These numbers at 42

[Anonymous]

I'm from the previous link about first RE appointment and realized I should do a s/o re day 3 numbers. My OB just said they're normal but didn't elaborate. Any insights as I wait three weeks for my RE appointment(s)?

AMH 1.81
Estridiol 36
FSH 8.3

FWIW, I turned 42 six weeks ago and have a 5 year old, and I had a MC in the spring, after one month trying.

[Anonymous]

There are other tests they do, but sounds like those were normal, or you're waiting to hear. If all else is normal, those are def good #s for 42. The #s don't tell you as much about quality, though, which is just as important. That's where age comes in as a predictor. You'll likely respond well to the stim meds and get a good # of eggs if you do IVF, but it's also likely that few will be normal. That means your chances for success are lower than a 30 yo (which I'm sure you knew already), but it doesn't mean it can't happen. The overall success rate for 42y olds who try IVF (as opposed to all 42 yo) is about 20%, so unfortunately it's not a sure thing. AMH of 1.81 at 42 is great, though. I also got pregnant at 39 w/o trying, then at 41 I decided to go to an RE b/c I wanted a second and knew I was old. I had a lower AMH and lower FSH than you (don't remember exact #s), but at 41 and 42, I did get a pretty good # of eggs on both high and low doses of stims. No luck after a bunch of cycles so I moved on to DE. Also, for reference, donors are typically required have have AMH above 2 in addition to having the age cutoff of 30-32. As far as IVF goes, it's a bit of a "best of the worst" scenario, so hopefully you can focus on the best part. I do hope it works out for you. Good luck!

[Anonymous]

OP here--thanks for your encouraging and candid response.

[Anonymous]

At 42 it's not really so much about those numbers, but rather the quality issue. Very few eggs are going to be PGS normal. If you're aware of that and willing to do this multiple times then it might be possible. However I would say also consider donor eggs if that is something you can do religiously/financially/other reasons, This is not easy stuff, but as someone a lot younger I couldn't make it work with my own eggs so I really feel for you and wish you the best.

[Anonymous]

I am 42 as well and had testing in December. My AMH = 2.55, FSH = 4.1. My office lists test results on a patient portal with and it includes this interpretation.

AMH
Reference Range, Females 41 - 46y: 0.26 - 5.81
Median 0.58
AMH concentrations of >= 1.06 ng/mL is correlated with a better response to ovarian stimulation, produced more retrievable oocytes and higher odds of live birth according to Gleicher et al. Fertility and Sterility. 2010:94:2824-2827.

FSH
Adult Female:
Follicular phase 3.5 - 12.5
Ovulation phase 4.7 - 21.5
Luteal phase 1.7 - 7.7
Postmenopausal 25.8 - 134.8

Your levels are good and as PP said means you will likely respond well to IVF. I had miscarriage last fall and then did 2 rounds of egg retrievals this past winter. They got 13 eggs and then 14 eggs. From those 4 blasts and 5 blasts. So far they have put in 7 w/o success. Waiting to do the FET on the last two. So as you see, you may generate a eggs/embryos but not take home a baby.

I wish you all the best luck!

[Anonymous]

I'm 33 and I'd kill for those numbers (DOR and secondary infertility). But your eggs are a decade older which means even if you get more at IVF retrieval, many/most of those may be abnormal. But again, it's a crap shoot, so you may as well try.

[Anonymous]

OP if you have a number of embryos after retrieval then see about transferring on Day 3 and use the highest number they will let you transfer at that point. At 42, you could transfer 5 at once if you have an RE who will permit it. I did that at your age and was successful.

[Anonymous]

Wow those numbers are great! I'm 42 and my AMH is dismally low. But yeah it's all about quality at this age (and as someone who has low AMH and is a poor responder, that doesn't bode well for me). I hope you're able to get a lot of eggs in the hopes at least one will be normal. Best of luck!

[Anonymous]

OP here. I appreciate everyone's input. I am trying to get a crash DCUM course in fertility! So is IVF basically my only option? Could I do it without all the meds, like the natural kind I read about? IUI? The more I know before I see the RE, the better my questions can be. Thank you all for your help! I think the quick pregnancy in February (didn't try for long) and then MC made me naive about how hard it would be at my age.

[Anonymous]

Hi OP,

I just turned 43. My numbers were similar. I’m 3 days into cycle #1. I went straight to IVF because, at this age, there’s no time to spare trying less aggressive measures if you want to try to conceive with your own eggs.

I’ve heard better numbers than 20% for IVF with PGS testing prior to implantation. Best of luck.

[Anonymous]

Ivf odds at 41-42 r about 20% overall. If you do get a PGS normal embryo the odds that the normal embryo will work much higher than 20%. At that point age matters much less. That’s also why DE has better success for older people - it gets you the normal embryo.

[Anonymous]

Don’t waste time with natural or IUI cycle. You’ll have to opportunity to try naturally between IVF cycles. But at 42 you have to be aggressive.

[Anonymous]

Anonymous wrote:Ivf odds at 41-42 r about 20% overall. If you do get a PGS normal embryo the odds that the normal embryo will work much higher than 20%. At that point age matters much less. That’s also why DE has better success for older people - it gets you the normal embryo.

Wow that's pretty high odds. I was told much lower at age 40 when I went in, I was told 10% or less with IVF and I have ok numbers.

[Anonymous]

Anonymous wrote:I am 42 as well and had testing in December. My AMH = 2.55, FSH = 4.1. My office lists test results on a patient portal with and it includes this interpretation.

AMH
Reference Range, Females 41 - 46y: 0.26 - 5.81
Median 0.58
AMH concentrations of >= 1.06 ng/mL is correlated with a better response to ovarian stimulation, produced more retrievable oocytes and higher odds of live birth according to Gleicher et al. Fertility and Sterility. 2010:94:2824-2827.

FSH
Adult Female:
Follicular phase 3.5 - 12.5
Ovulation phase 4.7 - 21.5
Luteal phase 1.7 - 7.7
Postmenopausal 25.8 - 134.8

Your levels are good and as PP said means you will likely respond well to IVF. I had miscarriage last fall and then did 2 rounds of egg retrievals this past winter. They got 13 eggs and then 14 eggs. From those 4 blasts and 5 blasts. So far they have put in 7 w/o success. Waiting to do the FET on the last two. So as you see, you may generate a eggs/embryos but not take home a baby.

I wish you all the best luck!

PP,were these untested 5 day blasts?

[Anonymous]

Anonymous wrote:I'm 33 and I'd kill for those numbers (DOR and secondary infertility). But your eggs are a decade older which means even if you get more at IVF retrieval, many/most of those may be abnormal. But again, it's a crap shoot, so you may as well try.

Ditto! Agree you should try, OP.