# AMH and FSH Question--thank you for your help!!



## lucyroux (Sep 15, 2010)

Hi!  

I'm 41 and TTC.
I've had 3 pregnancies= 1 blighted ovum and 2 miscarriages at 12 weeks (after heartbeats and strong HCG levels).
I get pregnant very easily.
Genetic tests are all good.
Sperm is good and happy.

my levels:
FSH: 8.7
AMH: 2.1 ug/l  (14.97)
Estradiol in luteal phase: 109

I had relatively low progesterone and am now on progesterone supplements.

So. My questions are:

1. Should I be able to conceive naturally and carry to term with these hormone levels?
2. What can I do to prevent a miscarriage in the future?
3. I am taking the progesterone starting my 15th cycle day. Should I continue to do this when I am pregnant
or should I take the progesterone all through the first trimester?

I live in France and my gynos have NOT been helpful. It was my husband who suggested I get hormone tests!

ANY HELP WOULD BE SO HAPPILY APPRECIATED!!!!!
Thank you!


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## daisyg (Jan 7, 2004)

lucyroux,

I am really sorry to hear about your losses. I think you are being unecessarily distracted by investigating hormone levels which may have nothing to do with whether you can carry to term. You get pregnant which is very good sign. You are 41 which means you have a higher chance of abnormal embryos, but 3 m/cs especially 2 at 12 weeks warrants further miscarriage tests IMHO.

Firstly have you and DH been karyotyped to make sure there are no inherited genetic issues you are passing onto the embryos?

Next - have you had any other sperm tests such as DNA fragmentation etc. to highlight any issues?

I would really recommend that you have some of the basic miscarriage tests. I don't know how easy this is for you to do in France, but in the UK many of these can be done by your GP.
This list would include:-
Thyroid (TSH, T3, T4 and antithyroid antibodies) very common cause of miscarrige if not controlled.
Uterine issues - have you had an hysteroscopy to check for any issues e.g. fibroids, polyps etc?
Clotting issues e.g. antiphospholipid antibodies, activated protein C resistance (Factor V Leiden), protein c deficiency, MTHFR, anticardiolipins, lupus anticoagulant
Other immune and autoimmune issues e.g. rheumatoid factor, antinuclear antibodies (ANAs)
Infection with you and DH: i.e. Chlamydia, Ureaplasma, mycoplasma etc.
Glucose intolerance testing,
Full blood count
ESR etc.

Level 2 testing (so called Chicago tests) are less common but may be indicated and these would include NK Cells, cytokines etc.

I think there could be something going on other than age with your miscarriages which needs investigation.

Regarding your hormone profile. What day was FSH and E2 tested? It must be between days 2/3 of cycle for it to have any accuracy. However, the biggest sign that your hormone levels are ok is that you are getting pregnant. I do agree that progesterone supplementation is a good idea as it cannot harm and may be a factor in your losses - although next time you get pg it would be a good idea to monitor your blood mesurement of prog. to see how you are doing. I would continue the progesterone after ovulation and throughout pregnancy and only stop at week 12 if your levels are ok.

You might find this board helpful and you may like to address your question there for extra advice as well. There are many other knowledgeable women there too help and maybe someone who has knowledge of the French system?

http://www.fertilityfriends.co.uk/forum/index.php?board=52.0

Again, I am so sorry to hear of your losses, but it is very important you insist on more testing of some common m/c causes for you and DH asap.

Best,
Daisy


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