Thoughts on my latest RE consultation

Thoughts on my latest RE consultation

Joined: January 12th, 2012, 6:08 pm

January 23rd, 2012, 12:26 am #1

Hello everyone,

I am relatively new to this forum but have already benefited from reading many comments and stories. I would greatly appreciate any comments about my latest RE consultation.

I am 36 years old (36 years and 4 months to be exact). My Day 3 FSH level was tested to be at 21 and my AMH level is less than .16. The RE told me that my chance of conceiving naturally is less than a half percent and my chance of having a successful IVF using my egg is 5%. He also said the miscarriage rate would be more than 60%. I was tested for Fragile X because the RE felt it is not normal to have my current FSH and AMH levels (don't know results yet).

I had an HSG which turned out to be normal. The RE did not suggest doing an antral follicle ultrasound (I believe that is what has been mentioned on this site). I asked if the FSH and AMH levels indicated the quality of my eggs (not just the quantity) and he stated "yes". He, of course, pushed for the donor egg with IVF. He also said I am borderline hypothyoid but said this is not affecting my fertility.

The RE also mentioned that every couple has a 15% chance of conceiving every month and by the end of one year, 85 out of 100 couples will be pregnant. Isn't this comparing ALL couples, despite their age? Are there "age-specific" norms for what is considered to be normal?

Nothing was as shocking as hearing (2 weeks ago) that I had "abnormal test results" and DOR. The shock has worn off a little bit but I am just wondering if my consultation is pretty much what everyone else is hearing from their RE.

Thanks so much for reading and for any comments!
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teresa
teresa

January 23rd, 2012, 12:49 am #2

welcome to the board. you are in the right place being here.

i'm fairly new here too and learning...but i will tell you this one thing that i know for SURE. there are more success stories than i have ever heard of here from women with high fsh after being given the DE speech, "it will never happen unless you do IVF" and getting booted from clinics..many here have heard these words. there is great support, advice and encouragement here. and success. you will feel MUCH better and more hopeful after spending some time here.

getting the initial diagnosis of having elevated/high fsh is shocking and scary and enough to throw you over the edge..it did to me..and then i found this board. i am learning to question doctors..these women have taught me so many thing i never would have known to ask/do on my own.


i am in the early stages of this journey and i am going to see one of the doctors that came highly recommended by many ladies here who have had success...but i will tell you to read the posts on this board, ask lots of questions, be super proactive and dont let a doctor make you feel hopeless because there is living proof that it CAN happen. seek 2nd even third opinions if you have to.

XOXOXO
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Joined: September 30th, 2011, 8:08 pm

January 23rd, 2012, 1:07 am #3

Hi. First of all I am so sorry about your news. I got diagnosed with high fsh back in Sept. The highest it's been is 27, the lowest 19.8. I agree with everything that was said in the previous post. I was in shock and devestated when I got this news. I had been pregnant twice in 2010 that ended in m/c. I felt like my world was crashing down on me and some days it can still feel that way. I am only 33. The shock does wear off somewhat. My RE told me from the start that it would be very difficult for us to conceive with my own eggs, but fortunetely I did not get the whole "donor egg" speech. My RE said to not give up on my own eggs yet. My age being a positive factor in all this. I believe my AMH was close to yours. I have been told a few things but if I understand correctly, AMH checks your egg reserve. It is thought that many women with high FSH may also produce poor quality eggs as well though. Like I said I have gotten a few different answers. You will find alot of support on this site from women who COMPLETELY understand what you are going through. With that being said, there are many different theory's on fsh and what may lower it,fsh friendly doctors, etc. It is important to like the RE you are working with because you will probably be at the clinic alot. I am in the middle of my first IVF cycle now with an FSH of 25 this month. I'm thankful that my RE would cycle me with a number that high and will go forward with retrieval even with one follicle. Many clinics won't. You are in the right place. As hard as it is, I try not to give up hope on my own eggs just yet....and you shouldn't either. I wish you all the best.
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Laura
Laura

January 23rd, 2012, 1:38 am #4

Hello everyone,

I am relatively new to this forum but have already benefited from reading many comments and stories. I would greatly appreciate any comments about my latest RE consultation.

I am 36 years old (36 years and 4 months to be exact). My Day 3 FSH level was tested to be at 21 and my AMH level is less than .16. The RE told me that my chance of conceiving naturally is less than a half percent and my chance of having a successful IVF using my egg is 5%. He also said the miscarriage rate would be more than 60%. I was tested for Fragile X because the RE felt it is not normal to have my current FSH and AMH levels (don't know results yet).

I had an HSG which turned out to be normal. The RE did not suggest doing an antral follicle ultrasound (I believe that is what has been mentioned on this site). I asked if the FSH and AMH levels indicated the quality of my eggs (not just the quantity) and he stated "yes". He, of course, pushed for the donor egg with IVF. He also said I am borderline hypothyoid but said this is not affecting my fertility.

The RE also mentioned that every couple has a 15% chance of conceiving every month and by the end of one year, 85 out of 100 couples will be pregnant. Isn't this comparing ALL couples, despite their age? Are there "age-specific" norms for what is considered to be normal?

Nothing was as shocking as hearing (2 weeks ago) that I had "abnormal test results" and DOR. The shock has worn off a little bit but I am just wondering if my consultation is pretty much what everyone else is hearing from their RE.

Thanks so much for reading and for any comments!
as our conditions are not life-threatening, and usually not covered by insurance, here's what goes on with RE's clinics: the higher their success rates, the more clients they get through the door, and the more they can charge for their services. Women with DOR tend to respond less to stims and have worse success rates bc of the fewer follies in play. These women will be bad for success rates, thus bad for business, so some clinics either boot them or just tell them that "it's not worth it" to try with OE and only DE will get you pg.

But, I think everyone here would say "YES IT IS WORTH IT!!!" So, find a Dr who agrees with you. My RE did not blink twice at my most recent FSH of 22. He did not give me the DE speech. Heck, he didn't even give me the IVF speech. He said, "let's see what we can do about this before we even start talking about IVF." So, find a Dr who HAS A PLAN for getting your hormones back on track first.

I think the majority of us here have been told or found that FSH has nothing to do with egg quality, or live birth rate. It is an indicator of how hard your brain has to work to get your ovaries to respond to recruit follicles. If you have fewer follicles, your brain will have to work harder, thus giving you higher FSH. What was your e2 (estradiol)? Your RE really should be doing an AFC every month, because that is the best indicator of how well you will respond to stims.
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Joined: January 12th, 2012, 6:08 pm

January 23rd, 2012, 2:05 am #5

Thanks everyone so much for your responses so far.

My estradiol level was 7.5. What does this mean?

I was surprised that the RE did not even mention an AFC. He said he is willing to work with my own eggs, if that is what my husband and I want. However, he kept warning us of the risks and made me feel like we would be wasting our time and money.

My other issue is that my insurance will cover a portion of IVF but only if my FSH level is below 19. I'm wondering if there is a way to temporarily lower it enough to test below 19?

This forum is a lifesaver - thanks again to all!
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Laura
Laura

January 23rd, 2012, 2:27 am #6

The good news is that your e2 is low (lower than 20 is low, higher than 80 is high) with high FSH, which means you will probably respond to treatments to lower FSH. If your e2 is too high, then it means your FSH actually should be higher, since e2 suppresses FSH.

I also had low e2 at the beginning of this cycle and FSH=22. I had a few follies visible on u/s, but they were smaller than they should have been, consistent with low e2. All my RE did was Rx estradiol to aid follicle development and I ovulated CD15/16 and had a 18mm CL cyst visible on u/s. I don't know what it did to my FSH, as FSH goes everywhere after CD5 and should not be tested until the next cycle, so we'll see what happens.
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Jamie
Jamie

January 23rd, 2012, 2:59 am #7

Hello everyone,

I am relatively new to this forum but have already benefited from reading many comments and stories. I would greatly appreciate any comments about my latest RE consultation.

I am 36 years old (36 years and 4 months to be exact). My Day 3 FSH level was tested to be at 21 and my AMH level is less than .16. The RE told me that my chance of conceiving naturally is less than a half percent and my chance of having a successful IVF using my egg is 5%. He also said the miscarriage rate would be more than 60%. I was tested for Fragile X because the RE felt it is not normal to have my current FSH and AMH levels (don't know results yet).

I had an HSG which turned out to be normal. The RE did not suggest doing an antral follicle ultrasound (I believe that is what has been mentioned on this site). I asked if the FSH and AMH levels indicated the quality of my eggs (not just the quantity) and he stated "yes". He, of course, pushed for the donor egg with IVF. He also said I am borderline hypothyoid but said this is not affecting my fertility.

The RE also mentioned that every couple has a 15% chance of conceiving every month and by the end of one year, 85 out of 100 couples will be pregnant. Isn't this comparing ALL couples, despite their age? Are there "age-specific" norms for what is considered to be normal?

Nothing was as shocking as hearing (2 weeks ago) that I had "abnormal test results" and DOR. The shock has worn off a little bit but I am just wondering if my consultation is pretty much what everyone else is hearing from their RE.

Thanks so much for reading and for any comments!
FSH is NOT an indication of egg quality. There are many, many studies showing that FSH does not reflect egg quality. It may reflect your ability to respond to the stimulation drugs for IVF, but I have an FSH identical to yours and I didn't have any problems when the right protocol was used.

AMH is an indication of the quantity of eggs but not the quality. AMH can be related to IVF outcome but only because you probably won't produce as many eggs. However, at age 36 your egg quality should still be quite good.

If I were you I absolutely would not deal with this person any longer. I had a very similar consult at age 36.5. It ended up costing me two years of time. When I finally found an RE with a clue, I was 39. On my first IVF with him I became pregnant and had my daughter, but now I'm 40 and racing against the clock to have another one. At your age you would have a good chance if you can get to the right RE.

Where are you located? If you post that someone will probably suggest an RE who would be more optimistic for you.

Glad you are here! I was you fours years ago . . . and I am here to tell you that often on this board there are happy endings.
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Jamie
Jamie

January 23rd, 2012, 3:01 am #8

Thanks everyone so much for your responses so far.

My estradiol level was 7.5. What does this mean?

I was surprised that the RE did not even mention an AFC. He said he is willing to work with my own eggs, if that is what my husband and I want. However, he kept warning us of the risks and made me feel like we would be wasting our time and money.

My other issue is that my insurance will cover a portion of IVF but only if my FSH level is below 19. I'm wondering if there is a way to temporarily lower it enough to test below 19?

This forum is a lifesaver - thanks again to all!
When I drank 1-2oz a day, I found that it lowered my FSH. The other thing many people have had success with is chinese herbs and acupuncture (when treated by a knowledgable practitioner who understands fertility). I was able to drop my FSH from 20 to 6.5 in two months using all this.
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Joined: January 12th, 2012, 6:08 pm

January 23rd, 2012, 4:00 am #9

FSH is NOT an indication of egg quality. There are many, many studies showing that FSH does not reflect egg quality. It may reflect your ability to respond to the stimulation drugs for IVF, but I have an FSH identical to yours and I didn't have any problems when the right protocol was used.

AMH is an indication of the quantity of eggs but not the quality. AMH can be related to IVF outcome but only because you probably won't produce as many eggs. However, at age 36 your egg quality should still be quite good.

If I were you I absolutely would not deal with this person any longer. I had a very similar consult at age 36.5. It ended up costing me two years of time. When I finally found an RE with a clue, I was 39. On my first IVF with him I became pregnant and had my daughter, but now I'm 40 and racing against the clock to have another one. At your age you would have a good chance if you can get to the right RE.

Where are you located? If you post that someone will probably suggest an RE who would be more optimistic for you.

Glad you are here! I was you fours years ago . . . and I am here to tell you that often on this board there are happy endings.
Thank you so much. I had been reading a lot about FSH and AMH so was surprised when the RE said that those levels were indicators of my egg quality.

I live in Milwaukee, WI and read about Dr. Lifchez in Illinois (a recommended high FSH friendly RE). I will definitely make an appointment with him to get a second opinion.

A family member of mine described this whole process as a huge roller coaster ride and I already can tell that's what it is (and it has only been 2 weeks my initial appointment with the RE).

Also, greatly appreciate the tip on wheatgrass. My RE went into this whole lecture about how he doesn't want me to waste my time and money on acupuncture, etc. I think he just says the same things to each and every patient that comes to his office.

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Joined: December 28th, 2011, 1:28 pm

January 23rd, 2012, 2:03 pm #10

Hello everyone,

I am relatively new to this forum but have already benefited from reading many comments and stories. I would greatly appreciate any comments about my latest RE consultation.

I am 36 years old (36 years and 4 months to be exact). My Day 3 FSH level was tested to be at 21 and my AMH level is less than .16. The RE told me that my chance of conceiving naturally is less than a half percent and my chance of having a successful IVF using my egg is 5%. He also said the miscarriage rate would be more than 60%. I was tested for Fragile X because the RE felt it is not normal to have my current FSH and AMH levels (don't know results yet).

I had an HSG which turned out to be normal. The RE did not suggest doing an antral follicle ultrasound (I believe that is what has been mentioned on this site). I asked if the FSH and AMH levels indicated the quality of my eggs (not just the quantity) and he stated "yes". He, of course, pushed for the donor egg with IVF. He also said I am borderline hypothyoid but said this is not affecting my fertility.

The RE also mentioned that every couple has a 15% chance of conceiving every month and by the end of one year, 85 out of 100 couples will be pregnant. Isn't this comparing ALL couples, despite their age? Are there "age-specific" norms for what is considered to be normal?

Nothing was as shocking as hearing (2 weeks ago) that I had "abnormal test results" and DOR. The shock has worn off a little bit but I am just wondering if my consultation is pretty much what everyone else is hearing from their RE.

Thanks so much for reading and for any comments!
Hello! My twin sister's numbers are almost identical to yours. Her FSH is 20 am AMH .2 We are 32 years old. Her RE put her on DHEA and recommended 3 months of acupuncture. My sister is still very hopeful and I am trying to do my best to help her stay positive. She was tested for Fragile X but it came back negative. I really feel for you and I hope with all of my heart that you and my sister both have a success story to share some day. Best of luck to you!
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