Newbie, critically Low AMH, ***TW loss mentioned*** — The Bump
Infertility

Newbie, critically Low AMH, ***TW loss mentioned***

Hi everyone!  Ive been reading everyones stories and struggles and blessings and I must just say I am blown away by the love and support I see on this forum.  

I wanted to introduce myself.  I am 37 (soon to be 38 in 3 weeks) and my DH is 39.  We got married in August last year and immediately started trying.  I had been on birth control for the majority of the past 20 years with a few small breaks in the past 4 years.  I had been diagnosed with MTHFR after a B6 toxicity issue 3 years ago and have been on L methyl Folate along with Methylcobolamin and I have been taking Prenatals for a few years to make sure my levels were where they needed to be.   

We suffered a CP in November and then after seeing a fertility doctor in March, we found out we were pregnant naturally a week later.  My AFC was only 5 and the doctor expressed concern about that and when I found out I was pregnant, I asked for my labs.  I saw my AMH was 0.27 and I laughed...HA, take that!   But after having our 9 week ultrasound expecting to see a heart beat, we saw a 6 week fetus and no heart beat, I realized the Low AMH meant something.   I had a D&C 3 weeks ago.

 We saw our fertility doctor.  She wanted initially to start IUI, but when we told her our dream is to have 3 kids, she said IUI would not be appropriate as I will have no eggs left after 1 pregnancy.  So our plan is 3 egg retrievals back to back to back and then FET in the fall.  She will freeze on day 2 and we will do PGS all at once after the 3rd batch.  We are pretty devastated that this is going to be our journey with no guarantee I will have any good eggs left.  She thinks not only is my quantity not good, but quality as well.  But we are committed to having our children and want to see what we can do to increase both my quality and quantity before resorting to donor eggs.

Ive been getting fertility acupuncture biweekly which I how I think I was able to get pregnant the previous 2 times, but probably both were chromosomally bad.  I am starting twice a week acupuncture this week to prepare for what is to come.  I also get Reiki and Healing Touch regularly (I also do both these techniques in my private practice), I do yoga regularly and meditate.  And Im an ICU nurse.  

Supplements:  Coq10 600mg/day, Vit C 1000mg, Royal Jelly 500mg, Prenatals, Methylcobolamin 2500mcg, Minerals (selenium, zinc, mag, etc), Probiotics, glutathione 500mg, Vit D 5000mcg, chlorella .

Any advice, support, or recommendations are welcome.  Wishing you all baby dust and success with your treatments!
37 year old (will be 38 on May 31 2019) .   DH 39.  Sperm looks great.

Me:  ****TW loss mentioned***
MTHFR Homozygous 677TT (dx 2016)
hypothyroid

8/2018           Off birth control
11/29/2018    CP
3/8/2019        Saw fertility doctor, AFC 5, labs drawn
3/14/2019      Pregnant
4/18/2019      9 week ultrasound  MM , stopped growing at 6 weeks, no HB
5/2/2019       Return to fertility doctor, labs show AMH 0.27. 1st of 3 Egg retrievals planned tentatively for July
6/29/2019     started Antagonist Protocol 
7/12/2019     First egg retrieval, only retrieved one egg and fell apart immediately, poor quality.
8/7/2019.      Second cycle (follicular antagonist) canceled on day 5 of stims when a very large lead follicle grew out of nowhere.

Re: Newbie, critically Low AMH, ***TW loss mentioned***

  • Not sure if you are still checking this or are getting support from the month threads (they are awesome!) but I went through something similar so I thought I should chime in. I was 38 when I started IVF. Like you, I wanted to have more than one child so I decided to bank embryos instead of going for another retrieval at 41. My RE told us to bank two embryos for every child we want to have. I saw that your RE is freezing the embryos on day 2. Is she doing biopsy of the embryos on day 2 for testing before freezing? I’m a bit surprised as these days PGS is done on day 5 or 6 blastocyst. Typically they biopsy a few cells (~5) from the blastocyst to ship out for testing, and the blast is then frozen until ready to be used (if normal) or discarded. Using the earlier embryo (like day 3) for testing limits the number of cells that can be biopsied as there are fewer cells at that stage and that can result in inaccurate or inconclusive test results, I think. 
    Me: 41  DH: 46
    Unexplained infertility/AMA, polycystic ovaries, insulin resistance
    FET#1(July 2017): eSET of first of 4 PGS-normal embryos, DS born 3/30/2018
    FET#2(Oct/Nov 2019): eSET  
  • Yes, this is my current dilemma.  She wants to freeze on day 2 zygote stage, then thaw the first 2 retrievals during the 3rd retrieval and grow them all to blast together and send off for pgs testing on day 5.  I got in contact with an embryologist who said that is too many freezing steps and could put embryos at risk.  And I called one of the companies my RE uses for PGS testing and they said they would charge one price for PGS testing when doing multiple retrievals if done within 9 months of each other.  I have another consultation with her on Thursday just to discuss this one topic before I get my cycle and schedule next Thursday.  Also, in my opinion, I think its better to let each retrieval grow to day 5 blast because if there is an issue with quality, maybe she needs to change my protocol up...if she freezes at day 2, I won't know till the end of the 3rd retrieval if something should have been changed.  I think she is unaware of the PGS testing policies of this company.  OR the other company they used may have changed their policy which is creating confusing.  We are trying to only pay for one PGS testing price of 4500 rather than 3 times that amount.  
    37 year old (will be 38 on May 31 2019) .   DH 39.  Sperm looks great.

    Me:  ****TW loss mentioned***
    MTHFR Homozygous 677TT (dx 2016)
    hypothyroid

    8/2018           Off birth control
    11/29/2018    CP
    3/8/2019        Saw fertility doctor, AFC 5, labs drawn
    3/14/2019      Pregnant
    4/18/2019      9 week ultrasound  MM , stopped growing at 6 weeks, no HB
    5/2/2019       Return to fertility doctor, labs show AMH 0.27. 1st of 3 Egg retrievals planned tentatively for July
    6/29/2019     started Antagonist Protocol 
    7/12/2019     First egg retrieval, only retrieved one egg and fell apart immediately, poor quality.
    8/7/2019.      Second cycle (follicular antagonist) canceled on day 5 of stims when a very large lead follicle grew out of nowhere.

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  • I’m no expert but I agree with the embryologist that repeat freeze thawing should be avoided. The freezing technique has vastly improved in recent years but it is still traumatic to the embryos and some may not survive. The pgs company my RE uses charges a lump sum for the first six embryos and a per embryo fee for any embryos in excess of that. The embryos didn’t need to be tested at the same time. For us, we sent out five embryos for testing from retrieval #2, they all came back abnormal, did another retrieval and sent 7 more embryos for testing. We ended up paying for the initial package plus six additional embryos. The clinic charged us with a fee each time we asked them to biopsy the embryos (twice, for retrieval #2 and #3). 

    One thing I learned from this journey is that you need to be your own advocate. If you have any questions, don’t hesitate to ask, there’s a lot at stake (and money too)! 
    Me: 41  DH: 46
    Unexplained infertility/AMA, polycystic ovaries, insulin resistance
    FET#1(July 2017): eSET of first of 4 PGS-normal embryos, DS born 3/30/2018
    FET#2(Oct/Nov 2019): eSET  
  • Thanks guys!  There was all types of confusion and miscommunication between the nurses, doctors and financial team.  I actually went back in today to have a consultation with the doctor to clarify and we are NOT doing zygote banking.  We are going ahead with growing to day 5 blast and biopsy and PGS testing with each retrieval.  It will be more expensive overall due to the cost of the biopsy with each cycle...but it will only be once price for the PGS of first 10 embryos.  But at this point, its so darn expensive overall, whats a $5000 more dollars.  But id rather know with each retrieval how many normal embryos we have rather than banking...plus if we get lucky and get a few good quality embryos in the first 2 rounds, there won't be a reason for round 3.  Feeling hopeful and optimistic!  
    37 year old (will be 38 on May 31 2019) .   DH 39.  Sperm looks great.

    Me:  ****TW loss mentioned***
    MTHFR Homozygous 677TT (dx 2016)
    hypothyroid

    8/2018           Off birth control
    11/29/2018    CP
    3/8/2019        Saw fertility doctor, AFC 5, labs drawn
    3/14/2019      Pregnant
    4/18/2019      9 week ultrasound  MM , stopped growing at 6 weeks, no HB
    5/2/2019       Return to fertility doctor, labs show AMH 0.27. 1st of 3 Egg retrievals planned tentatively for July
    6/29/2019     started Antagonist Protocol 
    7/12/2019     First egg retrieval, only retrieved one egg and fell apart immediately, poor quality.
    8/7/2019.      Second cycle (follicular antagonist) canceled on day 5 of stims when a very large lead follicle grew out of nowhere.

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