Very low AMH, endometriosis surgery

    • New

    Hello,

    I am 38, 15 years ago I had an operation to remove endometriosis cysts. Follicular tissue was removed in the process. My AMH is 0.04. I also have lipoedema, which was treated with liposuction. So hormonally everything is not so optimal.


    I have had 2 ICSI attempts in a natural cycle. 1st attempt, no egg could be retrieved. 2nd attempt, egg was fertilized but did not develop after the first division. Now my cycle has come to a standstill. I am currently doing a cycle reset with Zyclo progynovia.
    My partner's spermiogram was unremarkable.

    I'm wondering whether next time, if an egg can be retrieved, tests should be carried out to check whether the quality of the egg and sperm can lead to a promising embryo at all.

    How would you proceed in such a case?

    • New

    Dear supergirl,

    Thank you for sharing your story with us.

    You need to know that 38 years without any further fertility problems is already a crucial age for fertility to achieve a healthy pregnancy with your own gametes. From the age of 35, the quality of the egg cells begins to decline, and at 38 this quality drops significantly. For this reason, we receive fewer mature eggs and fewer embryos after an ICSI cycle, which is why we perform PGT-A on the embryos of almost all of our patients over the age of 38. We can also do a PRP infiltration before the cycle to try and get more eggs, but only if there is sufficient ovarian response.

    However, these are examples of treatments and techniques that we can use with an expected AMH of 38 (around 1) in women with no other medical conditions.

    In your case, PRP is not an indication, and certainly PGT-A would be recommended if you get a blastocyst, but at such a low AMH - and your body response is 100% your AMH - it is very, very rare to get a blastocyst, and our best indication for you to achieve pregnancy and hold a healthy baby in your arms is egg donation.

    I know you are still young and there is a genetic grief to accept, but if you were my patient, I would honestly tell you that this would be your best option to become a mother. If it is any consolation, please know that unfortunately you are far from alone in this. I am here for you if you would like to talk about this option, which is not allowed in Germany/Switzerland.

    Yours sincerely <3

    Dr. A. García-Villalba

    Ihr Vida Fertility Team <3

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