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  1. #1
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    Unhappy Low amh at 27 and pregnancy resulted in miscarriage at 5 weeks

    Hi,

    We have been TTCing for past 3 years and finally took the path of ART last month. After initial tests, I was diagnosed with low amh of 1.3 which is very low for my age [27] and a complex ovarian cyst on my right ovary.

    So my FS referred to a surgeon to get a laproscopy done to start IVF ASAP because of my diminishing ovarian reserve. But fortunately I got pregnant that month but my happiness was short-lived resulting in a miscarriage at 5 weeks due to low progesterone levels.

    My progesterone levels were normal at the time of initial test but not sure how they dropped so low in a matter of month. Could this even happen? Does this mean that I would be miscarrying every time? Just trying to get my head around these things.

    At this stage, I am considering donor egg IVF cycle overseas. Do I have to take progesterone supplements even for those cycles? Can someone please answer my questions.

    I got my test results on March 11th, positive pregnancy test on 18th of March and miscarriage on March 22nd. My life sucks

  2. #2
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    Hi wannakid

    Firstly, I'm so sorry to hear of your loss. It's heartbreaking and I really feel for you

    My story. I have an AMH of 4 so as you know, it's not as low as yours but it's still VERY low. I was given a 1% chance of conceiving naturally. I got my first ever BFP in January 2012 but sadly that ended in a missed miscarriage. After much testing, amongst a whole bunch of other problems, it was discovered that my progesterone was low after ovulation. Too low to sustain a pregnancy. My progesterone reading was 16 at 7dpo.

    I was put on Clomid to up my progesterone readings and after my first cycle on Clomid, my progesterone shot up to 69! No BFP that month. Next Clomid cycle my progesterone was 49 and bam, I got my BFP! I am now almost 31 weeks along


    There is hope. The AMH test is relatively new so even my fertility specialist told me not to pay too much attention to it. I was told I would need IVF and I got pregnant twice naturally so it can happen.

    I would definitely recommend you get your blood tested at 7dpo to see what your normal progesterone reading is. I would then get myself to a specialist who can prescribe you Clomid and see what your 7dpo progesterone reading is on that. There are always progesterone pessaries that can be prescribed for you for the first 12 weeks of pregnancy until the placenta takes over if progesterone droping really is the problem for you. I used a progesterone cream for the first 12 weeks of my pregnancy.

    Don’t jump the gun just yet with overseas donor eggs. You may not need it. You fell pregnant once so that’s a great base to start on. My strong recommendation .. don’t waste time. If you don’t have a fertility specialist, get one! Get testing started and take it from there.

    If you ever need to talk or have ANY questions, please PM me. I’d be more than happy to help

  3. The Following User Says Thank You to FirstTimeMummy2012 For This Useful Post:

    wannakid  (22-03-2013)

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    Hi FirstTimeMummy2012,

    Thanks alot I love you so much I do have a FS. She was the one who recommended these tests for me. Called her this morning to report about the miscarriage and left her a message. She gave me a callback without reading my file and made me feel worse by confusing my cysts with uterine fibroids She went on telling that I will be experiencing more miscarriages if don't get that fibroid removed After that I received a call from my boss asking me to work over the weekend since I took a day off today. He definitely needs me to work on Monday I feel like no one understands me I feel like the entire universe is working against me.


    My progesterone last month on CD 16 was 47.7 if that helps. Can I ask you about your FSH?
    Last edited by wannakid; 22-03-2013 at 11:10.

  5. #4
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    Oh you poor dear! I understand you so feel free to vent to me anytime you need

    To start with your FS sounds a little too insensitive for my liking ans she sounds like a twit! I didn't know much about them but I just did some research and it causes recurrent miscarriages in about 5% of women so that's a really low statistic. She shouldn't have said that you will have recurrent miscarriages as that's not necessarily true. It's not the end of the world. Uterine fibroids can be removed through surgery and/or shrunk with medication so something can be done

    What I would do? I'd get a second opinion from another FS. Can you find another and get seen by them asap? I'd explain the situation and ask them to do further testing to either confirm the diagnosis or advise you of what's really going on. Most uterine fibroids don't effect pregnancy so you just never know if that really is the problem.

    I gather your progesterone test was done at 7 days past ovulation? A reading of 47.7 is great!! Are you on any medication to stimulate egg production because that reading is super high and awesome!

    As for FSH, here's some info:

    Follicle Stimulating Hormone (FSH) Day 3 Reading of 3-20 mIU/mlFSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.

    I had a reading of 3 which indicates a strong ovarian reserve but my AMH test was low as you know so it doesn't really make sense. Those reults kinda contradict one another. What was your result?

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    Thank you FirstTimeMummy2012. you are a sweetheart. To be honest, my FS mistook my ovarian cyst for uterine fibroid as she didn't read my file before giving me call

    Next thing is she is pushing me to get blood work done to test my hCG levels tomorrow. However I think it is too early as I just started bleeding this morning.

    I am not on any medication for stimulation but been ovulating regularly for past 5 or 6 months. This was totally natural pregnancy. Arghh i wish my progesterone levels stayed normal.

    My FSH is slightly high at 12. Not having too much hopes at this stage.

    Is there any reason for my progesterone level drop? i hope it is a one off thing

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    Hi and sorry for your loss . Just something to consider, if a pregnancy is failing anyway (say there is something genetically wrong and it was always going to miscarry) then your progesterone levels will start to fall as part of the process of starting to bleed. So it may not have been the low progesterone that caused the mc but rather the progesterone was shown to be low because the pregnancy was already failing. This may mean that it won't be a problem for a future pregnancy.

    There are progesterone support medications that can be given (they still can't support a non viable pregnancy, but can help boost your natural progesterone with a healthy pregnancy) so you could always ask for some luteal phase support for extra reassurance next time, although if you don't need them they can be messy and expensive. Worth speaking to your specialist about. Fingers crossed for a sticky bub soon

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    wannakid  (22-03-2013)

  9. #7
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    Veggiemama you raise a very good point there

    Wannakid, I'm a little confused. So your don't have uterine fibroids and it actually is a cyst or vice versa??

    Personally, I would get your HCG tested to see where it's at. So you only just started bleeding today? Are you sure you're miscarrying or could it just be bleeding that happens in most pregnancies? I would definitely get that HCG tested to make sure of what's happening.

    Your FSH of 12 indicates a "diminished ovarian reserve" but fear not as age is on your side. There are plenty of women (after doing some research) that have fallen pregnant with an FSH of 12 under the age of 30. Remember that it's the quality of the egg and not quantity that counts when trying to fall pregnant and it only takes 1 egg to win!

    As veggiemama said, progesterone will naturally drop when a pregnanacy is not viable for whatever reason (genetic problems etc) so it doesn't mean this is always going to happen to you. Your initial progesterone reading was brilliant so I doubt progesterone is your problem.

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    Thank you again lovely ladies

    FirstTimeMummy2012, it is an ovarian cyst and NOT an uterine fibroid. The fertility specialist didn't have a clue. I had to correct her and then she said "Either way you have to get that fixed to achieve a successful pregnancy"

    I am tempted to change doctors at this stage. I am convinced that it is a miscarriage as the bleeding is heavy like periods.

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    What a horrible FS she sounds like! Wannakid I'd be changing her and quickly! An ovarian cyst doesn't cause miscarriages that I know of. I know HEAPS of women with ovarian cysts that have had successful pregnancies. If it gets too big you just get it removed. It's a really simple surgery

    Considering you started bleeding so soon after your positive pregnancy test I'd be inclined to say that it sounds like you had a chemical pregnancy but of course I'm just assuming.

    Unfortunately some pregnancies just aren't meant to be ..

    Seriously, I think you're going to be ok. I really think you'll get another positive that will result in a healthy and beautiful bubba! I'm fairly certain of it

  12. #10
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    Thank you Can you girls recommend some good fertility specialist around Parramatta who specialize in low amh problems? I feel my FS is not so compassionate.


 

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