometimes, but of course, not a clue if they're "good" eggs or not. I really hope your procedure works for you! As for the ADD, in all honesty, if he has a list and sticks to it, things work out well. Routine also helps immensely. The problem is just getting something to become a routine for him.

emmasemm · December 2017

@dreamscapes_ assuming that was a day 3 FSH then it might not be straight DOR, but could be an ovulation disfunction instead if you don’t always ovulate on your own. So if you’re not sure please push at your appointment to get a day 3 FSH and the AFC done at the same time. Some REs want to run the AMH through their own lab too just to be sure.
In order to take advantage of the insurance situation you could either push to get as much testing eg an HSG done during December so you know if your tubes are clear and thus if IUI might be an option, or push to start a treatment cycle. Though without checking your tubes first most REs won’t do an IUI.
But you’ll know more after the appointment.

A WTF appointment is a “what the f***” appointment to talk about what went wrong and what your next options are.

dreamscapes_ · December 2017

@emmasemm A day 3 FSH is when it's tested on day 3 of your cycle, right? Or am I reading that wrong? Anyway, that FSH result was during my luteal phase, CD24. I'll definitely ask about testing and stuff, but with it being the holidays and everything, I don't know what availability they'll have. So yeah, we'll know after Tuesday morning. The clinic we're going to has a little video of what to expect at your first appointment, and it sounds like they may do an ultrasound right then to check on tubes and all that. Thanks for the explanation of the WTF appointment! That's what I thought it meant, but I wasn't sure.

emmasemm · December 2017

@dreamscapes_ yes that means they need to take the blood sample on day 3 (day 2-4 is normally ok) and they should do the AFC at the same time. Unless your FSH is from day 2-4 then you can’t use it to gauge your ovarian reserve as FSH varies through the cycle. AMH is one of the few tests that doesn’t depend on the day it’s done.

Normally at first appointments they will do blood work and US, but if you’re not day 2-4 call you in for day 3 BW and US again. If you’re at another point in your cycle they will look to see the uterus and ovaries look the right size and shape for the time of the month, if you’re in the first half of your cycle see which side you have a follicle growing and that it’s normal progression for whatever day you are. If you’re in your LP then they might look at your progesterone level and to see if your uterine lining has the right thickness and is trilaminar. They should do a SA for you DH too. Feel free to check out some podcasts on the first RE appointment which are helpful - you will find good ones on “Beat Infertility” and “creating a family”.

dreamscapes_ · December 2017

@emmasemm Thank you for explaining that! They didn't tell me much when we made the appointment. I'm admittedly a little nervous about it, but I'm sure it'll be fine, one way or the other.

adc0417 · December 2017

My estrogen is still low unfortunately. RE wants to cx the cycle again. But DH and I really want to continue with the cycle. I normally now have longer cycles 5-6 weeks long, and naturally my estrogen doesn’t start going up till after 2 week mark. Anyways, so my RE agreed to continue the cycle and repeat monitoring on Wednesday. What do you guys think? Are we wrong to continue with our cycle? We want to believe there’s still hope to salvage this. I’ve never had a complete IVF cycle before so don’t know how many eggs can be retrieved or fertilized.

emmasemm · December 2017

@adc0417 well done for advocating for yourself to keep going. Sorry, I can’t remember if you’re covered by insurance or OOP? If money is not a major barrier, personally I would suggest pushing on to ER and at the very least ensure you learn how many of the follicles have eggs in them, plus whether those eggs are mature and look good quality. This will at minimum give you good information for your next step - and at best give you some eggs to fertilize!

JamieH2000 · December 2017

@dreamscapes_ - thanks! I really hope your day 3 testing comes in normal and good! When do you go into the RE?

@adc0417- Remind me, how many days have you been on stims? and was your FSH below 10 on day 3 of this cycle? I believe you are doing a low stim cycle, but I believe some DOR truly need high doses to really wake their ovaries up. I don't have that low of an AMH even, but i would only get 2-4 follicles to grow until I did max stims (450 of follistim, 150 of menopur). Cancelling really really sucks, but it may be worth to try again with another protocol if you aren't seeing any estrogen rise after a week or more of stims. Sorry you are in this situation.. I never thought I would get to a transfer after my first IVF was cancelled, second IVF only produced 2 eggs... but then my third IVF protocol worked so much better for me and I got 12 eggs total, 8 mature. So really don't give up hope yet, the protocol can make all the difference!

adc0417 · December 2017

Thanks for your supportive and motivating responses @emmasemm and @JamieH2000.
Yesterday was my day 13. I started out on 75 menopur and am now at 300. Naturally, my system doesn’t start kicking in till 2 weeks later. My first protocol was different( clomid + gonal f + menopur) and I had the same response and this was cx.
What 3 protocols did you try? @JamieH2000

Low AMH Level

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