I guess the title says it all, I am wondering if anyone out there has extremely high AMH levels and has successfully undergone IVF and not suffered from OHSS.
A little background, my husband had no sperm due to a micro-y deletion on his y chromosome. I have PCOS with a AMH level of 106.2 (so through the roof).
I have just had two letrozole cycles (one at 2.5mg and one at 5mg) intended for IUI cancelled due to no lead follicles growing but having over a 100 little follicles. I also had a positive ovulation test this morning and was booked in for my IUI tomorrow and hubby and i were so excited! Unfortunately, something just didn't feel right to me so I requested a scan today just to confirm and there were no lead follicles even though I got the positive test, so soul crushing.
They are talking about putting me on injectables for next cycle and most likely IVF but they are really worried that I will over-stimulate.
Has anyone else been in a similar situation and can relate or give me any advice, particularly regarding the OHSS which worries me a fair bit.
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05-03-2012 18:10 #1
PCOS, IVF, high AMH and OHSS
05-03-2012 19:14 #2
Angel- I have polycystic ovaries but my only symptoms are long cycles, otherwise I have normal hormone levels etc. I have never had my AMH measured. We had fertility issues due to my husbands chromosome translocation. Just thought I'd share my experience with you...
I did three rounds of clomid (with no monitoring apart from Ovulation predictors), two IUIs with injectibles (one lead follicle each time) and then moved onto IVF. My first three rounds I produced 13, 10 and then 7 eggs (on low dose Puregon) with all BFN. My fourth round I did a different cycle type (long down reg) and produced 16 eggs. I felt fairly bloated after EPU each time, but this improved after about 4-5 days later. With my last round I got a BFP and got late onset OHSS because of it (on day 12). It is the sickest I have ever been! I was so excited to get my BFP but so scared as I was so sick. I got really dehydrated, my stomach was huge and I could barely get off the couch. I was off work for 3 weeks and I didn't get back to normal until 8-9 weeks.
Not to scare you, but your fear is definitely a legitimate one. One way of avoiding late onset OHSS is to do a 'freeze all' cycle where they don't do a fresh transfer, but do a transfer on your next cycle (either natural or with hormone therapy). If I have to do IVF again, this is something I would consider. But having said all that, I would go through it all again to get my BFP. It is very scary at the time though, and there are other women who get even sicker then I did and have to be hospitalised.
I guess you just have to be guided by your FS and hopefully they will manage you really well so that you won't have to worry about it. Being aware of the risks and symptoms is a good start.
05-03-2012 19:51 #3
There are other ladies that can probably explain this better than me, but there are certain trigger drugs that can be used that eliminate (or heavily reduce the case of ohss). I also got late onset ohss with my first and successful cycle and it was late onset because the baby was releasing so much hcg! She was a strong baby and still is to this day haha
But I wouldn't wish ohss on anyone, it was terribly painful.
I think drugs containing straight LH hormone have a lesser chance on ohss compared to drugs with hcg. Do some googling and see what other people are saying. I found some great information and names of drugs I will be suggesting to FS when we cycle in may. I just don't have them with me right now.
05-03-2012 20:01 #4Senior Member
- Join Date
- Oct 2010
Angel ask your FS about IVM. Basically this procedure means that you are only stimmed for a short period of time (3-5 days) with immature eggs being collected and matured in the lab. It is mainly for women with PCOS so there is no chance of OHSS. I did this procedure on my last cycle.
28-04-2012 22:10 #5Junior Member
- Join Date
- Mar 2012
Hi Angel, maybe we can be buddies? Your post grabbed my attention because I fall in to the same boat exactly! I have severe poly cystic ovaries, been ttc for 12 months and just went through an IUI cycle that got converted to IVF because I over stimmed. You think your AMH is high? I know how you feel! Mine is 325. Yes, three hundred twenty five. I was on gonal f and not responding on low doses so FS added Luveris. It set my ovaries off like popcorn and then we coasted for a few days before we converted to an egg pick up. We used lucrin (LH) as the trigger rather than hcg. We were expecting 80 follicles at egg collection but unfortunately I didn't respond to the LH trigger and in end there were 0 follicles to collect we're now on a one month break before starting a long down-regulation cycle (my estrogen went up to 20,000 so needs time to get back to baseline). We are going to have to use the real trigger this time but it means close monitoring and extremely high risk of ohss and hospitalization. Unfortunately we have no other choice, nothing has gotten me to ovulate even once in the past 12 months so we're looking forward to hopefully getting some mature follicles and good embbies soon! Let me know if you want to be support buddies, I rarely see anyone else on here with such high amh levels too! Best of luck on your journey
11-05-2012 19:27 #6
Hi angel and honeybee, just saw this post and am interested to hear more on how things are going for you both. I too have PCOS and amh of 198, pleased to hear I'm not the only one way over 100 honeybee! Is there anything we can do to reduce the level?? Prob a stupid question but anyway... Based on the experiences of both of you it sounds like I shouldn't hold much hope that I'm going to get a BFP without IVF or serious overstimulation. Any other info you have to share on the gravity of this high amh situation would be greatly appreciated.
11-05-2012 20:13 #7
Hi SummerShine, thanks for the mention on IVM. I'd not heard of this and just doing a quick search now it sounds really interesting and something to keep in mind if injections don't work out. Doesn't look like anyone in qld knows too much about it though so you're lucky over there in WA. Hope it works out for you soon
17-05-2012 13:52 #8
Don't despair, there are a few tricks a FS will try before suggesting IVF. I have since found out I also have Endo and my husband has no sperm so given these factors IVF is the best solution for us to try to get pregnant and beat the endo coming back.
I don't know what your personal TTC journey has included to date but I suspect IUI might definitely be a path to consider, just because I didn't respond to the IUI drugs doesn't mean that you won't.
As for the OHSS, well I am currently on CD15 of my first IVF cycle and have been on Puregon since CD3. I am booked for egg pickup on Monday (as they can't do it on the weekend, which is about when they expect my follies will be mature). Whilst I am taking it very easy today and I am now receiving daily calls from the FN to check up on me, I am still feeling mostly ok....have a little bit of pain and am pretty bloated by no OHSS yet *touch wood*.
With regard to lowering your AMH levels, there is no way to do this that I know of, but if you find a way, let me know
17-05-2012 18:17 #9
Thanks for the reply angel, it's really just reassuring to know your not the only one going through these things iykwim! I'm still feeling pretty positive about it all. I'm young and have a great DP and it's still early days for us so will just try and take it as it comes. I started fsh today and all went well so will see next tues what effect that has had, fingers crossed. All the best with your egg pick up and a smooth transfer and of course hopefully that BFP
01-06-2012 21:20 #10Junior Member
- Join Date
- Mar 2012
Hi Greenfairy welcome! Great to hear you're on the journey too! Feel free to PM me if you want to share stories re high AMH levels! Hope your journey here is short and sweet
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