# High FSH/Low AMH - A little hope?



## Icedgem (Jun 4, 2009)

Apologies for this long, but ultimately happy post.

I wanted to share my story in the hope that it might give some encouragement to anybody who finds themelves 40, with a high FSH and low AMH. I know I found these boards a huge help and amazing source of information. I know that I wouldn't be in the situation I am today without them. Also, I know that for many of us there is no happy ending but I especially found "I beat the odds" stories kept me going.

At 39, I conceived after 2 months of trying but sadly (sadly doesn't really do justice) I had a missed miscarriage at 11 weeks. It was very upsetting but encouraged by how quickly I had gotten pregnant, we set about trying to conceive again. After six months of soul-destroying sex determined by the Clearplan monitor, I was still not pregnant. I knew that at my age we shouldn't wait any longer before going to the GP and requesting tests. We knew that because of our age (DP is same age), we might have to have IVF and were totally OK about this despite knowing we'd have to pay for it. What we weren't prepared for, given how easily I had gotten pregnant before, was how terrible my test results would be - effectively "game over".

DP was fine but my FSH was 23 and subsequently, we found out that my AMH was 1. I went into the surgery thinking that my tests would show some reduction in my fertility and the advice would be just get on with the IVF and that will solve the problem. We came out having been told that it was unlikely to the point of almost certain ("about 2% chance") that we would not be able to have a family. I think I went a bit crazy. Not having been at all interested in having kids until I decided that I really, really did want a family (if you see what I mean), I now felt like my whole world had ended. The only thing I wanted and to be able to give DP was not possible. I've had a pretty charmed life, not easy, but have generally managed with hard work, application and a little bit of luck, to get pretty much everything I've every really wanted. I found it really hard to take that I couldn't get what I wanted - not in a stamp my feet kind of way, just a sense of totally helplessness. I immediately googled my **** off and found this site. I think read stuff on here for about five days straight and while generally the opinion seemed to be that my stats made things pretty hopeless, there were one or two similar cases that saved my life.

My stats were so bad that I could only find one clinic, the Lister, who would let me make an appointment to discuss the possibility of treatment using my own eggs. UCH crushed me massively, by in response to my telephone query, relayed by receptionist was that with my stats they would only see me to discuss egg donation. At this point, I felt that we would have to go to egg donation but my partner outright vetoed that option and adoption so I was so desperate.

To cut a long story short (or is it already too late for that?!), although a poor responder - three follicles and two eggs, both fertilised and replaced), following treatment at the brilliant Lister, I got pregnant the first time. Unbelievable. In May last year gave birth to our darling, perfect, healthy and oh so happy son. It wasn't an uneventful pergnancy (cervical stitch) and birth (emergency section due to screw up with stitch) but my God, are we blessed and joyful every day that he is here.

To give myself the best odds, I did everything and anything, sane and crazy,before, during and after treatment. I list them here with absolutely no idea if any of them made any difference or indeed would be beneficial or indeed possible for anyone else. I want to give a little hope, but I was realistic about our chances and don't want to give false hope or suggest that if you do what I did, it will work for you too but just in case you are interested, I:


gave up work to reduce stress and free up time for treatment (I am freelance and in the middle of a lucrative but hugely demanding contract so this was not an easy decision). I lived off my savings as my DP doesn't earn enough to support us both. I appreciate I was lucky to have savings and this may not be an option for many people.
saw a nutritionist and followed her advice to the letter, Vitamin D tests and supplements (Zita West) up the wazoo
gave up all caffeine and alcohol
drank so much water I lived in the loo and ate so much protein I felt stuffed
Zita West IVF visualisation tapes
acupuncture - the wonderful Ian at Balance Acupuncture -before, during and after treatment
did meditation and visualisation classes at Zita West
put my feet up for three days after embryo transfer
and probably, loads of other mental things which I can't remember now.

Like I said, this is not a recommendation or anything, I just know that I was desperate for success stories and any information on things people felt might help. I needed something to allow me to believe that against the odds I might get the only thing it turned out that I wanted so very badly. I wish everybody reading this the very best of luck in their quests. Thanks Fertility Friends.


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## MauritianMum (Feb 15, 2011)

Love your post!!! Thank you for leaving it.
I'm 40, FSH of 15.5 and AMH of 2.28 - so similar to you. Your story is fabulous. 
My DH isn't keen on adding to our family (we already have a gorgeous 2 year old) but is happy to support me through one cycle of IVF. So, I need your luck! 
We live in Mauritius but I'm in London at the moment and I went to the Lister yesterday, saw Mr Tolba. My odds aren't brilliant, but I think I want to give it a go. Issue is - Stay in the UK and go with the Lister or go home to Mauritius and do it with the Harley St Clinic there (if they'll take me). Trying to balance it all out - bit stressful being in London with my 2 year old and without DH for 8 weeks, so that may reduce my odds of success at the Lister. Do you think it really matters which clinic you choose?
Did you do the LP at the Lister? I was suprised when they said I should do that - thought low AMHers were advised to do SP. 
Anyway - thanks for the inspiration. x


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## Icedgem (Jun 4, 2009)

Good luck Mauritian Mum. Glad you liked the post.  I did lp at the Lister.  Re: to do in London or Mauritius, it's my understanding is that anyone can prescribe the drugs but where the real skill comes is in the sonography and therefore the ability to tailor your treatment as you go through the cycle and get the optimum timing of any interventions.  Additionally you want a great lab to fertilise and support any embyos and I believe that the Lister has a great lab.  On balance, I guess I would probably choose to do it in London.  However, I don't yet know how stressful and tiring a two year old is.  Do you have any support in London?

I initially saw Dr Tolba but didn't think he was right for me and my partner. I went on to see Dr Yau who specialises in older ladies with high FSH.

Do let me know if I can be of any further help.  Very best of luck in adding to your family.


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## MauritianMum (Feb 15, 2011)

Thanks for replying IcedGem. We are both so lucky to have our little ones, aren't we?  

I desperately want to give my little boy a brother or sister, so hoping to find a way.  

So, here I am sitting on the sofa at 11.30pm with a deadline of tomorrow morning to decide what to do!!! Today, I pretty much decided to catch the plane next Monday and do the IVF in Mauritius. 2 of my friends who've gone through IVF thought that the emotional support of their partners was essential for them and that it was very important not to be too stressed during the treatment. I'm really keen to go home, life is definitely easier there and I think it's probably the best place for DS to be. I could find a way of coping with the extra 2 months in London with DS I'm sure, although there are times when it's incredibly hard work - ie when he throws a tantrum about getting in the pushchair or just screams when I leave him to go to sleep - but if my mother turns up on my doorstep to 'help' for 2 weeks I think I'll go potty! It definitely won't be stress-free and having to take him into the clinic with me for appointments sometimes would be very hard. 

However, I'm sure you are right about experience and the importance of the lab. The lab in Mauritius only has one embryologist - what if he's sick one day!?!? 

DH has said we can consider doing a cycle at the Lister later in the year if one in Mauritius doesn't work, but I'm worried that my fertility is falling over the edge of a cliff, so who knows how bad it'll be in another 6 months. 

Oh no. Now I'm thinking I'm a fool to leave London. Oh pants this is hard. 
Just tell me what to do! Please!


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## Icedgem (Jun 4, 2009)

We certainly are very lucky to have our children.  I would love another but think that it is very unlikely and my partner is not very supportive of trying our luck again.  He thinks we should count ourselves unbelievably lucky for having our son.  I am an only child found it hard and would love him to have a sibling so I totally understand your desire and am quite jealous of you getting to try!

Oh gosh  - it is really hard isn't it.  I guess I hadn't factored in the emotional support of your partner.  Two months is a really long time to be away from home.  What is the success rate of the clinic at home for your profile?  What do they say about what happens if your embryologist is sick? Do they operate weekends? If you were ready on a  Saturday would they do egg retreival then?

I know whre you are coming from re: any delay in trying but perhaps you could try the next cyle or the one after if the first one doesn't work?  We always committed mentally to two attempts and I found that this really took the pressure off the first cycle and perhaps that helped it succeed?

Stay positive, it can happen.


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## MauritianMum (Feb 15, 2011)

Thanks for your reply, Lovely Lady! You are such a sweetheart. 

Quick post as I have a clinic appointment this pm! I'm back in Mauritius and trying my luck here. Fingers crossed it was the right decision.

It's so funny - your position is so similar to mine in so many ways. My DH is very happy with having just the one (he keeps talking about school fees and skiing holidays being more expensive with 2)! Between you and I, I think he's being a bit shortsighted - the joy of having another bundle of fun is worth a million skiing holidays! I'm trying to listen to his point of view though as he's been so supportive in letting me have one shot at the IVF. I would say - be the perfect wife and your chances of your OH agreeing to another one are high  

So - I'm now waiting for AF (next week sometime). They won't start treatment here until I've got an FSH of 12 or below. Gulp. It was 15 in November and I suspect it won't be any lower now, but I'm hoping...  

I've got the drugs in the fridge and we'll do an FSH test on day 2, if it comes back ok, I start the drugs immediately. 

Remind me, did they put you on the LP at the Lister? I've been given the SP here and they've recommended ICSI and assisted hatching because of my age. Did you have that too? 

must dash - just wanted to say thank you again for the hope you've given me!
Please keep in touch. xxx


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## Icedgem (Jun 4, 2009)

Hi

Sorry for the tardy response - was off having a birthday.  Not much of a celebration these days!  I feel ten years, not one year older... Mind you the first hangover since DS was born probably didn't help.

How exciting getting ready to go.  Have you had your FSH test yet?  Is there any leeway on the numbers?  Obviously, it's good to have a lower FSH but I thought most places these days took AMH as a better indicator of likely success?  You might find that having made a decision and having got DH to agree to treatment that your FSH is lower.  Mine came down a whole 2 points (!) after I quit my job and got into the treatment cycle.  Do you have a good accupuncurist at home?  I don't know whether it helps your fertility, some claim it can lower FSH (am sceptical) but it certainly helped my head.

I had LP at the Lister.  Embarrasingly, I don't think I asked why.  We paid for ICSI, however, on the day after egg retreival, they phoned and asked why we were down for ICSI as DP's sperm quality was excellent (cut to DP punching the air).  It was a hard decision to make to not use ICSI as we only had two wggs and wanted the best chance, however we were guided by the lab.  I also remembered that we had been told that older eggs can be more crumbly and the invasiveness (is there such a word?) of ICSI can sometimes destroy the egg.  Why are they recomending ICSI to you?

Did you find out about the back up embryologist and weekend opening?

Re: Baby 2, I don't think cost is the #1 objection for DP (he's less a fan of skiing, more an enthusiast for the great indoors), I just think he thinks we are too old (i.e knackered looking after one) and getting and staying pregnant and delivering DS was so difficult that we should quit while we are ahead.  I chnage my mind on this everyday but on balance would take all the stress and tiredness of a second if it were possible - which it very probably isn't medically.

I would love to hear how you get on.  Do keep me posted.

xx


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## MauritianMum (Feb 15, 2011)

Hi there
Thanks for your message and HAPPY BIRTHDAY! I know how you feel. If we felt as if we'd 'completed' our families, another year older wouldn't matter so much. 

Well, here I am waiting for AF so that I can do an FSH test and find out if it's all stations 'go' or not  
I suspect AF will start tomorrow - getting all the usual signs, so I'm feeling rather nervous tonight. And I'm annoyed because I don't think my FSH should matter. It seems that no other clinic waits for your FSH to go down before they begin a cycle  
Mine has to have gone down more than 3 points since November - ha ha! Don't expect that's very likely. I was doing acupuncture whilst I was in London, but haven't found anyone here yet as we've only been back home a week. I'm also taking wheatgrass pills and royal jelly. Who knows, maybe maybe.....they will have helped. 

Really interesting that you had LP and no ICSI. That was what the Lister was going to do for me too. I'm losing faith in the clinic here in Mauritius, which can't be a good thing. It's so hard to just hand over control though isn't it? It's so tempting to look everything up on the internet and then panic when you find people saying such different things. Oh well, I think I just have to go with the flow here as best I can and if it doesn't work I'm going to have work on DH bigtime - gulp! and then uproot DS and I and head back to London again for a couple of months - more stress and stain on all of us sadly. Well, one step at a time hey?!? Will keep you posted as to what happens tomorrow. Thanks so much for being interested. You are so kind. 

Oh yeah, they said the assistant embryologist is trained to take over if the embryologist is away. Not open weekends though - I have to do blood tests at a different lab on Sats and just hope I don't need any on Sundays!!!!

How old is your DS now? That first year is a bit of a killer isn't it?!? SO worth it though. My little one turned 2 a couple of weeks ago and I love this age, so much fun. 

Thanks again for everything. x


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## Maisyz (Dec 15, 2010)

Thankyou for sharing your story. Gives me some hope when I felt all was lost. x


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## MauritianMum (Feb 15, 2011)

Hi Icedgem

Finally, some good news to post! Started my Gonal F today  

Thought my period had started yesterday but it seems to have stopped again, so must have been spotting. Had appointment at the clinic though, so explained the situation. They tested FSH - 7.17!!!! I'm guessing it's because I'm not really on CD2 rather than it being a magical 50% drop! However, they were happy to go with it, so finally I have a foot on the bottom ladder and now we just have to see what happens   PLEASE send me your vibes - you obviously have the luck of the gods and I could do with some right now!! Thanks Sweetie. 

Just wanted to say thanks for being there!

Keep in touch, 
Mauritian Mum x


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## JasmineX (Dec 5, 2009)

IcedGem - thank you so much for taking the time to post your story. It has given me hope. I am at the Lister too, and just getting ready for my second cycle. I think they are the best for low AMHers, and whilst I was worried they wanted to try me on long protocal this time (thought SP was best for PRs), your story just goes to show they know what they are doing!

Best wishes

 

Jasmine
XXX


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## Icedgem (Jun 4, 2009)

*JasmineX and MaisyZ* - I'm glad it made you feel a bit hopeful. Hope was in pretty short supply when I got my test results back and I found that hearing about people who had been amazingly lucky really helped. The very best of luck with everything you decide to do.

*JasmineX* - I am pretty hard to please (just ask my DP!) but had total confidence in them. They were expert and human. I ended up with a crush on their sonographer, Alison - she was so nice to us! I hope this cycle is the one for you.

*Mauritian Mum* - how is it going with the Gonal F? Are you feeling homicidal yet?! I was OK on it but have friends who have to remain indoors while they take it in case they give into their angry impulses!

IMx


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## MauritianMum (Feb 15, 2011)

Hi IcedGem
Thanks for your message. All good here. Gonal-F doesn't seem to have the slightest effect on me (apart from growing follicles), so that's great   Next scan tomorrow to check on progress. EC looking likely for Thurs or Fri. In the meantime, I'm listening to my Zita West pre-transfer track!
Thanks for all your thoughts and encouragement. I'm feeling really positive, grounded, calm and excited. 
Take care 
Mauritian Mum xxx


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## Icedgem (Jun 4, 2009)

MM

How are you getting on?  Often think of you and am wishing you all the very best of luck.

IMx


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## MauritianMum (Feb 15, 2011)

I think of you too, IM. Your story has got me through a few lows this week. Thank you!

So, here's the latest. EC was on Saturday morning. We got 5. Not too bad for my stats. Had the fertilisation result this afternoon - we're down to 2 (fertilised with ICSI). If they divide ok then they are going to do the ET tomorrow (Day 2). PLEASE PLEASE keep dividing my little embies  

Feeling really low tonight - need a hug - DH doesn't really understand. He thinks I'm dwelling on the negatives, but I've been so positive for the last 2 weeks and everything is just getting to me now. I'm paranoid the clinic is going to damage the embryos with the assisted hatching procedure. So silly I know. 

Need your good vibes today, IM. 

Thank you for everything!

MM xxxx


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## JasmineX (Dec 5, 2009)

Oh Mauritian mum , keep up the PMA love - sending you lots of hugs      

Hope all goes well and you will soon have two perfect embies snuggled up inside you

Jasmine
XXX


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## MauritianMum (Feb 15, 2011)

Jasmine, you are such a sweetie. Thank you!

Everything has gone really well and here I am on Day 1 post ET with 2 lovely embies on board (one Grade A and one Grade A/B). Can't complain at that.

Got a sharp pain in my lower right abdomen when I moved strangely this afternoon, so now I'm paranoid about that....but we all have to have something to worry about don't we?!?!? 

Test date is 5th April!!!!! 

Thanks for all your support, you lovely ladies. 

MM xxx


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## Icedgem (Jun 4, 2009)

Brilliant!  Two top quality embies on board.  Well done - that is fantastic.  When I felt low in the 2WW (and I had absolutely convinced myself that it hadn't worked, even had "period pains", right up to the point where I got a BFP), I just congratulated myself for having overcome every hurdle in the process and told myself that I was lucky to even be in with a chance.

You have done so well - nothing you can do now except take it really easy and try to stay calm and positive.  Accept that you will symptom spot like a mad woman, nothing you can do to stop yourself - it just goes with the territory.

Do try not to test before 5 April!  We'll be thinking of you.

IMx


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## MauritianMum (Feb 15, 2011)

Thanks IM  

Doing my best not to do too much during the 2ww but it is tricky not lifting a 2 stone 2 year old in and out of his cot, the car, the bath etc! Particularly as DH is travelling on business next week. Ah well - what will be......

Excited and happy to have made it this far over all those hurdles, no reason why we can't jump the last few too..... 

Will keep you posted. Any more thoughts on number 2, IM? 

x


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## MauritianMum (Feb 15, 2011)

Hi IM

Just thought I'd finish off the story, in case you were wondering. Sadly, we got a BFN last week. I was expecting it as I'd done a couple of HPTs on the Friday and Sunday - got a faint BFP on Friday and then a clear negative on the Sunday. Cried for 3 days but pulling myself together now. Good to be able to hit the gym and the wine again!
Have the post-mortem with the Doc next week, so we'll see if he thinks if there is any point trying again - might just be my aged eggs causing the problem and there's not much we can do about that. I did have good grade embryos however. Maybe, maybe there is one golden egg still waiting for us. I hope we can find it soon as I don't think I'll be able to push DH into more than 1 extra try. 

Any more thoughts on number 2 for you? 

Thanks again for your inspiration and support. 
Take care
MM xxx


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## JasmineX (Dec 5, 2009)

Mauritian Mum - So sorry to hear your news     
Good luck with your follow-up appointment, hope you get some answers that will help you for your next try.

 

Jasmine
XXX


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## Icedgem (Jun 4, 2009)

Ah MM that's so incredibly disappointing for you - especially hard after seeing a BFP, however faint.  I am so very sorry.  Have been thinking about you last week and this. Good luck with the follow up.  It may be that the age of our eggs isn't helping but you are at least able to produce a few of good quality and that is really encouraging if you do decide to try again. I hope you do as I think it must be hard to stop at one try.

Hope you are getting lots of love, kisses and cuddles from DH and your lovely LO.

IMx


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## MauritianMum (Feb 15, 2011)

Thanks IM. Had a good follow up yesterday and planning to go for ICSI number 2 in May, if my FSH is below 12  
RE thinks it's a numbers game as 80% of embryos from a woman aged 40 won't implant - we just have to find some of the eggs within the 20% bracket! Going to do exactly the same thing with the next cycle, but add some clomid on top to try and get another egg or two. Will keep you posted. 

Any more thoughts on trying again? My DH is not keen on trying again - think this may have to be my last shot - but I'm trying not to think about that. 

Thanks again for all your support. 

MM x


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## MistyLake (Jul 7, 2008)

IcedGem
Thank you so much for posting your helpful message. I have been trying to decide if to go for one cycle of IVF in UK, for a sibling for my son. I am 43 and have an AMH of 0.07. I have just conceived naturally, and unfortunately miscarried at 9/40. I was also wondering where would entertain such a terrible set of results. I have my answer now!
Thank you!
Rebecca


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## Gojogo (Aug 4, 2011)

Wow thanks for starting this thread. I've been scrambling around for hope having just come back from the docs with a FSH result of 46.


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## Icedgem (Jun 4, 2009)

Hi Gojogo

The stats are always a bit of a blow aren't they? Although I have to say I am just about to start another round of IVF (in a bid to give my miracle son a miracle sibling) and wouldn't have even bothered having the tests done before starting if the Lister hadn't appealed to my altruism.  With my previous experience I would have gone ahead with one more attempt whether my FSH was 26 or 46 to be honest.  I had the tests done again because my doctor (the brilliant Dr Yau Thum - specialises in older women and poor responders) explained it was only by having the data they have could they have offered me any hope or realistic view on whether I might actually conceive.

Do you know what your AMH is?  I understand that this is considered a better indicator of fertility than FSH.

What are the clinics like in Korea?  If you do decide on Europe, I can heartily recommend the Lister.

Are you Japanese or do you just live there?  We spent three weeks in Japan just before we decided to try for a baby and I fell totally in love with the country and the people.  Can't wait to go back.

Breathe and believe.

IGx


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## ml2012 (Jul 29, 2012)

Hi, I just came across this site and your post. Your experience gives us some hope, although we are still not sure what to do. I'm 42 and conceived my son naturally and very easily 4 1/2 years ago. We started trying to conceive two years later (2010) and waited too long to seek help. My periods were erratic and I though it was due to my body trying to go back to balance after the contraceptives (femulen first and cerazette afterwards). When we did, our GP said "do not worry, you'll be ok, you have one already so it means you can..." how wrong he was! he gave us a wrong sense of security and instead of seeking private help straight away (being over 40) we waited to get our studies done and eventually be referred to the local NHS/private clinic, which in any case kept stretching things and delaying it even more. By that time my FSH had gone  from 5 to 27 and then down to 12. At that point the NHS clinic sent a letter saying we should re-consider our request for referral because it was most likely we needed egg donation rather than IVF...well, we do now probably but maybe not when we starting seeking help! anyway, they agreed to see me finally and tested my AMH , which was very low, under 2 (no precision, just that...). My husband's test came back fine though. In the meantime I was also having some investigations for possible endo, but the laparoscopy came negative and the dye test sayd it was all clear. Anyway, after  my AMH results (of which I heard through my GP) they never saw us again. I kept calling and they say they couldn't see me at the moment...We then decided to go to the Lister clinic for consultation and had a meeting with one of the consultants. He told us they would do IVF with us, but our chances were 8% for embryo, and 4% live birth. This sounds like a very costly and draining lottery ticket, nothing more.  Besides, their website calculator shows no successes in women of my age and similar hormonal levels (and I failed to ask about this at the appointment). He didn't explain things in great detail though, particularly why is it that the Lister takes people in our situation...are they so much better than all the rest? the consultant was good at interpreting the results of my lap&dye test though (I took a copy of the discharge letter to the consultation). While the doc who did the lap&dye test told me everything seem ok in terms of fertility,  he disagreed because the letter mentioned that my left ovary was less mobile and one of my fallopian tubes had adhesions which made the whole thing more difficult.
Anyway, it is good to know that somebody in a similar situation was lucky at the Lister. The problem is that we don't live in London and it would be difficult to do it over there without support...We're going to have a consultation at the Bristol Fertility center soon, which appears to be good and is much closer to us, but I suspect the only ones willing to treat us will be the Lister and I'm not sure whether it is worth seeing other clinics at all (or whether it is wortht going to IVF at all!)  Sorry for the long post, but it is nice to feel somebody is out there listening...thanks!!


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