Missing

I have not blogged since March, so for about 3 months now. Where have I been? Well, no where really, but I have not had anything new to blog about and I have been a bit unmotivated as well. If I'm honest, I have been feeling a bit down and depressed in these past 3 months trying to sort out what I want to do now.

We met with our reproductive endocrinologist (RE) in May and have sorted out a plan. We are going to do two more rounds of IUI in June and July and then take a break until after September if neither of them take. I will be gone for the month of September to Ghana to do midwifery work, and upon returning, we will try IVF. Since my husband will be leaving for work for half a year in the fall, he will probably have to make several deposits before he goes and I will undergo IVF alone.

These are the things I have been dealing with. Going through IVF alone, spending the holidays along, possibly being pregnant for a large chunk of time alone and my husband missing out on all of this.

On a good note, we have been approved for the Attain IVF program where we will receive 4 rounds of IVF (2 fresh and 2 frozen) for $16,000 USD. If I were under 35, I could have qualified for having a percentage of my fees refunded if our IVF attempts were unsuccessful. But due to being 38, this is not an option because of the reduced chances of having a successful pregnancy via IVF after 35. Luckily my chances do not go down drastically until I reach 40, so I do have a good chance left still and that is why it is important to go ahead with the IVF even if my husband is not here. Every 6 months I wait, my chances decrease as my eggs get older and fewer.

The last bit of news is that I received my anti-Müllerian hormone (AMH) results. This hormone is suppose to be able to tell how much of an ovarian reserve one has and is a serum blood assay that can be drawn on any day of the cycle, unlike FSH, estrogen or progesterone. The results are as follows:

Interpretation	AMH Blood Level
High (often PCOS)	Over 3.0 ng/ml
Normal	Over 1.0 ng/ml
Low Normal Range	0.7 - 0.9 ng/ml
Low	0.3 - 0.6 ng/ml
Very Low	Less than 0.3 ng/ml

My result was 1.1. JUST above the normal cut off range. I have been researching this in journals and have found that IVF is most successful with a value of 1.24 or greater. The articles recommend taking DHEA. A good blog post about this is by Kylie Hughes: DHEA for low ovarian reserve. Her blog research and linked articles show that IVF success was significantly increased with DHEA supplementation for those with low AMH results. Right now my RE is saying my chances with no intervention is only 1.8% per month of conceiving on my own, 8.6% chance with IUI + clomid and around 50% for IVF. I am not sure if my AMH result now will affect that 50% chance for a successful IVF. These are the things I plan to ask her this Saturday when I go for my scan to see how many eggs have developed for this cycle. If there are enough eggs, as there have been in the past, we will do round 3 this week.