Advice on what to do next

[Anonymous]

I have an almost 3 year old boy. Trying for #2 and conceived earlier this year, but miscarried at 8 weeks in the spring. Since then I've been TTC and was nervous that it was taking so long, so I went to an RE.

RE did standard 3 day tests. Everything seems normal -- but AMH is .7 and FSH is 9.2. When I spoke with RE, he said everything is fairly normal (he didn't seem too concerned about AMH or FSH). But I am a little concerned about the numbers.

Husband tested and all is good there.

RE said if I were really anxious I could go the route of Clomid and then IUI (I seem to be ovulating normally). We've been trying since June and I turned 35 this month. Should I hurry things up with the Clomid/IUI (assuming it would work)? Should I continue trying naturally, knowing that it may be a while to catch a good egg? Any thoughts would be appreciated.

My understanding about my AMH level is that I don't have a ton of eggs left, but I still might have some good ones and it's a matter of time. Is that right?

I am considering doing an HSG (just to do my due diligence and check it all).

Thanks for any thoughts or help.

[Anonymous]

I'm in a similar situation. You didn't say how old you were? 40 myself with 3 yr old DS and trying to conceive for 1 year now with a miscarriage and TS pregnancy along the way. my FSH was 6 and AMH 1 and my D10 clomid challenge FSH was 10. My RE has told me that those values indicate diminishing reserve. We are trying clomid once more, then injectables. I guess it may depend on how old you are how much you may want to speed up the process. I think my RE would be concerned with an AMH of .7. My Dr didn't do the HSG since I've been pregnant 3 times.

[Anonymous]

I would absolutely go forward with Clomid. I've been TTC since December of LAST year and assumed I would get pregnant, at the very least, on Clomid and/or IUI... Fast forward 12 months and we're finally set to do IVF. I'm annoyed with myself that I waited so long to get moving, but, that's me!

[Anonymous]

OP here --

to 11:04, just turned 35 this month.

I got pregnant the first cycle with DC (at age 31), then got pregnant the second cycle we tried (in Feb. '10, at age 34) but that ended up in miscarriage. I am still trying to grapple with such a low AMH and what that means given my history.

11:30, thanks for your insight and I'll consider the Clomid more seriously. Many of my friends say give it some time -- that I've only been trying for 5 months, but it seems odd given my history of getting pregnant easily. Does ovarian reserve diminish that quickly?

Thanks for your advice!

[Anonymous]

I thought that clomid wasn't typically prescribed for
"older" patients (not sure where the cutoff is there) b/c of drying out cervical mucuous or implantation issues or the like... don't know the details but it's definitely worth asking your RE about as I know for some people it winds up backfiring and I think age is a fair predictor of this possibility.

[Anonymous]

What is your anthral follicle count? I think that's a better indicator than AMH. My AMH is 1 and I had 18 anthral follicles on cd6, RE said it was great.