# High Estrogen, not allowed to start IVF??? (Low AMH)



## huskysaffa

Hi Ladies,

Wondering if anyone else has had this issue? I was supposed to start my first STIMMS two weeks ago - I have an extremely low AMH (0.1 and the doc said I had to do IVF urgently - usually they wont do IVF with AMH lower than 0.3 / 0.2 but he was going to give us a shot (excuse the pun) because I am "young" 33.

So we go in for our AF day 3 scan with a plan to have bloods done the same morning and be sent home for instructions and meds to start IVF. Anyway, during scan doc sees a follie thats still there (should be gone as it was day 3 AF) and measures at about 13 mm. He says, this is strange but lets see bloods and make sure its not affecting you in anyway.

Anyway after a LONG drawn out morning with a Uterus X-ray and lots of bloods, doc calls me back into his room and says - look this is very rare and unusual but that follie is producing high amounts of Estrogen and basically telling your body you are pregnant - my Estrogen is as high as if I was in my third trimester!!!! (but not pregnant). So he said as your body cannot "fall pregnant while you're pregnant" I cannot start IVF as it wont work.

His plan of action is now, after telling me I have not much time left, so go back on the pill!!! He has given me one cycle clear of all drugs, hormones, ovudrel, scans etc and then I start on the pill after my next AF for about a month and then test again and see if I can start IVF. 

Has anyone else had this happen? Have no clue what I am feeling right now... its been up and down and up and down and up and down again... am sure you all understand this all too well. Hoping for an UP sometime soon.

Thanks.... and help?!
xx


----------



## hcmk13

Hi - 

I just had this exact same situation. 

I did one natural round, with IUI, and failed. Second round i did with clomid and IUI, and failed.

Did not get a regular period. kept checking if i was pregnant, but wasn't. had 3 days of VERY light spotting when i should have had my period, but went into the dr and they did an ultrasound and found a cyst. when the bloodwork came back, my estrogen was over 10 times normal!! (no wonder i was having mood swings!)

Since then, i went to dr every week for 3 weeks to take blood and do U/S. they found that the cyst broke up, but my estrogen was still high... it went down a bit each week. this week when i went to the dr, they put me on progesterone to take for 10 days and then i will get my period.

well, during all of this, i randomly requested the results of my first labwork. (i wanted to know if i had high estrogen always). on that paper, it showed my E2 at 35 (normal). My FSH at 9.7 (a little elevated), and my AMh at < 0.18!!

when i started seeing the reproductive endocrinologist in august, they never mentioned the AMH number to me. they told me my FSH was a little high but still okay. i was 35 then. i just turned 36.

so when i spoke to the doc yesterday we discussed switching to IVF. but now i'm wondering if it's worth trying with such low AMH. and i'm still waiting for my estrogen to fall, etc. she said sometimes clomid will cause a cyst and you have to take a month off to re-regulate.

wondering what the outcome of your experience is, as it was about a month ahead of mine.

thanks!


----------



## huskysaffa

Hey  hcmk13,

So sorry I only saw your reply now! Have been away and just got back on Saturday... And truthfully got stuck right back into tx and now on a DR Lucrin!

So my doc here feels that under 40 with such a low AMH is still worth IVF. He is top notch and girls come from all over the world to see him so I feel quite happy with his expert opinion. He says that AMH is a tricky thing that is still not completely understood and so he doesn't close the door, especially if all other problems can be worked with.

So having said that, they decided to do IVF but now a different protocol. So they put me back on the pill in the beginning of December so it would stop me having a "natural" cycle while I was traveling. The day I got back (Saturday 7th) I started my first Lucrin (think its also called Lupron) injections and am now doing them everyday. The Lucrin is supposed to bottom out the estrogen, almost like menopause. I had shocker symptoms the first four days and now have settled.

Tuesday I took my last pill and now waiting for AF to come - still doing daily injections of Lucrin. Not 100% sure of the rest of his plan for me, but when I get AF I go in for internal scan and blood tests... If all looks good I start on stimms.

Will keep you posted but fingers crossed his good attitude about AMH will result in BFP!

How are you getting on and what's your tx plan going forward?
Xx


----------



## 12FOXY

Hi,
        I have a similar condition and have had two failed ivf cycles. Before the first cycle my oestrogen was 10,000 and like you the consultant actually rang to check that I wasn't already pregnant! I had numerous cysts and despite  trying to downregulate me they couldn't. They went ahead on a low dose of stims (leaving the 14 cysts that were already there) but I only produced two eggs. Both fertilised and we did a 3DT of a single good quality embryo. BFN.

On the second cycle they put me on the pill for two months and zoladex to downregulate me (which gave me a lot of side effect including very large blood clots and severe cramping). It worked however despite them putting me on the top dose of stims I only produced 3 eggs and my left ovary did not respond at all ( I think they over downregged me). All three fertilised and two made it to blast. I had one good expanded blast put back in but still had BFN. 

My consultant has said it isn't worth a third cycle but won't clarify why- I have arranged a follow up to get some answers. I don't even know my AMH level and have not had an antral follicle count done.  I can't give up yet! Hope you have more success x


----------



## huskysaffa

Hi Foxy,

Thanks for your note. I am now on cycle two... Sounding much like yours. I was on the pill for two months (no AF continuous pill for 40 days) and then started the lucrin for DR with HORRIBLE side effects. This time it seemed to work but am now on stimms and DR and feeling nothing?! 

My baseline scan is tomorrow to see if any follies. Yesterday I told my DH that I have no pains, no symptoms and I am worried nothing is growing... Will see tomorrow but hope the keeping me on Lucrin isn't affecting the stimms. Will report back.

I agree you can't give up now. Would you consider maybe trying another opinion / different clinic? Most docs won't treat someone with an AMH lower that 0.3ng/mol and mine is 0.18 but I finally found a doc who said he feels there are so many factors (including a higher power) that he feels it's always worth trying. It's not fair that your consultant is not giving you the information you need but also giving up when you aren't and don't want to. 

One thing I have learnt from all the girls here is that it's seems each clinic and tx have different opinions an regiments. Some are more helpful and communicative and others are strict and instructional! Maybe it's something to consider...

Don't give up and keep me posted on your progress!! 
Xx


----------



## 12FOXY

Hi Huskysaffa,

Hope you get some follicles! Yes my husband and I are planning to go to another clinic, probably one in Sheffield where they do more research and investigations. I am going to still have one more appointment with current doc though to try and gather as much data about myself as possible- this will be in Feb half term so I will let you know what he says.

I think we should maybe keep in touch to try and see which drugs may work better than others for ladies with our unusual condition.
I had 2 months of zoladex then 2 weeks of buseralin to down regulate and then 450 (3 viles) of merional to stimulate for a week. This gave me 6 follicles but only 3 eggs.

Let me know how you get on with your scan- fingers crossed xxx


----------



## huskysaffa

Wow sounds like they really gave you huge amounts of meds... Eek. My dosages are much lighter, 1 jab of lucrin (DR med) and ten 300 of meopur for stimulation.

Just to go back to the estrogen issue though. My doc said this and AMH are two totally seperate and different things. Also that the ovulation issue with high estrogen is not consistent so it happens some months and not others. So just make sure when you go to te next appointment you get the doc to break down the different issues into seperate boxes do you are clear on the problems for when you go to the new clinic. 

You mentioned that you haven't had your AMH tested yet? See if before you leave the NhS they can do it for you as I think it's quite pricey in the UK (I am in South Africa).

Will be in touch tomorrow
Xx


----------



## 12FOXY

Huskysaffa,
                  Thanks, I will try and get the AMH done when I see the doc in Feb then. How did you get on today? x


----------



## huskysaffa

No good unfortunately. One follie so IVF cancelled again. No point going through with one follie... Next step, new protocol - pill, estrogen injections and then DR and stimms. 

Started acupuncture today... And cried alot.

When and what is your next step?

Xx


----------



## 12FOXY

Oh I am sorry  .

I don't understand why they want to give you oestrogen if you tend to have high levels anyway? Would they not be better giving you progesterone to try and level it out?
You could have higher stims I think yours was 2/3 what mine was. Another alternative would be natural IVF- I've read a lot about it over the past couple of days. It is drawn out but supposedly a good option for poor responders. They basically harvest the egg you produce naturally each month over 3-4 months- Freeze them and then pick out the best ones to put back in later on. It just means you hopefully have a collection of embryos to go at.
I've phoned a clinic today to enquire about discount if my husband becomes a sperm donor- they said it would mean we just have to pay for any unusual tests, bloods and screening costs (the drugs and treatment would be free). We are just waiting for the info pack now but it definately may be an option.
I am considering acupuncture too, I just need to get around to sorting it out- how was it?
Glad they have given you a new protocol- when do you start again? 
I know how you must be feeling but try and be positive- it only takes one and you did produce a follicle!


----------



## huskysaffa

Hey Foxy,

Thanks for the message  

Its funny you mention natural IVF - have spent the last two days wondering if we could try a natural cycle and then ask the doc to watch us and harvest if we have any eggs... now am definitely going to ask them! I have another scan tomorrow morning (think to see if the 1 follie has progressed) and they might give me an ovudril shot anyway just to try our luck.

Not sure of next step just yet. The doc wants me to get my AF and then put me back on the pill. This could be about two or three cycles before they start me back on meds... he called yesterday afternoon to check on me and suggested I book another appointment with him so we can ask questions... such as natural IVF. Thanks for sending info about it - am going to research and go see him prepared.

When is your next appointment?? Did you ask NHS or private clinic about sperm donation? Separate to the cost issue, I think its amazing that you guys are willing to help other couples... wow... 

xxx


----------



## 12FOXY

Our appointment is 3 weeks on Friday. I had discussed the possibilty of having a shot at the time when ovulation was due before our last cycle but Doc just pushed us onto the IVF. 

I actually bought a clear blue fertility monitor after the cycle failed and did get a peak on day 24-25 of the cycle but then started bleeding (too heavy to be implantation) a week after. There should be 2 weeks before a period so that was confusing. However I will see what happens this month and may ask to be given a shot when a peak appears just to ensure that the egg is actually released and doesn't just turn into a cyst. 

The NHS hospital charges £700 pounds for the cycle and up to 3 FET's (FET's not really an advatage to us low responders though) if you donate sperm, The private Care clinic charge around £800 but have a high success rate so would probably be the better option for us. It would man alot of travelling back and forth for DH but worth it overall. It would be nice to help others- I have a good friend that used a sperm donor on twice (both unfortunately ended in miscarriage).

When is your appointment booked for? Let me know what he says about the shot idea and the natural IVF xxx


----------



## huskysaffa

Hey Foxy,

So I had a scan on wednesday with the doc an asked about natural IVF - he said that it only gives about a 9% pregnancy rate but doesn't give a good live birth rate. But we are hoping to get an appointment with out main doctor soon (on waiting list) and I am going to discuss this with him again.

You should definitely get the ovudril shot on your next cycle. Not sure if the NHS does this but here they scan you on about the 8th /9th day after your AF starts to see if you have follies and what size, want them to be 18mm and then you keep coming back for scans (hence all my 5:30am scans) until they are the right size and then you get the shot and they say "go home and do your homework!!"

Amazing that the clinic gives you a good rate while donating sperm.... Very awesome! Know driving is a pain but if you can find a private clinic that can get you to a BFP than its worth it! My clinic is about 30mins away with zero traffic so have to leave home before the traffic starts.... Am here now 6:12am sitting in the stairs typing!! 

Have a good weekend!
Xxx


----------

