# My options - high AMH reading



## Jowo (Nov 22, 2012)

I'm 43 and had a pelvic scan and AMH test expecting them to confirm that my options would probably be egg donation, surrogacy or adoption.

I think I had around 7 follicles but had an AMH reading that was off the chart for my age , a reading of 34.9, which I've now found out through internet research that it may mean I have PCOS. I do have regular periods and the nurse did not mention anything about cysts, nor abnormal size ovaries, nor raise the issue of PCOS at all. I have a thread on the PCOS forum to find out more on that and will visit my GP and go back to the clinic to speak to the consultants.

The clinic is suggesting that I am a candidate for IUI and then IVF which was not what I was expecting so I am still processing this. Of course, I still appreciate that I have no more than around a 10% chance of a live birth due to the quality of my eggs, uterus, plus if I do have PCOS then I will have even higher risks (hypertension, preeclampsia,etc). However, this is just speculation until/if I get a diagnosis.

I just wonder if there are any women on this forum of my age who had high AMH readings with or without a diagnosis of PCOS and share with me what this could mean for me, or any thoughts on the matter. thanks


----------



## PixieX (Oct 22, 2012)

Hi Jowo 

Im 41 and may be in a similar situation although not down to AMH reading - down to the egg reserve hormone test which they said would like to see around 20-30 but came out at 4 :-(

My scan showed nothing unusual either.  I don't have PCOS but I did have a small cyst which they found negligable.  Each ovary had 6/7 little black specs of developing folicles and there were no cycsts etc.  But Im going to be on a very high dose of stimulation drugs to try and maximise the growth potential.

I found out the info out this morning and its really hit me hard.  I know the chances of getting a "good harvest" is small and that the quality of the eggs may not be great ... seeing it as just a few more, extra high hurdles that we have to get over, but we do think its worth the try.  They are not recommending egg donation for me at this first stage, whether or not this might change in the future, Im not sure but nothing has ever been suggested.  So we're going for it and hoping, praying and begging for a miracle ovulation round.  

Im starting this evening with my stimulation - taking injections of merional at 450 (3x150 viles) Im expecting to wake up deformed with rugby sized ovaries protruding from my hips ... a girl can hope!

Wishing you sacks and sacks of luck 

P
x


----------



## jo_11 (Apr 1, 2009)

Jowo:  I don't have PCOS but have been around these boards long enough to know a little about this... at your age, personally I don't see the point of IUI (sorry); you may as well just have sex!  Hopefully your OH is all OK on the sperm front (you don't say).  If you're doing IVF you 'may' need a very small dose of stim meds, although I would strongly suggest you ask your clinic to test this out on you with a few injections and taking blood results, so that they get this right.  Ladies who do have PCOS generally need to take Metformin, so you may want to look this up.  You would need to be DRed though I believe, and there are some clinics who trigger with a DR drug instead of HCG - it may be something you want to ask them about.  I hope your clinic look after you well, good luck!


----------



## Jowo (Nov 22, 2012)

Thanks for the info.

I'm afraid as a novice some of the acronyms are beyond me - please can you tell me what a DR is? thanks


----------



## jo_11 (Apr 1, 2009)

DR = down regulation, effectively it's an agonist which switches your hormones off.


----------



## Mish3434 (Dec 14, 2004)

Hi Jowo,

here is a link to the list of abbreviations

http://www.fertilityfriends.co.uk/forum/index.php?topic=190482.msg2945198#msg2945198

Good luck on your journey xx


----------



## Jowo (Nov 22, 2012)

Do local GP surgeries offer routine Day 3 blood tests for FSH, Lh, oestrodial and prolactin, for example, or this more commonly offered by fertility clinics?


----------



## jo_11 (Apr 1, 2009)

Yes, your GP should provide these for you; suggest you pop along and have a chat with them.  At my GP's you need the forms ahead of time, you can't just walk in.  You have to pay at a fertility clinic, although it's less hassle (when compared to my GP's anyway!).


----------



## Jowo (Nov 22, 2012)

jo_11 said:


> Yes, your GP should provide these for you; suggest you pop along and have a chat with them. At my GP's you need the forms ahead of time, you can't just walk in. You have to pay at a fertility clinic, although it's less hassle (when compared to my GP's anyway!).


But out of curiosity, are these tests provided by the NHS via GPs directly or do they then refer onto outpatient NHS fertility departments first? Did anyone here get them sorted quite quickly as my poor experiences of non-fertility related matters on the NHS made me think it would be slow and inefficient to get them arranged and receive the results on a timely basis so I arranged them privately.

Has anybody here had their local GPs do pre-treatment tests for rubella immunity, chlyamidia, syphilis, full blood count, HIV, Hep B &C? If so, I assume it's because you are going through NHS related fertility treatments/diagnostics without any private care/treatment?

I had my TV scan, plus AMH, LH, Prolactin, etc, at private clinics. I wasn't aware of NHS rules in Scotland or perhaps my area that forbid the mixing of private/NHS treatment so I've just been rejected by my local GP practice for the latter blood and immunisation related tests I listed.

The GP surgery seemed to think these private clinics had advised me to request them with my GP, based on the document they gave me where they list this as an issue they are addressing with NHS and non-NHS fertility clinics whereas I was just ignorant of the rules and I requested them from my own initiative.

It says things like "Unfortunately tests such as AMH tests and most infertility tests are NOT routinely available in NHS general practice...A patient cannot be both a private and an NHS patient for the treatment that is being provided by the private sector. GPs and the NHS in general are unable to offer a free of charge service to private patients in this circumstance....These should be carried out by the hospital clinic and will not be done by the practice...This [routine bloods, viral serology..courses of immunisations] is unfunded work and is not included in practices Global Sum"

I've never had private medical treatment/tests before so I wasn't aware that it would prevent me from having further tests on the NHS, that when I thought I was saving the NHS some money by paying for upfront tests myself to see if I was a candidate for future fertility treatment, I would end up doubling my outlay because I cannot now access other fertility related pre-treatments/tests.


----------



## Dudders (Jun 18, 2012)

Oh how frustrating Jowo.

Since I first saw my gp it has been very much a mix and match of private and nhs testing and ops.  That said, I am aware that we are lucky because many other people aren't as fortunate, and some areas do have policies which will exclude you from further treatment if you have any private tests - we see it as saving them money, they see it as queue jumping!  I believe it can be very much luck of the draw, and a lot of gps won't help with screening tests, although there a number of sympathetic ones out there.

Is there another doctor at the practice that you can see to discuss it further?

Good luck x


----------



## Jowo (Nov 22, 2012)

Dudders said:


> Is there another doctor at the practice that you can see to discuss it further?
> 
> Good luck x


No, I'm happy to follow the rules now that I know them and to be honest, I hadn't considered the 'queue jumping' interpretation, either, so that makes sense, also. These are rules for the city as far as I know. I guess it's making me understand a bit more about 'postcode lottery' aspects of healthcare.

I didn't want IVF treatment on the NHS and wrongly viewed those tests as quite routine ones performed by GPs so now I know better that they are out of scope, and that's fine. Our local NHS hospital has very much lower success rates than local private fertility clinics.

I haven't had much experience of NHS services or private medical services as I've rarely had any illnesses and no operations before but now I'm getting wiser about their pros, cons and differences now that I've had two efficient visits to private clinics now and two frustrating NHS visits to the GP and local hospital in the recent past.


----------

