UTI, Low AMH, TTC since 10 month

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Ruci
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UTI, Low AMH, TTC since 10 month

Post by Ruci »

Hi, I am 27years and healthy [weight-51.5kg, Height-5.2ft, normal cycle(27-29 days and brown spot 1-2 days before period), TSH-3.72 ulU/ml, T4-6.4 ug/dl, VDRL-negative, prolactin-9.37 ng/ml, normal uterus-ovary-tubes by vaginal Ultrasound].
Husband 30 years and healthy [weight-64kg, Hight-5.8ft, count-56mil/ml, active motile-25%, sluggish motile-10%, abnormal forms:head-15%,body-18%,tail-12%]

we are TTC since 10 month. All above test are done 6 months before and since 6 months I am taking folic-acid and productive-F, Husband takes productive-M (started Maxoza-L since 2 months)

Last week, I got my AMH done and it is 1.5ng/ml. Dr suggest to take Vitamin E for both of us. According to Dr my AMH is low compared to my Age. Can vitamin D3 improve my chance(AMH)?I Is my AMH too much low to conceive naturally? Please suggest options.

Also Since last 3 cycles I am getting UTI after 2-3 days continues(once a day) intercourse around ovulation. I have completed 11days course of Norflox-400(twice day) in last cycle and started to urinate before and 20-30 min after intercourse, still I got UTI in current cycle. I am married since 5 years and used to fall a sleep Whole night(without getting up) after sex but never got UTI. please suggest.
Dr. Wisot
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Re: UTI, Low AMH, TTC since 10 month

Post by Dr. Wisot »

What you have had done so far sounds OK except we usually like the TSH to be 2.5 or below.

But your evaluation is not complete and since you have been trying for almost a year I suggest you see a real infertility specialist to complete the remainder of the work-up and start treatment if necessary.

The UTI is probably not related to the delay in conceiving.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Ruci
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Posts: 3
Joined: Tue Aug 08, 2017 11:33 pm

Re: UTI, Low AMH, TTC since 10 month

Post by Ruci »

Thank you very much for the Answer. :)
I have visited the infertility specialist in past month(on TTC month 9).
According to her nothing is wrong and no further steps required at this point, but I suspect little bit about TSH so I have started Yoga and few diet chances to improve thyroid function.
She said:
'Even normal couples have only 5% chance each cycle, multiple things has to happen correctly. Even fertile couple can take up to 1.5 to 2 years to get pregnant. Give time to Nature to do the things, it's not like you want a be pregnant and you will be.'

Steps to follow according to her for 3 cycles(as per the my 27-29 day cycles) :
1.'Stop tracking ovulation(cervical mucus-BBT which I was tracking) and have everyday sex from Cycle Day 12 to 16 with complete abstain from sex 5 days before that (which I was doing every other day in fertile week without any abstain)'
2.'Urinate immediate after Sex, lying down will not do any help but cause UTI to happen' :cry:
3.'Continue with multi-vitamins/supplements, which we are taking'

She is very confident that I will not need to see her again. I am not completely agree with all the above and little restless, but my husband is very hopeful. Am I on right direction?

Your opinion on above steps(specially 1&2) and on next evaluation/steps will be very very helpful.
Dr. Wisot
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Re: UTI, Low AMH, TTC since 10 month

Post by Dr. Wisot »

1.'Stop tracking ovulation(cervical mucus-BBT which I was tracking) and have everyday sex from Cycle Day 12 to 16 with complete abstain from sex 5 days before that (which I was doing every other day in fertile week without any abstain)'

Technically it would be standard advice for someone 27 to try for a year before even an evaluation. My philosophy is to do the testing when there is concern and someone is stressed by it like you. Generally it's felt that two days of abstinence gives you the best sperm sample. The one test you have not had is a post coital test and if that's abnormal then you are wasting your time.

It's very difficult to stop stressing. So for my patient I would recommend that she have a post coital test and if normal just continue to try well-timed intercourse for another two months.

2.'Urinate immediate after Sex, lying down will not do any help but cause UTI to happen' :cry:

There is no need to stay on the back more than a few minutes and then urinate if it's needed. Don't hold it in. It does not help.

3.'Continue with multi-vitamins/supplements, which we are taking'

Sure.

She is very confident that I will not need to see her again. I am not completely agree with all the above and little restless, but my husband is very hopeful. Am I on right direction?

If the post coital test is good, then another few months of trying is reasonable[/b]

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Ruci
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Re: UTI, Low AMH, TTC since 10 month

Post by Ruci »

Thank you for the detailed answer. Suggestion for the next step is very helpful. :)
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