How would you act on this information?

[Anonymous]

I'm 30 and, although married, didn't plan on having kids for a few years. Recently decided to do a fertility workup (blood tests, ultrasound) to ensure all was well. The results were unexpectedly very poor (amh of 0.7, fsh of 5.1, 5 visible follicles, etc.)

DH and I decided to start trying now instead of waiting as we had intended. But beyond that, I am feeling confused about interventions I should be moving forward with while we try naturally--for example, freezing embryos--and am trying to wrap my head around different options before our next follow-up appt. Would be interested to hear from others who were in a similar situation - faced with very poor indicators without ever having tried to get pregnant in the past - and how you acted on them.

Hopefully post makes sense - TIA!

[Anonymous]

I probably would have had similar numbers if I’d checked at that age. By the time I check at 33, after trying for a year, my AMH was .3. I did a bunch of iuis, and none worked. You are still young. So, my advice would be to just start trying naturally. Don’t stress out about it. If that doesn’t work after 6 months, then I would start the natural cycle IVF process. It’s actually quite easy, and very similar to iui, and costs a fraction of medicated ivf. Don’t listen to any doctor who tells you to do regular IVF. People with DOR usually aren’t good responders. Don’t waste time/energy on iui. Did your husband get checked? He should, just in case.
So my story is try for years naturally, did the iuis, was ready for IVF, but ended up getting pregnant spontaneously. After my first was 1, I tried naturally for a year, then went straight to natural Cycle IVF. It worked on the first try, and had my second at age 38 1/2. My Amh was <.01 when I last had it checked at age 34. Numbers aren’t everything as long as you are getting your period, you are ovulating. Good luck.

[Anonymous]

I had similar numbers to you when I was a few years younger than you (mid to late 20s). The difference was that I was ready for a baby and DH also had severe male factor. I started with IVF and it worked first try. Six months after the baby, I began trying for number two and have failed ivf after ivf even though my numbers improved and eight years later I still only have one child. I would not advise you to wait. Maybe because DH has MF, but getting pregnant naturally has never happened. I would at least bank embryos while you still can. If you want to wait to transfer them, you can. But bank what you can now.

[Anonymous]

I wouldn't recommend waiting too long especially if you want to have more than one kid ultimately. Natural cycle IVF didn't work for me because my egg quality was bad, too. At your age, egg quality may be fine but if you are successful with natural cycle IVF the first time and then wait a couple of years to have another kid you may find your AMH and FSH deteriorated. I would do a medicated IVF cycle and try to get as many eggs and then as many embryos as possible. Embryos you create at age 30 will most likely be higher quality than embryos you create later. I'd also do PGS testing if you get a good amount of embryos. If you do a medicated cycle and end up with multiple embryos, you can also freeze them and try to get pregnant when you are ready if you don't want to have a child right away.

[Anonymous]

Anonymous wrote:I wouldn't recommend waiting too long especially if you want to have more than one kid ultimately. Natural cycle IVF didn't work for me because my egg quality was bad, too. At your age, egg quality may be fine but if you are successful with natural cycle IVF the first time and then wait a couple of years to have another kid you may find your AMH and FSH deteriorated. I would do a medicated IVF cycle and try to get as many eggs and then as many embryos as possible. Embryos you create at age 30 will most likely be higher quality than embryos you create later. I'd also do PGS testing if you get a good amount of embryos. If you do a medicated cycle and end up with multiple embryos, you can also freeze them and try to get pregnant when you are ready if you don't want to have a child right away.

pp from 7:57 definitely not natural cycle. What worked for me was low dose antagonist, but again, it didn't work for number2. You will want as many embryos as you can. You may not get enough for PGS testing though.

[Anonymous]

You will be fine. Amh only tells how you respond to stim medicine. With your amh if you go on IVF you probably will have five eggs retrieved instead of 15 from women with higher amh.

But amh indicates quantity it does not indicate quality. Quality of eggs is what matters, if you ovulate naturally. Egg quality decreases with age or major illness or abuse of substance. Amh does not tell you how Good your egg is.

You should try naturally first, and then maybe natural IVF because you might not respond well to stim IVF.

Good luck and you will be fine. It only takes one good egg!

[Anonymous]

I had very similar numbers at age 33 and never had success over 3 IVF cycles (2 mini stims) and 2 IUIs. Do not wait and freeze embryos, particularly if you want two kids. You could have low reserve and great quality or few eggs and poor quality. You don’t know until you try. We’ve conceived on our own a few times, but they’ve all been losses.

TL; DR: don’t assume everything will work out in the end. If often doesn’t (that’s when people use donor eggs). Act now and assume things will just get worse.

[Anonymous]

Thanks all - I appreciate the candid responses; this was exactly what I was looking for.