# Having a crisis



## mrs_ss30 (Dec 4, 2012)

Hi all.

Politeness tells me I should apologise in advance for this pity post but I really need to get it out.  I'm struggling so much at the moment.  It's just one knock back after another.  

I have just found out that I have low AMH levels - 5.0.  I found this out by chance at our IVF referral appointment.  I had the blood test last summer and was told my result was normal (no figure given), however at the appointment I saw the number written on the form and asked what that meant.  The nurse matter of factly said it was low and I felt absolutely winded.  I felt physically sick and started to cry.  Nothing the nurse or my husband said could console me and I felt frightened.  I knew that this meant my egg reserve was low and that nothing I do will change this.  I also felt gutted that I had been misinformed previously and angry that I've wasted so much time and effort on clomid and IUI when my reserves are running out.  

This may sound really silly or an over-reaction but I feel so upset about this.  Even though I have never been pregnant once in over 3 years of trying I have never 'felt' infertile before - I have always viewed my issues as problems waiting to be found and solved.  But this, low egg reserves, has made me feel infertile and I feel such a failure.  I'm devastated as I have no control over it and it can't be fixed.  Being fit and healthy as I am makes absolutely no difference and I feel cheated.  Friends of mine who are very unhealthy and unfit have all got pregnant.  

I don't know how to move past this.  I am panicking and worrying about the future and particularly whether my amh levels have dropped any lower.  I don't fully understand the impact this will have on me.  One resounding message that keeps coming up is that it is likely to affect how well I respond to the drugs, but with both clomid and injections I over responded and I had to be given baby doses (the lowest levels every other day rather than every day) and reached the point of ovulation quite early in my cycle.  This seems to conflict with what I believe low amh levels to mean so I am completely confused.

I hope this all makes sense and I'm not rambling.  Can any ladies educate me a little more about amh and what I can expect when we go to IVF?  I would really appreciate any feedback xx


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## Tincancat (Mar 19, 2012)

http://myselfishgenes.blogspot.de/2012/08/amh-paradox.html
Hi Mrs Ss
Try the above link.
I too wasted 18 months when the clinic never did AMH. No apologises for wasted time and money on IUI. Now is the time yo educate yourself about what you do next.
Good luck
TC x


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## goldbunny (Mar 26, 2012)

it's all relative and depends how old you are - if an 18 yr old is told they have low amh that's worse news than if a 39 yr old is told the same.... it naturally drops with age so age is a big factor in how you react to the news.

amh is a guide but not the whole story. a pregnancy requires one good egg.

my amh was 4.54 on my second cycle and i presume lower on my third though i don't know how low..

with a lot of luck and prayers my baby will be here in 10-12 weeks time... i was very lucky in that i had a good response to very high drug levels...i feel blessed to have got this far...

don't think 'panic' when you hear 'low amh' think 'good, i know about it now so i am able to take action'. it's really more of a problem if you don't know you have it. knowing the situation means you can get treatment and hopefully some frosties or a pregnancy x good luck.


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## Bumble Bus (Apr 23, 2013)

Hi Mrs SS,

My AMH level last summer was 4.5 when I just turned 31 so far from ideal. I was pretty upset at the time as we'd already had to deal with the news that my DH has no sperm and accepted that we'd use donor sperm. So it felt 'unfair' that we now had this to contend with too. However, as we all know, nothing in this game is 'fair'. The glass-half-full way of me looking at my situation, was that I have eggs! And eggs make babies!

Have a look on the low AMH area. There's tons of examples of women with babies with very low AMH. And also tips on things such as vitamins to give yourself a head start. http://www.fertilityfriends.co.uk/forum/index.php?board=535.0

My personal experience with 2 cycles of ivf is that I've needed big doses of stims, but my eggs have made embryos both times. So on my optimistic days I think, if I am making embryos this will happen at some point, and to a large extent don't think about the AMH.

You are not a failure. Any more than I am, or my DH is, or someone without tubes or with high NK cells, or whatever. 

Sorry I cannot help on why you've only needed low doses of the drugs you've taken so far. Are you able to get back in touch with your clinic to understand this better?

Good luck x


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## coucou2009 (Sep 12, 2012)

Hi Mrs SS,
I am no expert but your AMH is one part of the picture. There are other factors to look for like FSH and how well you respond to drugs. The fact that you respond well to the drugs is a good thing. It means you can get stimulated and produce follicles. I also ovulated very early and had only learned this once we did the stimulated cycles. You might need to go to IVF because you will do the birth control pills which will shut down your system so to speak, you will get the nasal spray to prevent early ovulation and once they take the follicles out, they will be able to see the quality. In the end you need one good egg to get a baby. I also never was on big dosages of drugs. Don`t fixate on that number. I think it is more for the doctor as one part of the picture.

Good luck


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## mrs_ss30 (Dec 4, 2012)

Thank you ladies for your kind words and support.  I know I need to hold onto the positives but that isn't my strong point! I guess I wasn't expecting that news at 31. 

Congratulations goldbunny, I hope your pregnancy is going smoothly.  I hope to be in your position one day!  

xx


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## lollipops (Oct 17, 2009)

I understand that crushing feeling of being told your AMH is low. 


Big hugs to you. 


But remember AMH is not the be & end all in the fertility world. Your still young, so yes you might not produce many eggs during treatment but the quality of the eggs you do produce should be good   


I've never produced more than 4 healthy eggs. For my age that's extremely low.....
However the quality has always been relatively good. 


There's always ICSI to consider too, my old clinic used ICSI on low AMH couples to try and increase the fertilization rates. 


Also your embryos don't have to be perfect to make a baby.


My last cycle I only had 2 fertilized embryos . Both of which weren't the greatest quality, and both fragmented ....one of them is my daughter. 


So please try not to get too hung up over your AMH. There are lots of factors that contribute to an embryo that brings you a baby.


Good luck on your journey x


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## mrs_ss30 (Dec 4, 2012)

Hi lollipops, thanks for your response.  Hearing your success story and reading your signature gives me hope.  May I ask what your AMH level is/was?  

I also see that you achieved your pregnancy with Nurture...that's where I am going for IVF very soon.  I appreciate reading that as that has made me feel very positive!  Thanks again xx


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## lollipops (Oct 17, 2009)

Hiya. 


I would really recommend Nuture. I know lots of ladies who have had success with them  previous to Nuture I was at Care Nottingham and I personally would choose Nuture over them hands down & not just because I got pregnant with them but because I found the personal level of care excellent. 


My AMH was 4 so very low. I have never retrieved more than 4 eggs on collection and I've produced very few follicles during treatment too. 
I suspect Nuture will put you on a very high volume of drugs to try and ensure they get at least 2 decent sized follicles for collection. It really can depend on how your body responds to the drugs though, I know lots of low AMH ladies who have been surprised and produced 8 or more eggs which for a low AMH is a great.
You just can never really tell. 




I wish you lots of luck on your journey and hope you reach your dreams xx


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## mrs_ss30 (Dec 4, 2012)

Yes, my husband and I decided to go with Nurture after attending open evenings for both Nurture and Care.  I think it says a lot that I came away from Care feeling low and negative about IVF but came away from Nurture feeling really positive.  It seemed to me that Care were very much a business and they kept referring to cost and what would happen if IVF failed.  I didn't like that attitude at all - I want them to be interested in making it work the first time (dare to dream)!  Nurture however seemed far more friendly and approachable so it was an easy choice really.  

Thanks for letting me know your levels.  I am not sure what it will mean for me in terms of drugs as, as I have already mentioned, I over-respond to very small doses!  I am not sure though if this will still be the case after down regging.  Time will tell I suppose.  I'll be sure to discuss this with them at my first appointment.  

xx


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## Susieque44 (Jun 14, 2011)

Hi Mrs_ss30

My levels have always been very low, started IVF at 22 and have watched them drop over the last 15 years. I have never produced more than 6 eggs. However l wanted to write this as over the years i have seen so many different scenarios. Ladies on here have had one egg and fallen pregnant. On my last IVF l only produced 4 eggs, needless to say l was upset. The quality was not the best and on day 3 we only had two eggs left one seven cell and one 4 cell, (on day three they should be around 8 cells) we are pregnant with twins !!! So IVF is so much more than the number of eggs you produce and it really does only take one little egg. 

Good luck for your journey xxxxx


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## Froggy82 (Nov 8, 2012)

Hi Mrs_ss30,

AMH is only part of the picture. You will get a better idea where you stand after an IVF cycle. Try to find a clinic that is not set in its ways as to what drugs they use (mine said they would not use anything else than menopur, which is know to sometimes fry the eggs at high doses).

A lot of women still manage to get pregnant with low AMH.

My case is not so positive: when I learnt that my AMH was 3.9, I was told that it was a matter of quality not quantity and that it could still work. But both turn out terrible and we didn't even reach fertilisation. My clinic gave me 0% chance of success given the AMH+this failure. I went abroad for a second consult and was given a "less than 10% chance" and the doctor there advised us (like the one in the UK) to go straight to egg donor.

Whatever happens, there are always solutions (e.g. donation, embryo donation, double gamete donation, surrogacy…). I would say try to take one step at a time, get through one cycle, and then, should it not work, get a couple of medical opinions.

I also wanted to say how sorry and enraged I am to hear what happened to you with your AMH test results. Some people should really get sued for their terrible mistakes and total lack of apologies or empathy.

Sending you lots of baby dust


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## lollipops (Oct 17, 2009)

Mrs SS - 30.

I totally agree with you on Nuture vs Care. And having being treated at both , I can happily say you have made the best choice. 

Care is very much a corporate machine. Waiting times and appointments are often delayed. A simple scan can take a whole morning as they have far too many couples cycling at the same time. It often felt like a cattle market in there, literally one in and one out ! 

They were very negative towards me after the second treatment failed. And after the 3rd attempt I knew that should we try again it wouldn't be with Care.
]Nuture was a breath of fresh air, and yes ok it's a nightmare for parking at the queens med, and the layout of the clinic is strange & it's no where near as ' modern and new' as Care is, but all of that really pales into significance as the consultants and nurses really do their best to keep you well informed and at ease. 

I hope they find a drug regime that suits your body. Maybe short protocol ? Keep an open mind and I do hope you get a positive outcome from your cycle with Nuture xx


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## mrs_ss30 (Dec 4, 2012)

Hi All

Thanks for all your replies!

Susieque - Thanks for sharing your story.  Congratulations to you on your twins!!  I am in awe of women who have persevered with their journey for years.  I have the utmost respect for you as I've only been going through this for 3 years and that's been hard enough.  Personally, the only way I can keep sane is knowing that one way or another this journey will have an end, as my husband and I have agreed on 3 IVF attempts maximum.  After that, we are going to have to draw a line under this whole saga and move on   

Froggy82 - I'm sorry to hear that there is not a positive story for you to tell yet, but I think you're incredibly brave for going down the donor egg route.  My husband and I decided quite early on that for us it's 50% me, 50% him or not at all because I don't think we could handle anything else.  I have a lot of respect for the ladies who do choose donor eggs, adoption, surrogacy etc.  I hope you don't mind me asking but did anyone give you any answers as to why both the reserve and the quality were affected?  Or did they (frustratingly!) just put it down to 'one of those things?'.

Thanks very much for your support - I too am livid that time has been wasted and I wasn't fully informed.  If we'd have known earlier we might have made different choices, but even if we didn't, at least we would have gone into with our eyes wide open.  

It's also useful to know that about Menopur - that's something I will raise with Nurture if necessary!  Thanks.

Lollipops - I'm sorry that you had to go through that during an already stressful time.  You've just confirmed we've made the right decision.  It infuriates me that Care can treat people like that and get away with it.  I am sure there are women who have had success with Care and rate it's service but the snap shot I had of them in that open evening did not sit well with me.  At least you moved when you did and achieved your dream, that's really all that matters!

xx


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## Susieque44 (Jun 14, 2011)

Hi Mrs_ss30

Meant to say on my last reply but before l went ahead with our last attempt l had six months of CoQ10 & Royal Jelly. Im not sure if that had anything to do with improving my egg quality or whether the quality was never really an issue just my womb issues. However it worked and l would defo recommend it. Ive tried everything over the years and this was the only thing for me that helped my eggs grow. But lots of ladies on here have some really good advice about preparing your body, diet etc.....

Another thing l read the other day ......... the greatest sadness in this world was caused by people thinking they were at the end of their story when in fact they were only half way through.

Lots of love and good luck xxxxx


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## Froggy82 (Nov 8, 2012)

Hi Mrs_ss30,

The UK clinic didn't bother investigating my low AMH or giving any sort of explanation. The doctor in Spain just said: either you were born with a low reserve or your reserve deteriorated much faster than "normal". Either way, the vibe I got was "there's not point on dwelling on it, it is what it is, look at the statistics and decide what you want to do".

Also I forgot to say (but you've probably read about it) that DHEA may help with the quality of eggs. When I was considering cycling again with OE, the consultant mentioned I would need to take it for at least 6 weeks before starting another IVF cycle. He also recommended 25mg 3 times a day if I remember correctly. This is just for info, you should probably talk to your clinic before taking it, as it is a steroid hormone, not a simple supplemented as it is marketed.

Oh, and my acupuncturist recommended royal jelly.

I hope things work out for you!!


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## mrs_ss30 (Dec 4, 2012)

Hey.  I thought about taking Royal Jelly, however this is a list of what I am currently taking:-

Levothyroxine (thyroid meds)
Prenatal multivitamin (inc folic acid)
Cod liver oil tablets (my acupuncturist recommended this)
Co-Enzyme Q10 (130mg tablet daily)
Maca (for endocrine issues) - every 2/3 days

If I am given a prescription for my high prolactin levels at my appointment on Thursday I will also be taking those.  That all seems like quite a lot and I don't really want to take anything else.  I'm sure if I take any more I'll start to rattle!!

I have only just started taking the Q10 and Maca and hope to start IVF within the next 4-6 weeks. I know that it takes 3 months for anything to impact on egg quality but I never thought this might be a problem until I found out about my AMH level.  I do have a healthy diet so I have to hope that I got enough Q10 naturally from that.

I am worried about the effect all of these pills are having on my body though, particularly whether the vitamins are affecting my thyroid medication and how they are all interacting with each other.  I do try to spread them out throughout the day though so I am not taking everything all in one go.  Did you ladies take anything else, and did it help? xx


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## Bumble Bus (Apr 23, 2013)

Mrs SS,

We are not supposed to take cod liver oil when TTC as it contains vitamin A which we are meant to avoid (same reason we shouldn't take a 'general' multivitamin, but a conception one instead - you will notice your prenatal vitamin doesn't contain vitamin A).

see the box 'if you are pregnant' on the link -

http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-A.aspx

I am surprised your acupuncturist is recommending cod liver oil to her TTC ladies. Omega 3 is a force for good, but there are plenty of tablets available not from fish liver sources (which is the issue).

xx

/links


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## mrs_ss30 (Dec 4, 2012)

Hi Bumble Bus

Apologies, it is Omega 3 I'm taking, not Cod Liver!  Phew, I got all panicked there for a moment until I ran upstairs and checked.  I did think that was weird as the tablet I'm taking was a Sanatogen vitamin that came as a double pack with the prenatal vitamin!!!  

Thanks for checking that though as the last thing I want to do is take something that hinders rather than helps!! xx


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## mrs_ss30 (Dec 4, 2012)

And omega 3 is what my acupuncturist recommended!! X


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