High AMH/ OHSS

Post Reply
jeathorne
User
Posts: 1
Joined: Wed May 25, 2016 5:29 pm

High AMH/ OHSS

Post by jeathorne »

Hello,

My husband and I have been trying to conceive for over 2 years now. I have an AMH level of 14 and am 31. Before meeting with the RE, I had somewhat normal cycles of 31 days and had an LH surge on day 17. We did one controlled cycle and my RE had me on what he said is the lowest dose of 75 units of Follistim. On the 7th day of follistim shots, I had an ultrasound that looked very promising. Unfortunately when I returned after the 9th day of follistim shots, my doctor canceled our trigger shot because we had about 6 mature follicles and many other follicles that were close to it. He also had my estroidal checked that day and it was in the 4000's, which he said is the highest he has ever seen. After not using the trigger shot, I didn't get my period. They put me on progesterone for 10 days to get my period and when I went in to see the doctor on day 61 of my cycle and had a cyst that was 35 mm. Luckily, 5 days later it had decreased in size to 22 mm so we tried a cycle with 5 mg of letrozole. On day 13, my ultrasound had 2 follicles that measured 14mm. When I came back in on day 16 one follicle grew to a 19mm but my lining was too thin. The RE said that letrozole would not work for me and suggested we start to think about IVF. We decided to try a month on clomid to see if it would work but the RE didn't really think this would work.

What I want to know is if there is anything else I can try before jumping into IVF. I am 5'6" and now close to 150 pounds after gaining 10 pounds from the fertility treatments. I work out 5 days a week and eat a clean diet. I have a tilted uterus and my RE said I may have a little endometriosis because my right ovary seems to be stuck to my uterus when he does an ultrasound.

Is there any treatments that my RE may be overlooking? Thank you in advance for your help.
Dr. Amin
Site Admin
Posts: 56
Joined: Wed Mar 30, 2016 10:49 am

Re: High AMH/ OHSS

Post by Dr. Amin »

Having a high AMH level and having so many follicles puts you at risk for having a multiple gestation (twins, triplets, etc.) pregnancy and ovarian hyperstimulation syndrome. In this situation, some options to try include letrozole, clomid, a lower dose of FSH, or IVF. Your reproductive endocrinologist may be suggesting IVF because it's easier to control the risk of multiple gestation and OHSS with IVF compared to a controlled ovarian hyperstimulation cycle with FSH. It's difficult to give you an exact recommendation about what to do next without seeing your ultrasound myself, but these are some options to discuss with your reproductive endocrinologist.

Marli Amin, MD
Reproductive Partners Medical Group
Orange County, CA
Marli Amin, MD
Reproductive Partners Medical Group
Orange County, CA
Post Reply