# Low AMH & 2 Failed IVF ICSI Cycles & now a bit lost 😔 (Kent based)



## Busybee83 (Aug 27, 2016)

Hi,

I'm 32 and based in Kent. Iv just done my 2nd IVF ICSI cycled which failed and now I'm a bit lost on what to do next. 
My partner was diagnosed with low sperm count due to illness and that's how we started this process about 18months ago. As we started I then got advised I have a low AMH of about 3. The first cycle I was given 350 menopur and we got one embryo to blastocyst but failed. This second time I was bumped upto 450 menopur and we had 2 embryos put back on day 3 but we're not the best quality. 

I am now a bit lost as to what to do next. I am waiting to have an appointment at my clinic to discuss any findings from the last round but they have indicated they are saying low AMH is causing poor egg quality, which I thought it didn't have an effect on it was purely quantity. I think they are going to start discussing donor eggs 😔

Has anyone else been in a similar situation? Neither of us are 100% about our clinic but it's the closest and not many clinics seem to deal with low AMH. 

I really feel lost, after the first IVF we still had options to improve, now it feels like we have ran out of options 😥

Any thoughts would be greatly appreciated xx


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## latte lover (Aug 27, 2016)

Hi busybea83, I wish I had some advice for you but as you may have seen I'm just starting out on my ivf journey with a similar low amh score and age as you. I have read conflicting arguments about whether the score indicates a decline in just quantity or quality as well. I hope your next appointment comes quickly and they are able to answer your questions. Best of luck.


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## Dory10 (Aug 6, 2013)

Hi busybee

Welcome to FF 

I'm sorry that your cycles haven't worked out  Here's a link to a thread with suggestions of questions to ask at follow up appointments http://www.fertilityfriends.co.uk/forum/index.php?topic=261901.0. It's in the negative cycle section which you might find helpful too.

Take care

Dory 
Xxx


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## Sparkle2016 (Sep 15, 2016)

Hi BusyBee, 

Sorry to hear your cycles have not worked. 

This is my first post on here but I can understand how you are feeling. 

We have gone through 3 ICSI and 2 FET, all unsuccessful even though we had apparently good quality embryos. We have male infertility factors (hence ICSI), have tried endometrium scratch and assisted hatching. I've also had an NK test (which came back in normal range). 

We recently changed our clinic, and will be embarking on our 4th ICSI cycle in November. The consultant suggested I take DHEA as there is some evidence that it can help improve the quality of the eggs when taken for at leaset 3 months prior to EC (my egg reserve is low (just waiting for the new figures following recent blood test) as our first EC they got 10 eggs, second was 3 eggs and third was 2 eggs). There is lots of conflicting information about DHEA, but it may be worth asking your Consultant about it. Every consultant is different and has their own preferences, but it might be worth asking about it and see what they say. There does appear to be a correlation between low egg reserves and poor quality of eggs. 

I do not know if DHEA works, but it is something new we have just found out about, so it may be of interest to you. 

Best of luck


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## Leesalou33 (Sep 28, 2016)

Hi, I see you are from Kent I am too, 
I'm new to on here and am looking to meet new people that are going through what I am,
After taking a break from ttc I am in the process / discussion of my 2nd ivf plan, 
But I've got to have another lap done before I go ahead with ivf, as my results show I have 
More than likely got  Hydrosalpinx In my only remaining tube, so I may have to have his clipped or removed before next cycle of Ivf, 

I've posted  my story on the new members xx


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## DutchSasky (Nov 18, 2015)

Hi Busybee -
Not sure I have any good advice for you, but  I just wanted to   . It sounds a bit like my story that's why I thought I'd leave you a message... I do not live in the UK, though, so I am not sure any of my thoughts are  of any use to you.

Just a few questions:
I guess your FSH is still ok? There are stimming meds that are more frequently used in older ladies (Fostimon, Menopur) that seem to work better for them. I had my best quality eggs and the beginnings of a pregnancy (first time bloodtest came back with HcG above 0, but it was only 6 so it wasn't enough) when using Menopur, so that might be worth discussing.

Is your lining fine? Did you have a hysto or something similar to check for problems with the womb? I would recommend a good hysteroscopy if you haven't had one, if your consultant is going with that.

I would definitely look into the DHEA, and maybe, if you're up for it, something like accupuncture. It didn't work for me - funnily enough I only got pregnant on cycles where I didn't interfere too much with my body, but this might have been a coincidence, but I have heard of people where this did help egg quality and quantity. It did help me to calm down a lot though and solved some other problems I had so it was quite good after all.

And have a look into other clinics. I cannot give any advice about which one is good or not, but with low AMH you might want to investigate clinics that have good results with ladies around 40 for example, because they usually have lower AMH and they might be more used to it.

We changed clinics and it was a bother (because much further away)but my experience is that treatment is totally doctor-related (not sure if it's the same for the NHS though, they might have to follow more strict protocols) Our first doctor was very happy when he saw my age and blood results and assumed he would get me pregnant in no time - boy was he wrong(although he should have seen that the AMH was probably low already at that time. Since he didn't pay any attention to it, it took me another 2 years and a change of doctor to get that diagnosis). My second doctor took a much more personalised approach and while it didn't work for us, the quality of the eggs seemed to improve with different drugs and a different stimming programme.

You say your husband's sperm count is low due to illness, but what about the motility?, is there any chance that might improve? There are some vitamins, supplements (zinc) that he could take to try and improved. Having said that, my husband also has very poor sperm and taking vitamins and supplements didn't help one bit here (no history of illness), but also here, I have heard of massive improvements. 

My doctor told me that it's usually a good idea to do a 5-day blastocyst culture, because you get more information on the quality. For example, sperm quality only starts to factor in on day 4 and 5. The fact that you had a blastocyst in your first cycle sounds pretty good to me (although, do you know the quality of the blastocyst?)  I had 4x IVF, 2x 3 day cultures  that 'looked good' but when my new doctor did a 5-day culture it became clear that the eggs weren't developing that great (they were developing but slow). We only managed a starting blasto once - but it was only starting so it was already a bit behind). The clinic I was at only did 5-day transfers, their opinion was that if an egg arrested development on day 4 or 5 that's very hard to deal with but still better then transferring eggs early, then waiting and being nervous for two weeks while taking all the meds and be disappointed. 

Low AMH indeed indicates just the number of egg reserve, but in my opinion, nature doesn't do 'save the best for last' so chances are that the eggs that go last are also of lower quality than the ones that you produced in your teens/twenties. But that's my own theory. The doctor said it was a matter of 'hitting the right cycle' in which you have a good quality egg. if you're already on IVF that's a bit of a gamble of course. 

In the end, our problems turned out to be so severe we moved on to double donation, but that's hopefully  not necessary for you.
I hope it works out in the end!! take care!


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