Unexpected but not unexplained anymore

Our clinic got my AMH blood test results back sooner than expected. The instant I saw the subject line: Results, I knew it wasn’t ideal.

My nurse started it off like this:

“Hi Lindsey. I received your AMH result and it is a little lower than we would have liked to see – this may explain why you having such difficulty becoming pregnant. It is basically telling us that you have a decreased ovarian reserve (which means that you don’t have as many eggs as someone else your age). It doesn’t mean that you can’t have a baby. Based on the findings Dr. H has recommended that we increase your dose of medications to try and get the most from your ovaries.” 

You know that moment when you read something you don’t really want to be reading, so you literally don’t digest any of it? Yeah, that was me. Hmmm, kinda makes me wonder if this is what happened with my Mom before… anyway… 

I wrote her back and asked, “Does this mean I have diminished ovarian reserve?!?!”  

She responded with yes. Clearly Lindsey. Re-read the paragraph! 

My AMH measured 14.99 pmol/l.  The chart below shows that I’m at the high end of low fertility.

Ovarian Fertility Potential pmol/l ng/ml
Optimal Fertility 28.6 – 48.5 4.0 – 6.8
Satisfactory Fertility 15.7 – 28.6 2.2 – 4.0
Low Fertility 2.2 – 15.7 0.3 – 2.2
Very Low/Undetectable 0.0 – 2.2 0.0 – 0.3
Higher levels, can be associated with PCOS > 48.5 > 6.8

I have the eggs of the 36-37 year old, when I only JUST turned 29.

However, there are still many positives to focus on:

  • I am only 29. We still have time to get pregnant
  • I’m only low, it could be A LOT worse
  • IVF will help us and that’s where we are headed

When I start stimming, I’ll be on Puregon and Repronex. After finding out these results, Dr. H increased my Puregon from 150 IU to 225 IU to start.

The irony of the situation is that my parents are SO RELIEVED that we have a diagnosis and are now fully supporting our journey to IVF. Was that really all you needed? I could have made up a diagnosis if I knew that! 😐 

So, here I am: I officially have diminished ovarian reserve. Our (in)fertility is female factor. 

Not sure if I enjoy being labelled. Unexplained was more mysterious. 😉

UPDATE (2014/10/22): After our 1st IVF cycle, it’s obvious due to the numbers of follicles produced (29 retrieved) that my AMH result was NOT a good indication of my ovarian reserve. Right now, we are back to unexplained with slight male factor (low-ish morphology).

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62 thoughts on “Unexpected but not unexplained anymore

  1. Well, I’m sure part of you is not happy with this…but on the other hand at least now you know! I’m also glad to hear they’re tailoring your meds around your new diagnosis. I’m so confident that IVF is going to be the solution for you guys!! Wtf….in response to your parents reaction. I’m glad they’re finally on board, even if it does seem weak that this is why they’re on board!

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  2. I’m so sorry for this news hon, but still very hopeful for you. My diagnosis for RPL was DOR. My AMH level was 0.16 ng/ml, so really, really low. Now that you know, I’m sure your doctor will really take good care of you and make sure you have the right dose of meds.

    So weird about your parents! It doesn’t matter what they think, but I am glad they’re on board now and will hopefully give you the support you need. Hugs friend. Hang in there. Keeping everything crossed for you!

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  3. It’s good to have answers. I’m very very surprised you’ve never had your AMH levels checked before, that was one of the first things my RE checked. Nonetheless, it’s great news in the sense that now they can appropriately medicate you.

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  4. Not ideal news, I know – but you have answers and explanations – and therefore treatments! Those are all positive! You def. still are so young, so there are so many things in your favor!!! You are on the right track, girl!

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  5. did you have your AMH checked before this? i also came back with a borderline low number of 1.28 ng/ml recently, though a year ago it was 6.13 :/ this was after we found out we had male factor infertility, so we’re now in the lovely combined group. i’ve also been reassured that IVF will be a great help, and yes, you’re still young! i am actually 36 and have eggs that are more like 37 😦

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  6. I am both happy and sad for you at the same time. I am sure it’s a relief to have a diagnosis. It’s kind of like finally there’s a map to your desired destination. It sucks that it’s DOR though. But like you said, at 29 so you have a little more time! I’m sure you already know many bloggers with the same diagnosis, but if you’re looking for more I have follow mostly DOR bloggers and have them listed in my side bar. I am glad your doctor is taking immediate action in upping your dosage. I will keep my fingers crossed for you this cycle!

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  7. I have low AMH too (.7) and am only JUST 27. My RE says this has zero impact or indications on *quality* just quantity. It’s also the reason we are fast tracking to IVF too. At least there are answers, and you have a good plan going forward!! Keeping fingers crossed for your ivf cycle!!

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    • Thanks for sharing with me. I knew in my gut we needed to continue moving forward even when our family didn’t agree and I was right. Still trying to understand what all this means, but no matter what I know there still is hope.

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  8. Getting a diagnosis is double-edged. Sure it is nice to know, yet, you don’t really want to know it is you (or your partner). I still have a hard time believing my diagnosis is endometriosos. That’s “all” that is wrong with me… :S

    I think I had the same dosage of Puregon. Injections. I still shudder. 🙂

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  9. I just wanted to let you know that I’ve been thinking about you. I know this is hard, but with explanation I know it leads to some sort of relief. Now you can make informed decisions based on this new knowledge. Praying so much for your IVF cycle already!

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  10. There must be a sense of relief in knowing even though it’s an unfortunate situation. I know as much as I hated our diagnosis (mfi) I was glad to know the cause. Good luck stimming. Hope you make more follies with the increase in meds!

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  11. I’m so glad you reached out. I know its hard to find out when something actually is “wrong” but I believe you will be okay! I believe the IVF will be your answer 🙂 and im so glad to see that Freija Chloe has a list of others with DOR too!

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  12. Like what many people said up there, age 29 is a huge advantage even if you’ve been diagnosed with DOR. Age is a very good indicator for egg quality. Your first IVF will tell you how you respond to IVF protocols. If the first one is not successful, you will have time to tweak. I hope you don’t need to, but in the future if high stim protocols don’t work for you, maybe mini ones do. Let me know and I can talk to you more about it. I have a 27-year-old friend who was diagnosed with DOR did a couple of rounds of IVF and just gave birth to a baby girl. So age is to your advantage. Looking at your AMH level, you may still respond well to stims. What is your antral follicle count?

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      • That’s what RE or IVF clinics usually do when they try to come up with a diagnosis. 3 things they do: FSH (with estradiol), AMH, and AFC. They usually do a scan to see how many resting follicles you have. Hopefully they do all these things to get a full picture of your ovarian reserve and how well you’ll respond to an IVF protocol.

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  13. I’m glad you have an answer! I also have low AMH (0.6 ng/ml), but I’m 36, so it’s probably not such a surprise. 😉 Of course, having endo doesn’t help, either. In fact, I think the endo was more of an issue than low AMH, but IVF totally bypassed that.

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  14. I’m sorry to hear you received this news but like you said, IVF is a great place to start solving this aggressively and there is absolutely hope. Knowing what to target will only increase the odds because they know just what they need to treat. I am hopeful that your IVF will bring success and I’m super glad your family is on board the IVF baby making train.

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  15. It feels so much better to know! I think at least… all my stress just melted away when we made the move to go with IVF.. and funny thing is that after they found out why we were doing it (MIF), they were a lot more supportive.. up until then, everyone (including my husband) thought i was just being impatient and should just keep trying..

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  16. Hi, I also have Low AMH for my age. I am 32 and my first AMH came back at 2pmol/L and the second at 8pmol/L. I was devastated! Our fertility specialist suggested we try for a bit longer. So, we are still hopeful that we will conceive naturally and are just about to hit our 1 year of TTC. If we don’t conceive in the next few months we will be going down the IVF road as well. I am sorry to hear about your diagnosis, just know you are not alone on this journey 🙂

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  17. I have low AMH and once they adjusted my meds to deal with that, I had completely normal response to IVF. So the test allowed us to avoid a cycle that I would have been considered a poor responder. My dr. also told me that it is only a test that is helpful for knowing how much medication to give you. It has nothing to due with egg quality.

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  18. Pingback: Planning the trip for IVF | Awaiting Autumn

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  20. Pingback: Another curve ball on the journey to baby | Awaiting Autumn

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