Poor Responder - Egg Freezing?

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Concerned

Poor Responder - Egg Freezing?

Post by Concerned »

Hi

My sister is 34 1/2 years old. She is currently single and is in a panic about being able to have children when she eventually finds a partner. She was looking into egg freezing and went for a consult. Her Day 3 AMH was 1.57 and her FSH was 8.1. On Day 7 she had an ultrasound in which the Antral Follicle count was 6. The doctor made her believe that her fertility was in dire jeopardy and that she should freeze eggs immediately but warned that she may be a poor responder and would require more than one cycle of freezing. What do these numbers say about her ability to conceive naturally one day in near future? What do these numbers mean as far as egg quality go as well? She is extremely depressed upon hearing this and is also worried financially. She hasn't stopped crying. What is your opinion of the information she was provided? She is looking to go for a second consult as well.

Thank you.
Dr. Wisot
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Re: Poor Responder - Egg Freezing?

Post by Dr. Wisot »

Her numbers are not bad. Her FSH is fine. Not everyone can make a large number of eggs so her AMH and AFC are also not so bad and predict a fair to mediocre response.

But that does not say anything about her ability to conceive now which, based on these numbers and disregarding other potential factors, should be fine. The problem is that we never know how quickly a woman's ovarian reserve will deteriorate.

I suggest she get a second opinion from another doctor who hopefully will not be so alarmist and since she is so concerned she should probably do egg freezing or she will just keep worrying about it and she will make as many eggs as her body can.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Concerned

Re: Poor Responder - Egg Freezing?

Post by Concerned »

So the low AMH of 1.57 is not of great concern? We've read that it can indicate diminished ovarian reserve and poor response to stim? She has been convinced that she will never have children of her own and "has hardly any eggs left".
Concerned

Re: Poor Responder - Egg Freezing?

Post by Concerned »

I received the following reply from the Sher Institute:
Clearly you sister has diminishing ovarian reserve as evidenced by her AMH and AFC. Yes she could conceive naturally on her own, but it is very important for her do bank her eggs and ideally to selectively bank genetically tested eggs before it is too late.

Would you agree with this?
Dr. Wisot
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Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Poor Responder - Egg Freezing?

Post by Dr. Wisot »

I am not going to comment on someone else's opinion.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Concerned

Re: Poor Responder - Egg Freezing?

Post by Concerned »

I'm sorry Dr. Wisot. I hope I did not offend you by sharing another provider's opinion. :( I understand that you cannot comment on another opinion. We've just been so confused and frustrated by the very different points of view we are being offered based on the same numbers (1.57 AMH, 8.1 FSH, AFC 6, Age 34.5). It's such a huge decision - emotionally and financially that we're just trying to make sense of reconcile the opinions we have received. Thank you so much.
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Poor Responder - Egg Freezing?

Post by Dr. Wisot »

A real second opinion with a doctor not associated with the first might help make the decision of whether to freeze or not a this time.

Free consultations are usually worth what they cost. 8-)

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Concerned

Re: Poor Responder - Egg Freezing?

Post by Concerned »

Dr. Wisot - my sister just had her AFC redone (today is Day 2 of her cycle). And they found 13 follicles - 6 on one side and 7 on the other. The last time her AFC was done on CD7 and they found only 2 on one side and 4 on the other. Is such a variance typical or should the first AFC not have been done on Day 7? I've been reading that AFC should be done on Day 2, 3, or 4.
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Poor Responder - Egg Freezing?

Post by Dr. Wisot »

It is more reliable on day 2 or 3. But is very objective anyway and will vary from time to time and between observers.

Same recommendation: get a real second opinion with someone whose will be the same as mine. :D

Arthur l.Wisot, M. D.
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