Old Mother Hubbard

went to the cupboard

and discovered she owned dessicated gonads.

My antenna waved Danger! as soon as I heard the tone of the nurse’s voice down the phone: even over the bustle of the RSC foyer and Harry’s grief-stricken howls (we had just discovered you need to book a timed ticket to go up the tower, and he had been Promised An Immediate Ascent) I could clearly hear that she was projecting enough Cheerful for two; I swiftly deduced that she anticipated I was about to be in deficit. 

(AMH testing is Clever-Shiny-New fertility science, and they’ve recently changed methodology to a 2nd generation assay giving values 40% higher than previously. Keep Calm and multiply by 1.4 if your previous happy AMH level suddenly looks wide of the goal posts.)

Ovarian Fertility Potential                pmol/L  (Not ng/ml, which’d be helluva lot lower.)
High Level                                            > 67.9 
Optimal Fertility                                    40.04 – 67.9       
Satisfactory Fertility                             21.98 – 40.03              
Low Fertility                                          3.08 – 21.97          
Very Low / Undetectable                    0.0 – 3.07       

I scraped a 20. Distinctly and saddeningly sub-optimal, but not quite fully disintegrated into oocytical dust in the coffins of my ovaries, either.

I… wasn’t expecting bad news. Alive to the possibility, yes, but my Autumn 2009 FSH & E2 were – I quote my Consultant – ‘beautiful’, and I felt reassured. Once I’d got my head around the difference between US & UK lab units of measurement, that is. John had been blithely complacent (the man is a congenital optimist, even appertaining to my haphazard reproductive abilities) that I had the ovaries of a nubile teenager, and has had to mentally regroup accordingly.

Ah, well. It’s been a while since I felt really slugged in the stomach. They do say a change is as good as a rest.

Of course, my previous poor response to gonadotrophins now looks completely divorced from the possibility of a still-stunned pituitary after a shitty downreg, and simply looks like common-or-garden Rapidly Emptying Ovaries instead. And the shortened cycle I was crowing over last night might credibly be the dark horseman of the Menopause galloping towards me, waving his scythe, with hot flushes spilling from his saddlebags.

Damn it.

My Consultant has altered my protocol still further on receipt of this glad news and has now prescribed me Gonal F instead of Menopur: I’m not sure why & absolutely can’t be arsed to Google it; the woman knows her business. 300iu for 10 days pro tem, and we’ll see what we get. Another day older and deeper in debt. Sources of Gonal F are, naturellement, more circumscribed than Menopur, although I have managed, after a few phone calls involving Far Too Many Fucking Zeros to get a quote that just squeaks in at under £700, so the cost differential isn’t as Implicationy as I first thought it might be.

If nothing else, this news has made me feel a little more exculpated for already having chosen IVF over IUI – and exonerated altogether for wanting medical reproductive input this time around. 

I know it only takes one egg, but we’ve got to find the bugger first.

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17 Responses

  1. Oh bollocky bollocks. Sorry about the results. Almost satisfactory though so definitely nowhere near over by any means. So that horseman can f off for the time being thank you.

  2. Arse. Feck. Bollocks. Etc.

  3. You’re far too young for that sort of thing. Unfair.

  4. So now we send really extra special positive egg finding thoughts. No worries. I am thinking them as I type 😉

  5. Oh my goodness. A kick to the gut, indeed. Although you are very very close to the lower boundary of Satisfactory.

    Well, on the upside, as you said: it seems like just the right thing that you are scheduled for a well-monitored round of IVF shortly. You have Science on your side!

    Wishing good eggs to a good egg (sorry, I hope you are like me and find lame wordplays cheering).

  6. No no no, I’m not done with the dark horseman just yet, he can’t just gallop off…….

    IVF quickly and with ‘strong’ protocol is what I was told (300 menopur) while my FSH was not beautiful at all, so you should do better than my 2 measly follicles…
    wishing you good eggs.

  7. Oh, curses! Unprintable curses. Feggit!

    The unexpected blows are the worst. I am sorry. You’re only 36, for Gawd’s sake. However, all is not lost, and it is indeed timely that you are poised for IVF.

    So be about your business, Menopur. A good one, please.

  8. Can we please have fate stop kicking poor HFF Wifey when she’s down? Please?

  9. well, shit.

    however. i feel compelled to say that AMH is far from perfect data. sometimes it is just wrong. even my re says so: http://infertilityblog.blogspot.com/2010_01_01_archive.html

    (look about halfway down, in the ivf questions part.)

    don’t feed your ovaries to the poor dog yet.

    • My spaniel shat on the dining room carpet last night, before moving onto the lounge to repeat his triumph. The furry fucker’s getting a single dog biscuit for tea, let alone my Pweciouses!

      • In contrast we were assured that our dogs had been spayed when we adopted them… that was bollocks, they’ve both dripped blood over the house now.
        The added insult was that this week we were in a hired holiday cottage with a £150 damage deposit.

        Maybe I can send you her ovaries when they chop them out in a couple of months time?

  10. Arse arse ARSE arse fuck damn shit bugger. And blast.

    Many hugs. Large glass of something highly alcoholic and soothing. Hanky. Cake. And then we’ll go down to the bottom of the garden and break plates.

  11. Ugh. NOT what you want to hear. At all.
    Hugs and hot water bottles (I defy anyone not to feel just a teeny bit better with a hot water bottle)

  12. Not sure if this helps, written by a Dr on a Dr forum:

    “AMH can change over time and some women’s results improve even though I don’t think there’s an understandable scientific/biological reason for this. One of the clinics I’ve been to doesn’t do levels as they feel it’s ‘little better than the toss of a coin’ with regard to predicting pregnancy.”

    • Yes, John is stoutly disbelieving, bless him! Sadly, I have always been such a shit responder (except for the time I grew a 20mm follicle in attempted downreg!) that I am Darkly Convinced!

  13. Foul news. I’m sorry. And am hard manifesting one tiny, perfect, glistening, hairy-child-producing egg for you on the horizon.

  14. well that’s not particularly helpful, I am sorry.

    I still have puregon (same as gonal f, diff brand name) in the fridge. I will check expiry.

    Menopur is extracted from urine and therefore is not pure – it has FSH but with a bit of LH hanging around. Gonal F is pure FSH produced by putting the gene into cultured cells in the lab and getting them to pump out the stuff. Early on there was a hypothesis that a bit of LH helped mature the oocytes, more recent studies say that’s nonsense.

    So most clinics are moving to the recombinants as they are cheaper and the amount of drug you get is much more controllable (with menopur every batch is different).

    having said that completely unclear why this partiuclar bit of info would make them switch. Docs are odd.

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