Potentially huge setback

Just had a call from Karen Fordham. Looks like my biggest fear may have come true. I've waited so long for the funding, I might have waited too long.

My blood test results are back already. Nice of Karen to call so late in the day, it was 7:30 pm and she was still working!

Results were:

E2: 152 ... Fine
FSH: 6 ... Fine (needs to be less than 9)
AMH: 2 ... NOT fine, ideally should be 10

Seems this could be a potential show stopper. I feel a bit sick, just the injustice of it. Still, they haven't said no, yet. The biggest problem is that the PGD test takes months, possibly a year, so if my level is low now, it's likely to be even lower at treatment start time. There's a meeting next Tuesday evening, my case will be discussed then to see if there's anything can be done.

So now we wait a few days, feeling deflated, but trying not to give up hope.

I have follicles and he has working bollickles!!

Hubby laughed when I said that. I guess a sense of humour is going to be vital through this :)

Today I was seen by Lynn (doctor) and Nathalie (nurse) and I had an ORT (Ovarian Reserve Test). The description on the CRGH website is:

"The ORT (Ovarian Reserve Test) is performed between days 2-5 of the period. It involves a transvaginal scan and baseline blood hormone profile (E2, FSH and AMH)."

So they tell you what it is, but not what they are looking for or why they do the test. The scan (see blog dated 4th November 2011) was to count the follicles. I had five one side and four the other. This is a good number, a relief given my age. The number of follicles is a good indicator of how many eggs a woman has left (remember we're born with all our eggs, once they're gone, they're gone!)

While I was having my scan, the nurse said "I'm just going to take some blood while you are having that done". Hang on a minute! One thing at a time, I'm busy! Oh, I don't think I have a choice in this. I guess might as well get it all over at the same time! I'm a woman, I can multitask. There was of course the advantage that I was laying down, no chance of passing out :)

I was reading a CRGH brochure that I'd kept from a visit about 3 years ago. It describes how they used to just test the FSH hormone levels, but that it was possible that a woman can still have normal FSH levels even though their egg reserve is low. Hence they now do the scan and use the number of follicles as an additional indicator.

Blood test over and done with very quickly, and I was told to phone Karen next Tuesday as the results will take about 1 week.

I found a useful diagram:

I also found a few videos, I'll evaluate them and post a link to the ones I think are best.

More detailed information for those who want to know ......

First day of period flow is counted as day one.

A follicle is an anatomical structure in which the primary oocyte (mature egg) develops. Typically around 20 follicles mature each month and only a single follicle is ovulated (an oocyte is released). The rest undergo atresia. That single dominant follicle becomes a corpus luteum following ovulation.

The blood test checks for three hormone levels:

AMH (Anti-Mullerian Hormone) is a hormone that is produced by the ovaries and is strongly correlated with the egg follicle pool. This hormone does not fluctuate month to month like other hormones, and is a strong predictor of ovarian reserve.

E2 - Estradiol (also known as Oestradiol). From Wikipedia: estradiol acts as a growth hormone for tissue of the reproductive organs, supporting the lining of the vagina, the cervical glands, the endometrium, and the lining of the fallopian tubes. It enhances growth of the myometrium. Estradiol appears necessary to maintain oocytes in the ovary. During the menstrual cycle, estradiol produced by the growing follicle triggers, via a positive feedback system, the hypothalamic-pituitary events that lead to the luteinizing hormone surge, inducing ovulation. In the luteal phase, estradiol, in conjunction with progesterone, prepares the endometrium for implantation

FSH - Follicle Stimulating Hormone, produced by the pituitary gland and directly stimulates the ovaries to recruit and support ovarian follicles, each containing one egg. The hypothalamus adjusts the production of FSH depending upon the levels of other hormones such as estrogen.

Healthy day 3 FSH levels are generally less than 10. Values of 10 to 18 are generally intermediate and are sometimes associated with lower fertility and higher miscarriage rates. Pregnancies are rare and miscarriages increase with high FSH values more than 18. This hormone level needs to be considered along with the E2 level, to check that the FSH level was tested whilst the E2 level was low (which it will be on days 3/4). A high FSH level can be an indicator of low ovarian reserve in older women, less so in younger woman, hence the additional Antral follicle count.

Plenty of lead in his pencil !!

I called the hospital today as we hadn't heard anything. They said they wouldn't have called us unless there was a problem. I needed to speak to an embryologist if I wanted to know the results. I did just that. I wasn't expecting quite such a level of detail, a real eye opener!

Volume: 3.6 ml
Concentration: 27.3 million per ml
Motility (how many are moving): 56%
Progression (how much they are moving / speed): 2-3/4
MAR (Mixed Antiglobulin Reaction): IGA=18% IGG=11% (2 anti sperm antibodies measured, need these measurements to be low)
Morphology: 7% normal
42% head defects
51% neck defects
0% tail defects

Verdict was: Volume and concentration levels were good, motility was above average (anything over 45% is good). MAR and morphology could be slightly better but levels aren't of concern and would not affect treatment.

It's only the start, but at least it's a positive one!

Some success

Well I ended up being so nervous, mainly because I had little idea what to expect, apart from having a blood test, which is not something you'd really look forward to anyway!


We got to the unit on time, just before 4pm. We waited, there seed to be some confusion, although we gave our names when we arrived, the information had not been passed to the person who needed to know. I heard my mobile number being read out, then my bag started to vibrate. I looked up and saw the receptionist on the phone, she started to leave me a voicemail asking where my husband was as he had not turned up for his 4pm appointment!!

Hubby went off to 'produce' as they so nicely put it, so I realised as my appointment was now due, I'd be on my own. I was called soon after into a room which had what I could see was a screen from an ultrasound scan, and what looked like half a bed / stretcher. There appeared to be lots of gadgets, and something standing tall and proud and looked like something from an Anne Summers store! The internal scan turned out to be totally painless, but sadly inconclusive. Looks like I am too far into my cycle, so will have to come back next month. No blood test today.

I felt relieved, and won't have any worries about going back there next month. Hope to get results of Hubby's analysis on Monday or Tuesday.