# Low FSH, high AMH but poor eggs?



## sunnyday

Hello ladies,

I'm just looking for some answers following a BFN after our second ICSI (first was successful).

I have a very good hormone levels for my age and a high antral count bordering on polycystic so I'm told (about 20 each side), although I have no other symptoms of PCOS and normal cycles.

In the follow up consultation the other day I was surprised to be told my eggs are quite poor quality. I thought the low FSH/ high AMH was a sign of a good ovarian reserve. Do those just refer to the quantity of eggs but not the quality? Does the PCO affect egg quality or is it just my age? Or maybe the protocol..?

Confused!! And now worried about future cycles having been lucky until now.

xxx


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## Gribbie

Hiya.  Your numbers are about the same as mine - fsh 5.5, amh 52.1.  I was also told that my eggs might be poor quality after my fist ICSI failed.  My clinic is adding steroids to my next cycle (dexamethasone) which it is thought might improve egg quality.  I'll let you know if it makes any difference.  Apparently if you have PCO your protocol is very important.


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## sunnyday

Hmmm, so it's not just me then. Its weird isn't it because you're led to believe its all about FSH and numbers of follicles. I'll be interested to hear what happens with the addition of steroids. 

That wasn't suggested for my next cycle but they did say they'd try me with gonal f rather than menopur and maybe up the dose slightly from the alternate 150/ 75ml I was on before. Maybe it was too low as it seemed to take ages for the follicles to take off although a few got there in the end.

It feels such a fine line between not overstimming as I did last time- but getting enough quality eggs to stand a good chance.

x


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## Gribbie

My clinic do a mix of gonal f and menopur - so I get to jab myself twice each day  

Interesting thread here: http://www.fertilityfriends.co.uk/forum/index.php?topic=234006.0


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## Mistletoe (Holly)

Hi, the low FSH and high AMH just indicate that there are lots of eggs left - it gives you no information about egg quality I'm afraid. You produce what you do and the embryologist does their best.

There is currently no way of improving egg quality and no easy way to test them, other than the egg turning into a live child.

You can have CGH done which is a new technique, about £2.8K a shot, whereby the polar body of the egg is tested to see if it has normal chromosomes. A friend who has PCOS has had this recently after failed cycles and out of 5 fertilised eggs only 1 was normal.


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## sunnyday

Hello


Hopeful Hazel said:


> You produce what you do and the embryologist does their best.


Does this mean that egg quality will always be the same on every cycle regardless of protocol? I had assumed my eggs were ok as we were successful first time round but now I'm thinking that might have been a fluke. I did manage to get to blast this time but only one made it out of 8 embryos. We had 80% fertilisation though.

I guess in any given batch of eggs there will be a range in quality so maybe we just have to hope that with our high numbers there's more likely to be one or two that are ok.

Arghhh! I'm just having to rapidly revise our situation. I thought it was all MF and I was fine but maybe not so!

x


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## Mistletoe (Holly)

It is not that you had a fluke - you are now a couple of years older and this does make a difference.
Different protocols may make a difference and you need to discuss your needs with your consultant. The more eggs retrieved that are properly matured the better the chance of finding the one.
It does increase your chances of success the more eggs you produce at any age.

I find the information on this website very helpful in understanding success.
At my age I take solace in the fact that there is still a 44% chance according to these data of me having a live birth with my FSH level of less than 4 and an antral follicle count of about 20.

http://www.advancedfertility.com/eggquantityquality.htm

/links


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## sunnyday

That illustration of the red dots/ green dots is the best summary of the IVF process I've ever seen! All clinics should show that at initial consultations. 

By the way- I turned 39 3 days ago. I need update my age on my sig right now..
x


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## karenanna

Hi everyone

I also have low FSH (3.7) and high FSH (53.1)- was diagnosed as having PCO (no symptons of the syndrome so not PCOS) during treatment.

I moved clinics after 4 BFNs - although they collected lots of eggs and they were always doing well as embryos at day 3, by day 5 they were not great quality. I also always found that I only stimmed for around 8/9 days before being triggered.

My new clinic placed me on metformin - ladies with PCO/PCOS have insulin resistance and the metformin helps them but their bodies energy into producing some larger better quality follicles and eggs (although they will still have lots of smaller ones - the body will stop trying to put its energy into producing eggs in all of the follicles). This is how it was explained to me anyway.

I was then stimmed on very low doses - they interchanged/mixed merional and fostimon. My largest dose was 150 for 1 day and I soon dropped to half of this and some days had no drugs (they tested by blood everyday and some days twice a day to get the doses right). 

I managed to get to day 13 before being triggered and got the best blastocysts I've ever had. As you can see they both took and I'm nearly 31 weeks pregnant with twins.

Hope this helps

Karenanna xxx

PS I also thought out issue was MF until I got into the treatment


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## Gribbie

Thanks for that Kanenanna and congratulations!    some interesting info there.


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## sunnyday

Thanks Karenanna and congratualtions! I've read about Metformin but thought it was only applicable for insulin resistance in PCOS. It was never mentioned at my clinic. Maybe I'll bring it up with them. Thanks for the info. And good luck!
x


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## sunnyday

Wow- you both got BFPs!!!!! Congratulations Gribbie and Hazel!!!!


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## Mistletoe (Holly)

Thank you - good luck for your next try!


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## Gribbie

Thanks - best of luck to you   

I had steroids (dex), growth hormones and metformin this time round.  What one made the difference, or if it was a mix of them all I don't know.


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