My Day 3 infertility testing has not changed much in 5 years

[Anonymous]

I've had Day 3 infertility blood work drawn once a year every year for 5 years (been TTC for 5 years, no luck).

I started out at age 38, I am now 42. I would have thought the numbers would have changed significantly in this time, but they haven't.

Age 38 stats:

FSH: 8
LH: 6.1
AMH: .60
Estradiol: 52
AFC: 10

Age 42 stats:

FSH: 16
LH: 7.4
AMH: .40
Estradiol: 64
AFC: 8

How do I interpret this? I know it's not good that my FSH has increased, but I wasn't able to get pregnant at 38 either when it was normal.

[Anonymous]

What did your dr say?

[Anonymous]

Your numbers moved in the right direction. Given that your ovarian reserve was already low at 38, your rapid decline must have happened before age 38.

[Anonymous]

AMH and AFC aren't that much of a change but I believe those change a lot slower once you get that low anyway.

I'd say FSH is a huge change, especially since Estradiol (which suppresses FSH to an extent) also went up.

[Anonymous]

I’m sorry you haven’t had better results OP.

[Anonymous]

Anonymous wrote:
I'd say FSH is a huge change, especially since Estradiol (which suppresses FSH to an extent) also went up.

OP here, what exactly is the implication of my estradiol going up?

[Anonymous]

Anonymous wrote:Your numbers moved in the right direction. Given that your ovarian reserve was already low at 38, your rapid decline must have happened before age 38.

OP here, I got pregnant on the first try at 36 with my son, easy pregnancy and delivery. So did my rapid decline happen during pregnancy because we started TTC #2 when he was 12 months old? This is the part I don't understand.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I'd say FSH is a huge change, especially since Estradiol (which suppresses FSH to an extent) also went up.

OP here, what exactly is the implication of my estradiol going up?

NP - high estradiol makes FSH looks lower than it is. so not only FSH climbed a lot (not sure why are you saying that things have not changed much... your FSH rose 8 points!!) but so did your estradiol which means your FSH is probably more like 18 or 20 now.

I am sorry you are dealing with this and can’t get answers. But your numbers did change.

[Anonymous]

Also your estradiol was always too high, so your FSH was probably over 10 at 38 which is bad.

I was incredibly lucky to have gotten pregnant several times starting at 38. My AMH was low throughout (all my IVFs failed) but my FSH was always under 10 and my estradiol was in low 20s even at 44.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I'd say FSH is a huge change, especially since Estradiol (which suppresses FSH to an extent) also went up.

OP here, what exactly is the implication of my estradiol going up?

NP - high estradiol makes FSH looks lower than it is. so not only FSH climbed a lot (not sure why are you saying that things have not changed much... your FSH rose 8 points!!) but so did your estradiol which means your FSH is probably more like 18 or 20 now.

I am sorry you are dealing with this and can’t get answers. But your numbers did change.

OP here. But the doctor didn't say my estradiol is high, he said it is in a normal range. Also I am having symptoms of low estrogen, so I don't really understand what's going on with my estradiol. If my FSH is 18 or 20 is my infertility journey over?

[Anonymous]

Anonymous wrote:Also your estradiol was always too high, so your FSH was probably over 10 at 38 which is bad.

I was incredibly lucky to have gotten pregnant several times starting at 38. My AMH was low throughout (all my IVFs failed) but my FSH was always under 10 and my estradiol was in low 20s even at 44.

I thought low estradiol is bad. Can you explain why high estradiol levels are bad? I'm unclear about this.

Also my FSH between age 38-40 ranged from 5-10 on the three times it was measured during those ranges but still no luck in getting pregnant.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also your estradiol was always too high, so your FSH was probably over 10 at 38 which is bad.

I was incredibly lucky to have gotten pregnant several times starting at 38. My AMH was low throughout (all my IVFs failed) but my FSH was always under 10 and my estradiol was in low 20s even at 44.

I thought low estradiol is bad. Can you explain why high estradiol levels are bad? I'm unclear about this.

Also my FSH between age 38-40 ranged from 5-10 on the three times it was measured during those ranges but still no luck in getting pregnant.

only the highest FSH is relevant. high FSH indicates that eggs are not signaling well which they think is related to their quality. if you hit 10 at 38 that would indicate low quality for your age.

as for estradiol, it masks your FSH making it seem lower (i.e. better) than it is. so if you FSH was 8 while your estradiol is 40s that means your "real" FSH is more like 10 or 12.

this is independent on whether high estradiol is good or bad. the point is that it makes FSH (which is more important) look better than it is and needs to be taken into account.

as for estradiol itself... low is not good when combined with other hormones which indicate menopause. however, i think the doctors don't quite understand the levels and how they relate to infertility. my own hunch is that estradiol needs to be low (e.g. low 20s) but also climb very sharply before ovulation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also your estradiol was always too high, so your FSH was probably over 10 at 38 which is bad.

I was incredibly lucky to have gotten pregnant several times starting at 38. My AMH was low throughout (all my IVFs failed) but my FSH was always under 10 and my estradiol was in low 20s even at 44.

I thought low estradiol is bad. Can you explain why high estradiol levels are bad? I'm unclear about this.

Also my FSH between age 38-40 ranged from 5-10 on the three times it was measured during those ranges but still no luck in getting pregnant.

only the highest FSH is relevant. high FSH indicates that eggs are not signaling well which they think is related to their quality. if you hit 10 at 38 that would indicate low quality for your age.

as for estradiol, it masks your FSH making it seem lower (i.e. better) than it is. so if you FSH was 8 while your estradiol is 40s that means your "real" FSH is more like 10 or 12.

this is independent on whether high estradiol is good or bad. the point is that it makes FSH (which is more important) look better than it is and needs to be taken into account.

as for estradiol itself... low is not good when combined with other hormones which indicate menopause. however, i think the doctors don't quite understand the levels and how they relate to infertility. my own hunch is that estradiol needs to be low (e.g. low 20s) but also climb very sharply before ovulation.

OP here. Okay, so if an FSH of 10 at age 38 implies low quality eggs for my age, how did I get pregnant on the first try at 36? I have no idea what my hormones were at 36 when I got pregnant because I didn't have an infertility problem then. Is it possible to have normal fertility for my age at 36 and then two years later be completely infertile? This is what I don't really understand, how the decline could happen so sharply. My AMH at 38 was .60 which is already low. At 36 could it really have been that much higher?

[Anonymous]

many clinics have an FSH cutoff of 12 or 15. 20 is a lot. 40+ is menopause.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also your estradiol was always too high, so your FSH was probably over 10 at 38 which is bad.

I was incredibly lucky to have gotten pregnant several times starting at 38. My AMH was low throughout (all my IVFs failed) but my FSH was always under 10 and my estradiol was in low 20s even at 44.

I thought low estradiol is bad. Can you explain why high estradiol levels are bad? I'm unclear about this.

Also my FSH between age 38-40 ranged from 5-10 on the three times it was measured during those ranges but still no luck in getting pregnant.

only the highest FSH is relevant. high FSH indicates that eggs are not signaling well which they think is related to their quality. if you hit 10 at 38 that would indicate low quality for your age.

as for estradiol, it masks your FSH making it seem lower (i.e. better) than it is. so if you FSH was 8 while your estradiol is 40s that means your "real" FSH is more like 10 or 12.

this is independent on whether high estradiol is good or bad. the point is that it makes FSH (which is more important) look better than it is and needs to be taken into account.

as for estradiol itself... low is not good when combined with other hormones which indicate menopause. however, i think the doctors don't quite understand the levels and how they relate to infertility. my own hunch is that estradiol needs to be low (e.g. low 20s) but also climb very sharply before ovulation.

OP here. Okay, so if an FSH of 10 at age 38 implies low quality eggs for my age, how did I get pregnant on the first try at 36? I have no idea what my hormones were at 36 when I got pregnant because I didn't have an infertility problem then. Is it possible to have normal fertility for my age at 36 and then two years later be completely infertile? This is what I don't really understand, how the decline could happen so sharply. My AMH at 38 was .60 which is already low. At 36 could it really have been that much higher?

it’s obviously possible - I mean you said you were trying all these years with no success. to me it looks like you didn’t have a lot of eggs and also they were low quality. during those two years both things got worse. so maybe you used to have 3 good eggs per year at 36 and then 1 good egg per year at 38 and fewer after that. so maybe you only had 2-3 good eggs to work with since 38.