# New to the group and still in shock after a fertility test



## longhairedgeneral (Jan 18, 2015)

Hi all
This is my first post; I'm 31 and have just undergone a fertility test, as I was hoping to hear that I'm just as average as I am in every other physical department, and that my new husband (aged 29) and I can safely continue to prevent parenthood for another 1-2 years. Instead I heard that my fertility level is "off the scale" on the low side. I had an antral follicle count of 8 and an AMH of 2.8 pmol/l. I gather this is extremely bad but the nurse at the private clinic was fairly unhelpful beyond telling me this at 10am on Friday morning. After half an hour googling, I went home from the office in tears. Now I'm feeling a bit more positive, largely because as an Army wife my husband has been in some awful situations which put life very much in perspective, but I do want to know what options we have. Whilst we've decided to get on with trying for children immediately, my hopes are pretty low. Should we wait a year and then see a Dr regarding drugs or should I get on drugs straight away? I hear something called Clopid might help although I've also deduced I may be a lost cause already regarding IVF. Would IUI be an option? I know I'm jumping the gun but I'm trying to realistic as well so knowing what the options are will keep me going over the next few months I think. 
Thanks for any ideas!


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## Cloudy (Jan 26, 2012)

Hey honey, glad you found us.

Have a look on the low amh threadS and you will soon learn two things:
1) you are not alone
2) you are far from a lost cause.

Women with an amh/afc lower than you have conceived both naturally and with help.

Have you got an appointment with a Dr to discuss your results? Also, has you DH had his sperm analysis results yet as they are can be a big deciding factor in what path you take.

Good luck xxx


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## Lilly83 (Jan 19, 2012)

Hello

You have come to the right place  

Your results aren't too bad so don't panic, an AFC of 8 isn't really that low? That's 8 follicles so 8 possible eggs at ivf and more often more pop up during stimulation, your AMH is low yes, but many ladies have success with that AMH or lower, do you know your FSH? Personally if I was you and you and your partner are ready I would set the ball rolling soon as clinics often put a cut off point on AMH they would accept to cycle, like I said though your afc is higher than I would expect for your AMH so it's not all doom and gloom

As for iui and Clomid it's not often used if your egg reserve may be on the lower side although Clomid I guess can be, have you had your tubes checked? They would need to be clear for either of those too 

L x


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## Ali_123 (Mar 13, 2014)

I would get cracking on trying and see what happens. Low AMH/AFC doesn't necessarily mean low egg quality from what I've read, especially in young women and it's not an exact test either, just a rough guide. Do you have regular periods? Given that you've not even tried yet I wouldn't go into it anticipating problems, you might well find yourself pregnant in no time! Good luck


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## longhairedgeneral (Jan 18, 2015)

Thanks for the quick responses, you've made me feel so much better already. My DH hasn't had any tests at all, I guess if we don't get anywhere in the next few months then that's the next thing to check. I haven't had a follow up with the clinic, but I'm speaking to an NHS nurse tomorrow who should be able to let me know the process of getting assistance if it's needed, tho definitely want to give it a few months for nature to do its thing. Was v surprised to hear the words 'early menopause' given my periods definitely haven't gone away and everything else feels completely normal. Haven't had the FSH test at all. Good to know there's options and mostly that people with my poor stats have had success. Thanks again and will update when I know more..


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## Ali_123 (Mar 13, 2014)

Honestly, these tests are not so exact, they are only a snap shot of what is going on. The clinics might tell you that antral follicle counts/amh are very stable and don't vary much month to month, but in my experience that is just not the case. They like to think that they are consistent because they use these measures to come up with IVF doses etc.....To give you an encouraging example, in my second AFC test I had 10 more follicles than I did in the 1st and the number has stayed high ever since. I think you are taking a wise approach as you will be prepared to move fast if needs be.....but I hope that you are in for a nice surprise in the next few months. You could always try ovulation tests to try and speed things up, then at least you'll know that you are timing things well!

I would imagine that many 31 year old ladies would be in for a shock if they took these tests, fertility starts going downhill from the mid 20's after all, doesn't mean that women in their mid 30's or even early 40's all struggle to have babies though, most don't. Whilst I can see that these tests are valuable in terms of telling you that it might be best not to hold back on trying to start a family, I bet they also cause a huge amount of unnecessary worry! As I say, you just don't know until you try - have fun


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## CrazyHorse (May 8, 2014)

I wouldn't worry too much about the early menopause thing unless your FSH comes back really high (like, >1. Remember FSH needs to be measured on Day 3 of a natural cycle (CD3), where Day 1 is your first day of full menstrual flow, not just spotting. You can also order this test yourself for about £70 (see http://bluehorizonmedicals.co.uk/), if you can't get your GP to cover it and don't want to wait for a specialist referral.

AMH is basically a somewhat crude measure of the number of remaining eggs available for use in your remaining lifetime menstrual cycles. The higher your AMH, the larger a number of follicles your body will recruit on each cycle, from which one or two will be selected for maturation on a natural cycle -- or many of which will be matured on an IVF cycle, when the follicles are stimulated. So, with higher AMH and AFC, you will get more eggs per IVF cycle, which will (on average) increase your odds of success per cycle. But low AMH and low AFC on their own do not mean you will get poor quality eggs with low fertilisation rates, or that you will stop having monthly ovulation anytime soon.

High FSH on CD 3 means that your body needs to produce more FSH to mature follicles each month -- it's like your body needs to lean harder on the gas pedal to get things to work. As you approach age, CD3 FSH rises overall (although it can jump around from month to month), then starts to soar upwards as you approach menopause. The higher your background FSH is, the more additional FSH is required to get your body to mature additional follicles for an IVF cycle. Really high FSH levels seem to correspond to poor egg quality on IVF cycles, although many perimenopausal women (who presumably have high FSH) still conceive naturally.

Basically, if you don't conceive naturally after 6 months of consistently trying during your fertile window, I would go straight to pursuing IVF (or jumping through NHS hoops to get in the IVF queue). Your odds with IVF will be much higher than with IUI or Clomid. While you're trying naturally, it would be good if you can get an HSG done to verify that your Fallopian tubes are open (if they're blocked, no amount of trying naturally is going to get you pregnant, and you need to go straight to IVF).

Wishing you lots of luck!


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