Youngish with very high FSH

gotthemoxie · April 2018

Hi everyone, this is my introductory post to what appears to becoming an unexpectedly more complicated journey.
My girlfriend and I decided to go ahead and TTC with assistance (can't do much without swimmers!), and my prenatal work up shows I have an FSH of 31.3 on CD3. I don't have a copy in front of me so I don' know what the other levels are, but am assuming normal since they only informed me of the FSH. I am getting a followup AMH this Thursday. I am 30 years old, no previous conceptions, regular cycle of around 24 days. My mother struggled with IF for five years before her first pregnancy. I don't know if the cause is related. I also have IBD.
On reading the literature, it seems pretty grim. I was hoping to get by with natural IUI or ICI, but the majority of recommendations are to waste no time and go straight to IVF, assuming enough follicles could be stimulated, which is also considered unlikely. It's all a bit depressing.
Any words of wisdom? Anyone with a similar scenario? I've been reading the boards and see that even slightly elevated FSH is treated as an indicator of poor fertility. I want to know more about what the research says.

Thanks guys.

dragonette505 · April 2018

Hi, Would y'all consider using your girlfriends eggs (providing she still has ovaries and etc... I know some ladies have early hysterectomies because of endo and etc).

tosh24 · April 2018

I was just going to ask the same question. I've seen a couple of ppl on here use one partner's eggs while the other partner carries the pregnancy. If funds to pay for IVF are limited, I'd really consider this option since it could be fairly risky to try a cycle with an FSH that high (and lots of RE'S wouldn't begin a cycle with an FSH of 31...they'd likely keep canceling you until you have a cycle with a lower CD 3 FSH). I'm so sorry this process has just gotten more complicated than you expected. It can be quite a devastating blow. Are you seeing an RE? If not, I would make an appointment.

gotthemoxie · April 2018

I have a an appointment with the ob/gyn at the local fertility clinic in May. I'm going to ask her about an RE then. I didnt see any certified REs on the team at the clinic. I would use my girlfriend's eggs if that was the next best option.We have limited funds so multiple IVF cycles would probably not be an option. I think we need more data on what my ovaries actually are or aren't doing.

JamieH2000 · April 2018

@gotthemoxie- sorry you are going thru this! IF is cruel at any age, but especially at 30 (I am also 30) since this just isn't supposed to be an issue at this point in your life and all your peers are SO fertile usually. I would highly reco setting up an appt with an RE and not wasting your time with an OBGYN. With this FSH result you need an RE to really help you understand what your options are. If it gets to the point that you can't use your own eggs, feel free to join us on the Donor Egg IVF page. While its a nice option to use your girlfriend's eggs, its still a loss of your own genetics in your child that you weren't planning on.

gotthemoxie · April 2018

I need a referral to see a specialist, so no reason not to keep the appt with the OB/GYN. The clinic is the starting point. I may need to travel out of town to see an RE, but we can at least get preliminary testing done here.
My GF has a little boy from a previous relationship, so I was hoping to have a genetically linked child myself. I know intellectually it shouldn't matter, and to some extent it may be a more rational choice *not* to pass on my genes considering my autoimmune disorders, but there's still that want.
Whatever happens, even if we end up adopting, I know there will be happiness. But for now it's still a little heart breaking.

Thanks for the kind words and advice. X

JamieH2000 · April 2018

@gotthemoxie- Your attitude is great! I only mentioned skipping the OB since for all the REs and clinics around me (in the midwest at least), you don't need a referral to make an appt. But perhaps if your insurance covers any infertility stuff, they require it. Most insurances don't cover anything for IF, so if yours does, that is a great reason to wait for a referral!

gotthemoxie · April 2018

I'm already checking out IVF clinics - will have to travel out of town (5-8hrs) if it comes to that. The least expensive charges 6000 per IVF cycle, not including medications. My extended health will cover meds up to 2500 lifetime limit. Unfortunately BC does not offer any coverage beyond the initial consult, so everything will be OOP with a partial return via tax credit. Damn. My GF is cautious about spending a lot of money on this, but we're waiting on what will be recommended and learning more about what the odds are before getting down to deciding how much we can invest.
Also I've been using OPKs and it doesn't look like I'm ovulating - at least this cycle. Balls.

mayflower513 · April 2018

Lurking and wanted I say I’m sorry and I hope things can move quicker once you see the RE!

Also, It might be worth temping next cycle in addition to OPKs... I know there are some that never get a positive OPK.

emmasemm · April 2018

Sorry you’re here but good to find it now rather than later.

I would second what some others have said in that going to an RE sooner rather than later is key - and be aware some REs will not accept results from an OB, they will want to run all tests again.
Some REs will offer free phone consults, so I would suggest already booking yourself in for some of those to go through the test results you already have (AMH should be back within a week and they will want to know an AFC from CD3 normally too). LP progesterone might be useful to pinpoint if you Od or not.
With your FSH number, if the AMH comes back corresponding I would say every month counts a lot if you want a shot to use your own eggs,

As for potential causes of such a high FSH at your age, a good RE for you will either have an interest in autoimmune issues or will refer you to an REI. There’s not many studies or much evidence around, but what there is does support some link between autoimmune issues and low ovarian reserve (I have rheumatoid arthritis) but there are also a very small number of genetic issues which mean you don’t properly make certain proteins necessary to stimulate the follicles or have some additional proteins on the ovaries which block the receptors of FSH etc.
Do think carefully though how much time and money you want to spend on testing if at the end the course of treatment will be the same. It’s nice to have answers, but it’s better to have success.

As @jamieh2000 mentioned, if you decide to use your DW eggs or a donor then the DE thread is an awesome space. If you get your AMH confirmed low and decide to give it a go with OE come on over to the Low AMH thread. We’re the girls who do retrievals for single digit eggs on a regular basis. Whilst some of us are still in the fight, we also have some active success story members.

adirat · April 2018

Hi and sorry you find yourself here. I just want to echo what @emmasemm said -- you're so young that it's worth a bit of investigating why you are already facing DOR. You might have an autoimmune disorder you would want to treat before trying to get pregnant to reduce risk of loss. You might have endometriosis which may suggest a different stimulation protocol. You may be a carrier of a genetic condition that you want to know about before passing on to a child (that's my category with ovarian insufficiency and low amh at age 27). A good RE should help you get to the bottom of it before you start fertility meds. Good luck!

gotthemoxie · April 2018

I have IBD (Crohns) and Celiac which are both autoimmune. There's not a ton of research on how Crohns affects reproduction, assuming it is in remission and no surgeries have been done. My thyroid always tests normal - though I do have some nodules awaiting biopsy, they're like a benign goiter. I don't have symptoms of endo - my cycles are pretty regular with no excessive pain or bleeding.

I have an appt with my gastroenterologist in a couple weeks, and I'm going to discuss the Crohns or previous medications as a possible cause.

I believe most diagnostic procedures are covered by the provincial health plan. AMH wasn't, for some reason, but I can submit it for a tax credit.

dragonette505 · April 2018

I have celiacs, hashimotos thyroiditis and have siblings with crohns... autoimmune conditions can definitely impact fertility, egg quality and etc.... Ive been on an paleo aip (autoimmune protocol) diet as well as tons of supplements during my cycles and it seems to have marginally improved some of my numbers. I would get that AHM for sure because that will help give you an idea about whats going on overall. These numbers aren't the be all end all, but together they will give your RE an idea about how to create a protocol that might help.

gotthemoxie · April 2018

My AMH came back - 0.07.
FML.

emmasemm · April 2018

@gotthemoxie I’m so so sorry you got this news. It sucks. Big time.
It does correspond to your FSH.
Please remember what we said above though - if you’re still ovulating naturally every month you still have a chance to get KU, but chances are lower and I guess they will tell you they would expect a very poor response to IVF stims. I hope your RE takes time to discuss all options with you in terms of chances of success for different approaches, and then the cost. Maybe at home insemination could be an option to get as close to matching what a hetero couple would be advised to try each month at home in between treatment cycles, if the vials of sperm aren’t too crazy expensive, so as not to waste any eggs.
I only get a few eggs each IVF cycle. But we’re still pushing ahead with more IVF as we have tried 3 years with TI with not a single BFP and I have some auto immune issues too which should benefit from additional treatments alongside the IVF.

gotthemoxie · April 2018

Semen is pretty pricey - 700-800 per sample if washed, tested, and donor screened. If we can figure out if I'm still ovulating, maybe IUI with medication would be an option. The cycle regularity seems to suggest that. The thing is, I don't have a documented infertility history, I just have really terrible numbers and what would be referred to as "social infertility". So what the numbers mean is a little more ambiguous than if we had hard evidence of poor fecundability.

I'm both dreading and looking forward to our consultation - May 5th.

At least spring cleaning fills out the time - we've already rearranged half the house and donated a trucks worth of old toys!

gotthemoxie · April 2018

Re: autoimmune issues. Currently I'm managed very well with humira and diet. Before humira, I was on budesonide, methotrexate, Imuran, and LDN. Not all at once! Humira has worked the best for me, no flares in almost two years. No surgeries needed either, so IF related to that isn't an issue.

gotthemoxie · May 2018

Update:
GE didn't have any advice to offer regarding Crohn's as a cause of infertility.
The doctor at the fertility clinic was great. She recommended against trying IVF, IUI would be better considering the apparent gamete drought going on in my ovaries. Costs about 1500/cycle including donor semen. Wants to avoid medicated cycles, at least at this point. I asked about an RE, she said she would be happy to refer me if I really wanted to, but said at this stage they wouldn't be doing anything differently. Although her background is OB/GYN she did do additional education in RE, just not as much as the specialist.
Going to do further testing to rule out some causes of POF/DOR but doesn' expect to get any positives. Her opinion - probably autoimmune related, my body attacking itself and laying waste to the reproductive material like it does to my intestinal lining and dermal tissues. Ultrasound showed one big and one small follicle on one ovary, and two medium sized ones on the other (day 12 today). So it looks good for ovulation, just that - unfortunately - it's an "army of one or two" situation.
I'm feeling a bit better about everything.

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Youngish with very high FSH

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