# Low FSH but also low Ovarian Reserve - would Clomid help?



## Jo Macmillan (Mar 19, 2007)

Hello there,

I was just wondering whether any of you knowledgeable girls could help me out here.

Although I have always had consistently excellent FSH levels for my age (all below 4) I have very low ovarian reserve which was diagnosed through an AMH test (0.7) and no response to stims on my 1 IVF attempt. 

I know this is quite rare, although I have come across someone else on these boards with the same thing. In my simple little world ( ) I think I have come up with a possible solution: as the body normally produces more and more FSH as the ovaries run out of eggs, to stimulate the follies to pop out more eggs, as in my case this has not happened for whatever reason, surely some kind of drug to stimulate the ovaries (to replace the extra FSH I don't produce) would help to produce an egg, if I have any left. Otherwise I have very little eggs and very little way of getting them out surely?!!

Before I embarrass myself by tactfully presenting my home-spun hypothesis to my GP and requesting Clomid or another drug to stimulate the ovaries, can anyone spot any obvious flaws in my theory? My knowledge is so simple, I'm sure I've missed something obvious and have over-simplified things!

Many thanks,
Jo xxx


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## MistyW (May 6, 2008)

Hi Jo
I really don't know the answer to your question, but I think it's got to be worth a go? Let us know how you get on.  Clomid is a fabulous drug!


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## JW3 (Apr 7, 2008)

Jo,

I don't really know anything about ovarian reserve, but not sure clomid would be suitable as can lead to wasted eggs.  For example I have overstimmed before and produced 3 or more eggs and then I couldn't go ahead with the treatment and those eggies all popped out of the follicle and died.  There was no option to freeze them even though I am having clomid through an IVF clinic.  

I think you would need to speak to your consultant.  I've never heard of it being used for this & maybe there is a good reason for that.

I have no idea why they use different drugs to stimulate the ovaries when going through IVF or IUI but there must be a reason to it all.

Not sure whether I've been helpful, but I know I am concerned (maybe wrongly) that I might use up all my eggs if I keep going with this too long over IVF.


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## bella 64 (Oct 1, 2008)

Hi Jo
Im not to sure i can help, but i have the same AMH as you and the doc has put me on 100mg clomid.

This is my 1st cycle of clomid and today i had my progesterone (day 21) to see if i have ovulated 
The doc has put me on clomid for 6 mths, so im just and staying .
your best to go and have a chat with doc its certainly worth a try.

good luck let us know what happens.

sharon


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## annacameron (Dec 16, 2008)

I understand where you're coming from. I think you're right to try to get more eggs each cycle. (The concept of wasted eggs by the way is rubbish. the body selects a certain number each month and those are lost regardless of whether they mature with stimms or not (normal, except for dominant foll obviosly)) 

Youa re saying that the body normally cinreases FSH and yours isn't doing that. you might be offered Cl as you say from cons (gp cannot) - it redcues E2 which is meant to trigger more FSH. if your fSH mechanism is dodgy and i think it might be, from what you say, I wld be tempted to go for injectables - exogenous gonal f for instance? take eg 75 on alternate days, then trigger with hcg. also, no side effects with GF whereas horrednous ones with Clomid - crazy moods, volatile, all the symptoms of the low E2 it is generating. 

the more i think about it the more i think that GF might be the answer. 
by the way NHS cons are less keen to prescibe as it is dear comapred with Cl. you may have to make your case. 

good luck xx


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## Jo Macmillan (Mar 19, 2007)

hello all - many thanks for your replies.

Anna - I agree with what you're saying - I am concerned about side effects of Clomid. I was on Gonal F during IVF and only produced 1 egg which was immature, but I guess that's all I need to conceive naturally - obviously it was a disaster for IVF.

thanks girlies. x


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## bella 64 (Oct 1, 2008)

Hi Jo

Good luck what ever you decide. Last year i was taking Menopur & pregnal i had the same problem i hardly produced any follicles 
Clomid is the much cheaper option, if it works for you.

Bella


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## annacameron (Dec 16, 2008)

JM, 
for waht it's worth, my foll count is very volatile - ranging from 8,9,10 to 17 consisnetly over the summer. taranissi (argc) prefers cycling over the summer and i beging to think he has a point....


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## Jo Macmillan (Mar 19, 2007)

Hi Anna and Bella,

Thanks for your replies. I'm feeling very down as AF arrived today. I've been fine for the last 18 months so don't know why it got to me today.........I think now I've been on DHEA for 5 months now I was hoping for a miracle.....

So Anna - that's interesting about the summer...you've cheered me up a bit...here's hoping !

Love to you all - and good luck to both of you xxx


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## bella 64 (Oct 1, 2008)

Hi JM

Sorry to hear af has arrived and your feeling down.
Im feeling upset myself today as i have just got my progesterone test back and it was 4.
So im really fed up, going back to docs mon.

What does this DHEA do? i heard about it.
Does it make you have reg cycles?

Bella


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## annacameron (Dec 16, 2008)

Bella, don't despair. day 21 is only relevant if you ovulate day 14 and have a luteal phase of 14 days. a more accurate term would be 7 days post ovulation. 

for exmaple, if it were me, day 21 would be FAR too late to take progesterone test. i need to do it around 18....


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## bella 64 (Oct 1, 2008)

Hi AC

Thanks that mad me feel a little better, yes next month i will have to remember to get it taken 7dpo.

Would it make a huge difference if the figure is so low as being 4?
I even got a + opks day 16.
AC could you please explain to me about this luteal phase, not sure how that works.

Bella


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## annacameron (Dec 16, 2008)

if you got a positive LH test (OPK) day 16 then you were testing too EARLY. 

you have the opposite scenario to me


the OPK indicates that your LH levels are high enough to trigger ovulation (assume egg, assuming release from follicle, blah blah blah) in 24/36 hours so let's say day 17. so you should have tested progest on day 24.

now, you are looking for a figure of around 30 7dpo so it would have to be at bottom level before styarting to build up for 7dpo when you got the 4. 

i'd do it again a few times to work out what's going on.


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## bella 64 (Oct 1, 2008)

Morning AC

Do you think day 26 on monday is too late for another blood test? which would be 9dpo.

Im thinking i could need my clomid increased maybe to 200mg, well i will find out monday when i see doc.

Day 24 today and now i just want af to turn up, as i know there is no chance of me being pg this month 

Bella


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