Friday, March 13, 2009

Could Be Worse, Right?

The last of the Black Market Blood Results are in:

Anti Mullerian Hormone (AMH) is a hormone marker that defines ovarian reserve, ovarian aging, ovarian dysfunction and ovarian responsiveness. AMH levels decrease as the quality and number of ovarian follicles decline with age.

Basically, it indicates how "old" your ovaries are and how functional they are. It also predicts your response to ovarian stimulation protocols, or how well you will respond to the meds they give you for IVF.

Women with low AMH levels have fewer oocytes, lower fertilization rates, generate fewer embryos, and have a higher chance of miscarriage during fresh transfers, ultimately resulting in half the pregnancy rate per IVF cycle as compared to women with high AMH levels.

AMH Reference Ranges:
Optimal Fertility=28.6-48.5 pmol/L
Satisfactory Fertility=15.7-28.6 pmol/L
Low Fertility=2.2-15.7 pmol/L
Very Low Fertility=2-2.2 pmol/L

I just turned 26, and my AMH level is 2.8.

Apparently, I do not have rockstar ovaries.

To be fair, I just started researching AMH about an hour ago, and I'm certainly not an expert on it yet. I don't even know if my level of 2.8 is measured in pmol/L, it could be measured in ng/mL instead. That would actually be much better, because in contradiction to the above doomsday chart, a "normal" level can also be 0-7 when measured in ng/ml; the higher, the better.

Either way-measured in pmol/L or ng/ml-2.8 is not higher, or better.

Maybe it's simple-they'll just put me on stronger drugs, using a protocol more appropriate for a 45 year old than for a someone in her mid-twenty's. Because somehow in the last two weeks we've officially gone from perfectly normal and unexplained to having dysfunctional ovaries with old, shriveled up eggs and lazy, sluggish sperm that never had a chance.


I'm such a drama queen.

I have a phone consult with Dr. Greene on Monday after noon. Until then, I'm holding onto my sanity and refusing to panic, soothing myself with the realization that things could be much worse. At least they caught this now, and they'll make sure they put me on the correct dosage of meds instead of assuming I have an amazing ovarian reserve because I'm young and healthy.

This is probably my own fault anyway, I'm being punished for not being patient and just waiting for the Dr. to call me with the results himself.

I will no longer be writing "copy to patient" on my own lab slips.

"When things are bad, we take comfort in the thought that they could always be worse. And when they are, we find hope in the thought that things are so bad that they have to get better."
-Malcolm Forbes


Sara Scissors said...

It's so funny to read your blog because you sound just like me...Type-A personality all the way! I am so impatient and need all the information I can get, like yesterday! I know there's sites out there that tell you what's "normal". I've always been told that each lab is different and only your RE can tell you what your level in each area means. So try your best not to worry quite yet. They might just score things slightly different.

Also did they test your Inhibin-B with all those hormone levels? That's the only one I didn't see you mention and now that I know we go to the same set of clinics I was just wondering. Good luck at your CD 3 b/w review either way! :)

Hillary said...

Wow, Tabitha, I'm sorry! Even if your RE can shed a better light on that number, I know it's difficult to *think* you could have "bad" news. :( I like your plan to just wait until Monday to see what the RE says, and rest assured that God knew you would get this number and DOES have a plan for you! **hugs**

♥Tabitha said...

Actually, they haven't tested my Inhibin-B, and I was going to ask him about it on Monday. Some things I've been reading say that AMH is a better indicatior, but then others say that Inhibin-B is a better indicator...stupid google!!

Lisa said...

I hear ya...I have a body of a 45 year old women too and it sucks. Trust your Dr's and I am sure it wont matter, they know what they're doing!

Anonymous said...

Don't give up hope about the AMH levels. You need to know the units- it definitely matters. My AMH was 0.9 and 1.1 ng/mL and my RE said that the cutoff for good outcome is 1.0, so 2.8 would be really good. I'm pregnant with twins and am 40 after the 2nd IVF.


Anonymous said...

Forgot to mention, that the reference ranges given in pmol/L do not translate to ng/mL- you have to get another reference range for the ng/mL. I don't have the info at hand, but I'm a scientist and could find the info for you if you don't understand.


♥Tabitha said...

Thanks for the info! (and congrats on your twins!) I actually found out over the weekend that my final number is 2.8ng/mL. So 1-7ng/mL is considered normal according to the lab, but I do have a phone consult with my Dr. in about 45min to go over the results. I'm anxious to hear what he thinks about this number, and I'll keep you guys updated!