Fertility Workup Results

I would love some insight from those who may have had some similar experiences, or those more informed about this than I. So I had my first Clomid + Ovidrel cycle with the RE. Of course he did labs and ultrasounds to give me a general fertility workup.

I am 42 years old (so no spring chicken). Basically the only things that the RE said were concerning were that I had an AFC of 6 and an AMH of 0.509. He said the AMH was discouraging but did say he's "seen hundreds of women get pregnant with that AMH". So basically, I have a low reserve.... However, at 42, I would guess that's pretty normal. And from what I've researched, this AMH seems pretty normal for someone over 40, so I guess I kind of don't understand why he would have thought it would be much better than that? The other concern was my thyroid (TSH) level, was up to a 2.6, from a 1.85 in the summer. So he did agree to up my levothyroxine from 88 to 100.

From what I gather, the rest of my results look really good, especially for my age, but he didn't spend much time talking about the rest of my labs (didn't mention my FSH once). So my FSH was 3.96, LH 2.47, and Estradiol was 46. I was really encouraged by these numbers but he didn't mention them at all at my appointment. He did tell me at my ultrasound yesterday (CD 11), that I had a 20 mm follicle on my right ovary, and that I had a "beautiful" triple stripe endometrium of 11 (not sure exactly what that means but I guess it must be good). He even said he could tell on the ultrasound that I had a lot of fertile CM in the cervix (he said it shows up on the ultrasound as "water")....never knew your CM could show up on an ultrasound! Lol. So by appearances, everything looks like it is happening the way it is supposed to. I am encouraged by that, but still keep coming back to the low reserve and worrying how much that is hurting my chances of becoming pregnant. He did print off a picture of my follicle "in case I get pregnant this cycle", meaning he's not saying I have no chance or anything, but he did mention that although everything looked great on the ultrasound, it doesn't mean the egg is good genetically (which I already knew).

I keep telling myself that if my FSH and Estradiol were that good I am either making at least some good eggs and / or I still have healthy, responsive ovaries, so the AMH doesn't mean I can't get pregnant naturally, but I still feel a little bleak about the reserve issue. From what I've read some fertility experts say AMH doesn't really matter much unless you're going to do IVF? (Not in my plans).

I also am a little worried that my TSH being 2.6 might hinder my chances of successful pregnancy this month, since it is over 2, but I don't know if it's really so out of range that it would hurt my chances? I think I'd be encouraged to know if anyone was able to get pregnant with their thyroid levels being a little off. Of course I started taking the higher dose of thyroid medication right away but I know that will take some time to affect my TSH.

Anyway, I have mixed feelings about the results - I'm happy to know my body is doing everything it is supposed to do, but also worrying that my reserve is such that I have slim chances of achieving pregnancy.

Yes. Subpar AMH is to be expected at 42 and it DOES NOT mean you can't get pregnant. It means that were you to do IVF, you couldn't make 5-10 good eggs a month, but you probably can still make one good egg, in some months, and so that's what we need to have happen here.

I actually think Femara may be better for you than Clomid but since you've responded well to the Clomid this month that's great!

Your TSH - as long as they've corrected your medication, they've done what needs to happen to enable pregnancy to occur.
That's all we can ask for and so I'd try not to worry about it. It sounds to me like you're in good hands. Good luck!!

Thank you Atomic, as usual your response helps to ease my mind 😊

I do think he is a pretty good RE, when I first went in for the consult I was expecting him to be down about my chances due to my age, but instead he just said because of being older I had a lower ratio of good eggs left but that it just means you have to keep trying until your get that 1 out of 5 or whatever the ratio happens to be.

I was expecting him to put me on Femara too, because of my being over 40, but he told me he was going to try Clomid because he wanted me to develop more than one egg, to give me a higher chance of getting a good one. Though from what I've read it usually takes more than 50 mg to make more than one develop (maybe they were just being cautious). I did have another on that ovary that was 12 mm, so it was trying to develop but apparently didn't quite catch up to that 20 mm.

That's reassuring about the TSH. I figured if it was so bad that it would interfere with my chances that he would've told me not to try this month and he didn't so that makes sense. He is having me go back for a blood draw in six weeks to check the TSH so I am happy about that.

I am encouraged that aside from the AMH, my body seems to be doing everything it is supposed to do to allow a pregnancy to take place. That does reaffirm to me that i do have a chance. I am convinced that is because of the things I've been doing according to what you advise on here for boy swaying - HE diet and supps to improve fertility / egg quality. I've even been drinking organic whole milk most of the time, which was a hard switch for me because I wasn't used to it. I really think the HE diet and supps to improve egg quality such as ubiquinol and fish oil and antioxidants are the reason my FSH was so low despite having a low AMH. On a side note I also found it interesting that my dominant follicle was on my right ovary, and the next largest one was too. I remembered what I've read you saying on here that when your body is in a good state (like when swaying for a boy), you are more likely to ovulate from your right side.

Thanks again so much for researching and sharing so much helpful advice on here for swaying and ttc.

EXACTLY! That's right! It doesn't mean we don't have a good chance of conceiving, it may mean we don't have as many chances as a younger woman and thus have to be diligent about trying to catch Goldie the Goldie Egg! :)

FX and TX too! Sending you all my "vintage mama" dust! :)

Vintage mama.....love it! Lol