# Anyone heard of either having a low AMH and a normal FSH or an AMH doubling?!



## Attagirl

Hi

Interestingly I just had my amh retested and got a result of 8.12pmol, almost double the previous result (4.36). Has anyone heard of amh changing? I thought the whole point of it was that it was stable but declining.

Also does anyone know of anyone who has a low AMH but a normal FSH? I have been trying to look into this and see how people like me fair with fertility treatment but have been unable to find anyone to compare myself to. My treatment is to be determined so am doing the research.

Thanks


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## harden77

Hi Attagirl

I cant really comment on the AMH test but in relation to your second query I have normal FSH think was 5.9 however I had low AMH 5.6.

Our treatment went really well - as you can see from my sign off we got 10 eggs each time and whilst we havent got that elusive BFP yet we do have 6 snow babies.

Hope this helps & good luck xx


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## Attagirl

Thanks Harden77, that does sound positive. Good luck with the latest round of your treatment!


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## joycep

Hi Attagirl, just doing some research in to this myself. I have just had an AMH result of 3.5...it was 17 18 months ago. My FSH was 6.5 so that seemed ok. Did you find out anything more??


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## Attagirl

Hi Joycep

Re the change in my AMH, my doc said he has come across different readings between different labs of increments of 1 but not 4 (my doubling was from a first reading of 4.39 to 8.12). Without doing a third test, which I am reluctant to pay for right now, I guess I dont know which result is more accurate.

Re having a low AMH and a normal FSH, I have now spoken to four consultants about it and the majority emphasise the newness of the AMH test, the fact that you just dont know what AMH  "normal" people have as they dont get tested and that if your FSH is normal you are unlikely to be menopausal. In short AMH readings should be taken as guidance only and in particular are useful to predict how much IVF medication will required to harvest as many eggs as possible, if you end up going down that route. Additionally egg quality is equally important as you only need one egg....

What were you told? I think our low AMH/ normal FSH readings are unusual so it would be good to compare the advice I have received with what you have heard. Thanks

Attagirl


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## joycep

Hi Attagirl - thanks for getting back to me. That's interesting but also quite comforting to hear. I have been a bit distressed about it as i cannot understand how mine has gone down so quickly. I only have info on what my consultant told me yesterday which is not as helpful as your post. She said some people will place a lot of emphasis on amh and others don't at all. She used 3 things, fsh, amh and antral follicle count to assess my situation. AFC was 12 so that's not great but above the 7 they look for and fsh of 6.5. So the amh level doesn't tie in with those 2 things. She has no answer apart from "when you have been dealing with fertility as long as I have , you realise there is a lot about fertility we don't understand". !! 
I noticed a girl who had replied to a previous post of mine awhile ago had an amh level of 2.8 and then on another test it had leapt to 11....so it sounds like it can be unreliable.

It's a bit of a minefield isn't it? One number can frighten the life out of you. I am going to have a lap and start ivf around Xmas time I think.


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## Attagirl

Hi Joycep

Thanks for your response. I totally understand the anguish that the results cause. I have gone from a paralysing fear that I wont have another child to complete denial! I just feel like it can't be true! 

We are considering treatment options now. Can I ask why you have chosen to go for IVF rather than IUI? Other than the low AMH I have no other known fertility problems so on the one hand IVF feels a little drastic, but on the other hand I dont know how much time I have and IVF is obviously more successful than IUI.

By way of context my AFC was 17, my FSH was 3.6 on first test and 7 on second.

Thanks

T.


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## joycep

Hi Attagirl, your AFC is amazing and so really doesn't tie in with your amh result. How bizarre. I am doing the exact same thing, total fear to pretending I haven't heard the result. 

I have done IuI already and I just feel there is a deeper problem going on with me like immune problems or something. The decline in fertility can't be the only reason. I don't have a child yet and when I miscarried 2 years ago I had an AFC of 20. So my count has declined very quickly. I fear I don't have much time now and this sudden urgency has come about from the latest results. My consultant basically said we shouldn't hang around now. If my figures were more like yours I would be inclined to wait before doing ivf. How long have you been trying?

It's horrible isn't it- I am glad we have the options now but ignorance is also bliss!


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## Attagirl

Hi Joycep

Science is definitely a mixed blessing. Completely understand the need and desire to move quickly. Also it is good to know that you are doing everything you possibly can. Have any homeopathic remedies been recommended to you? I started taking Coq10, dhea and royal jelly all of which are natural remdies which can apparently assist cell production and therefore egg quality. They apparently can do no harm so it seemed like a no brainer. I have also been having acupuncture which I think has made a difference to how I feel in myself. If you down the IVF route it can apparently massively enhance your chances, so I would definitely recommend it (from a fertility acupuncturist).

We have been trying for 7 months. I am chronically impatient though and I also had a sixth sense that something was wrong so I wanted to go ahead with the tests sooner than many people might (they were also covered by my insurer which didnt hurt!!). I just didnt feel quite right after the birth of my daughter who is now 20 months old. Now that I have the results I really feel like I need to get a move on. I can't help thinking that the majority of people wait at least a year to have tests because the NHS promotes waiting as it can't afford to cover tests earlier...

Anyway my consultant is on hols at the moment but I think we will push forward with IUI next month...just tempted by the higher success rates of IVF!

I have a friend who kept on having miscarriages after her first pregnancy and they couldnt find anything wrong. The doc she finally saw ended up guessing what was wrong (something immune related) and treating her with steriods the entire pregnancy and she gave birth to a healthy little boy, so if it is an immune thing, there are routes to take. Where are you based? The guy she saw worked in Harpenden and Hitchin ie Herts-ish.

Good luck!!!!! When will the IVF start?

T


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## joycep

Hi Attagirl, sorry for the delay. I had a bit of an Olympic weekend {watching not taking part of course!}. I haven’t had any homeopathic remedies. I do have acupuncture though. DHEA is an interesting one as I keep seeing htis mentioned. Isn’t this for people with low AMH or bordering on the menopause?
 
I totally understand about the impatience. I have had to reign it in now, as after 2 years I have to resign myself to it not happening naturally. However, I was getting tests done just 4 months after my miscarriage because like you I felt something was wrong. I do believe we know our bodies better than anyone. The tests at that stage all came back pretty much normal. I had people keep telling me to relax and it will happen and I thought that perhaps I was getting in a panic over nothing. It’s difficult because you don’t want to jump in to anything too early but now having got my latest AMH result, I wish I pursued a few more things earlier.
 
I’m pretty convinced I have immune issues. I rarely get ill and I have  the odd month where I feel like something is going on. AF arrived today but it was my longest cycle in 2 years and I had extraordinary period pains on Friday which I just never get especially not before AF arrives. It honestly felt like my body went in to meltdown and I killed off whatever was going on. It’s very strange.
 
Do you feel like you have something else going on ? I don’t think your AMH level will be the issue.
 
I am based in London and I think I will be going to the ARGC where they do all the immune testing. Where are you based? I was actually booked in 2 weeks ago but I chickened out and thought it best to wait to see what my nhs doc was going to say. So my plan is to have this laparoscopy and just check nothing sinister is going on inside and I think I will kick off all the immune testing. It’s such a rollercoaster...having had clockwork cycles , to quickly getting pregnant to miscarriage to infertility to diminished ovarian reserve and all in 2 years, it’s all incredibly emotional. But I know worse happens to a lot of people so I have to remember that.


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## Attagirl

Hi Joycep

Hmm the immune theory is an interesting one, but from what little I have read about it I thought (and I could very well be wrong) that if your body rejected a pregnancy it was more likely to occur slightly later ie post implantation so you could still get a positive pregnancy test a result of the fertilisation of the egg...

Whilst I would totally be doing the same as you in terms of having the tests and the treatment asap, it is still possible that it is just bad luck that you haven't had a postive outcome yet. The more you focus on this (and I am not telling you not to as I always think it's ridiculous that people tell you not to think about it all - as if you can switch it off) the more you may be increasing the stress hormones...

I think I may have actually been a bit depressed for a few months. When I started having regular acupuncture, I felt so different after a couple of weeks I almost felt like I had been put on anti depressants (I never have been but I felt so much lighter). Since then I definitely feel a bit more in sync, on the other hand all of this may just have been a natural defense mechanism as I was wallowing in self pity!!

I am based in north west london. I was at the bridge centre but hated the people so am now travelling up to Harpended but if it goes to actual treatment I'm not sure where I will go. I think I will ask for the Lister as it is relatively convenient and I think they specialise in dealing with people with low amhs. I took a look at the ARGC as well following your email and they have a very helpful website which is clearly a good sign!!

I think you do have to remember that people in impossible positions get pregnant and have some faith that it will happen to you...incredibly difficult I know!

Re the dhea, I discussed it with my latest consultant and he had heard of it  - it has appaently been used for about 10 years predominantly in the states. it has not proven result but he didnt dismiss it and confirmed it did not harm either. It is often taken by people with low amhs or menopausal as it is meant to improve the egg quality of the remaining eggs.

Let me know how your tests/ treatment goes. Wishing you the very best of luck.

Attagirl


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## joycep

HI Attagirl,
 
Well that’s exactly what I thought with immune problems but I have been reliably told that it can affect people in different ways. Some people will have multiple failed pregnancies which don’t get beyond a certain point. Other people could have one pregnancy which triggers the NK cells to go in to overdrive and then from then on no embryo is able to implant. Other people never get pregnant and have multiple failed ivfs and then find out they have immune issues.
 
You are right though, I probably focus on it too much. I think it’s impossible not to. I have had months where i have been quite stressed about it – this month in particular after those results. Luckily I don’t have a stressful job though as I think it would tip me over the edge!
 
I am a regular over on a thread on Mumsnet. Most of us have been trying for our first for over 2 years and one girl said that she thought at some level we were all probably suffering some kind of depression. I think she is right. Most of us have become pretty reclusive – avoiding friends, dreading large groups of people, scared of hospitals, anxiety.  And it doesn’t seem to escape people who are struggling for their 2nd. We all think we will be grateful to have just one child but if that miracle happens, I can imagine feeling the pressure pretty quickly to try for a sibling. It can’t be easy when you see friends having their second with ease. Although my friends are starting to have their 2nd in less time than i have been trying for their first but life is always relative!! It is terribly easy to wallow in self pity but you just cannot underestimate the emotional pressure when you try for a baby and it doesn’t happen. That’s what we are built for and the fear, the guilt, the worry etc etc is palpable.  Anyway my point is, I am glad you have found acupuncture helpful. It’s very important to try and keep balanced and not let all this rule your life. Although I ‘m too far gone for that !!
 
I think the ARGC are suppose to be the best. I will get a round of ivf and a FET on the nhs but something tells me we are just going to have to go for the best now. They believe in the immune testing as well and if they can’t get me pregnant, nowhere will. Eeek. Financially it will ruin us but desperation does seem to take over.  I really really hope you don’t get to the proper treatment stage. You are still well within the bounds of ‘normal’. Many people do take 1-2 years of trying and your body has done it before so I’m absolutely sure it will happen again for you.. And someone on my thread on MN has just got  a natural bfp after 2 years of trying, she has  dodgy tubes, a husband with crap sperm, a short luteal phase and a failed ivf round behind her.
 
Thanks so much for the info on the dhea. It’s very interesting stuff and i may look in to it seriously.
 
Really best of luck!!

Joycep


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## Attagirl

Hi J

I haven't explored Mumsnet yet, might have to venture over. Are you Joycep there too?

Interesting what you said about your job at least not being  a cause of additional stress. I am unfortunately not in that situation. I hate my very stressy job and have been itching to resign for ages but can't because of the potential need to pay for treatment. I am reaching a point though where I think  that if stress is an issue I need to give it a go and just resign. We are lucky enough not to be at breaking point financially with just my hubbie working but his job is less stable than mine. All so difficult and not helped by the fact that I am asked on a DAILY basis when I am going to have another child! Completely illegal but there is nothing I can do and just to make it extra in my face my nanny just announced she is pregnant with supposedly her second unplanned pregnancy (yeah right!!).

Re the amh result, try and remember that it may not be having an effect at all on your fertility now. It just means you need to get a move on (which you are). 

Re dhea and the other supplements I am taking they are all meant to encourage cell production and energy levels in cells... not sure I explained that bit.

Anyway, maybe see you over on Mumsnet!


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## joycep

Hi Atta,
 
I am joycep over on the conception board on MN - \i like continuity! I never would have put myself down as someone who would start chatting to people over the net but i found myself on there looking for support after i had a miscarriage. I have been on the TTC 10+months for about 18months and they have just been a massive support -  in fact quite a few of us ended up meeting in real life.
 
Stress can have a huge effect on conceiving. I have heard several stories of people quitting their job and then getting pregnant. Isn’t it something to do with cortisol levels or something? It’s difficult though if you are thinking you will need to pay for treatment. My husband wants us to go on a lovely holiday to somewhere like the Maldives but I keep saying ‘no, we need the money for treatment’. We spent £10k worryingly easily last year on private treatment like iui and hsgs and so I can see that we will need a big savings account for ivf.  And like you my husband’s job is less stable – he is freelance. I can imagine it is awful being asked when you are going to ahve a second baby...no one should be asking that in a company! People are so nosey as well. Mind you before i had problems, i am sure i asked people when they were going to have kids. People just don’t think sometimes.
 
Right i shall be running off to get some dhea!
 
Have a lovely weekend.

J


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## Attagirl

hi J

I am exactly the same - I would never have anticipated chatting to people online. It is such a support though. The problem is that fertility problems are so longterm I think you end up boring people who are close to you with it as unless they are going through the same they just don't get it. In fact I bore myself sometimes!!

The olympics are proving an excellent distraction to the fact that the end of the month is approaching and part of me thinks I have been having symptoms but the pregnancy tests are negative... I wish my brain had a bit more of a learning curve! I go through this practically every month!

I have set myself a deadline of resigning at the end of september if i am not pregnant. I have a 3 month notice period and would be held ot it so that would get me to the new year...I just have to make sure I dont wimp out of resigning...I have worked in the same place for almost 9 years!

Thanks, I hope you have a great weekend too.


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