This is IVF... Low AMH - Monica Bivas

This is IVF… Low AMH

Jan 4, 2022 | This is IVF...

Words by Rachael Robinson | @rr_fertilitynutrition 

Even the darkest night will end and the sun will rise. I kept this quote on my phone for nearly four years to help me through some of the darkest days.

My name is Rachael Robinson, and I am a fertility nutritionist based in the UK. Christmas is my favourite time of the year. I had a wonderful Christmas wedding in December 2016 and thought I would have a bouncing bundle of joy by Christmas 2017. How wrong I was.

I had a feeling that something wasn’t quite right early on, my periods did not look particularly healthy and from my temperature charts, I suspected that my luteal phase was too short, so I went to the doctor for some routine blood tests in March 2018.

I will never forget the doctor’s call saying, “your hormones look fine, except you have a low AMH, so is it likely to be difficult for you to get pregnant.”

I didn’t even know what AMH was, but I felt panicked. I wondered what I had done wrong and thought about all of the things that I could have done to bring this on myself.

AMH stands for anti-Mullerian hormone and is the hormone your follicles give off, an indicator of egg count.

This is IVF... Low AMH

I felt so clueless and vulnerable. A lot of information online is doom and gloom when it comes to low AMH, as we cannot increase the number of eggs we have. However, I began to understand that egg quality is far more important than quantity. We continued to try naturally with no luck and were advised by a gynaecologist to go straight into IVF. So by the Christmas of 2017, I was not holding a baby in my arms as hoped but getting ready for my first cycle of IVF.

I remember thinking to myself, “I am young (33)”. I was told that there was an 80% chance of success, so I just followed all of the rules they gave me and thought it would all work out. The clinic I was at encouraged you to drink a litre of whole fat milk a day; that is one of the main things I will remember about that cycle. I had two embryos on day 3, which we transferred, but that cycle did not work. The devastation from an IVF cycle failing is something else. I felt empty and like a complete failure.

I picked myself back up and decided to go for my second cycle in March, and then, on the day my period was due, I had a positive pregnancy test. The joy! Joy of being pregnant, of knowing that I didn’t have to do IVF anymore. The relief was incredible. I went for an early beta and then scanned, and my numbers were really high for 4 weeks. The scan showed two sacs – I could not believe my luck. I was going to be one of ‘those’ people that had the miracle story. Well, that was short lived.

Within 5 days, it became clear that neither baby had developed a heartbeat. The words “I am sorry, but it’s the end of the road for this one” still ring in my ears. I had a D+C and, although devasted, I was quite positive as I now knew that I could get pregnant. Looking back, I should have grieved for longer, but I was like an out of control train; I just couldn’t stop.

Two months later, I went back for my second IVF cycle. I knew it would work, and it did. I got a positive pregnancy test and a good first beta. Then, very quickly, things started to go wrong, my beta didn’t rise enough, and I was told it was likely a chemical pregnancy. I went to the hospital as I was worried, and they told me the same, that it was very unlikely to be an ectopic pregnancy, with only a 1% chance of this being the case. Well, it turns out that someone has to fall into that 1%, and it was me. I was in the hospital twice a day at one point as there was a concern about my fallopian tube rupturing. I needed two shots of methotrexate which meant that I couldn’t try to conceive again for six months. I was discharged from the hospital on the 23rd December 2018, 2 years after I got married.

I went into 2019 broken, but the steam train was still ploughing ahead full power. I moved clinics and my new gynaecologist was a surgeon as well. He performed a laparoscopy to check that my tubes weren’t blocked and then I did a cycle and PGT-A testing. That cycle needs up with 3 abnormal embryos and 1 mosaic. I decided to do one more then move on to a donor egg. The final cycle only had two embryos to test; one was borderline, but I had paid for up to 12 in a year, so they tested it. Well, that borderline embryo came back as normal.

This is IVF... Low AMH

I tried to do two more cycles, but my body stopped responding to the medication, so I converted to IUIs, which didn’t work. The steam train was finally out of steam.

On Halloween 2019, I transferred that one normal embryo and was given the world. I bled in my early pregnancy and was completely traumatised, and for 39 weeks, I felt that I was walking a tightrope but we made it to July 2020 and Felix was born in the middle of a global pandemic.

I have been very fortunate to have my nutrition background to help my body heal and I am so grateful to be able to help others now. It makes some sense of all of the trauma.

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