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Maria72

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1

Thursday, December 30th 2010, 3:24pm

I need help understanding my test results

Day 3 blood results:

Oestradiol= 336pmol/L
progesterone= <2 nmol/L (why have the progesterone on day 3??)
prolactin 189 miu/L
FSH= 7 u/L
LH 3.3 u/L

amh is very low, non existant amh = 0.85 pmol/l
Can someone help? I know only consultants can, but so that I have a rough idea at my appointment on the 4th of jan.
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Thursday, December 30th 2010, 4:08pm

I am not entirely sure but have got my own set of results out to see what they say and compare....hang on!

These are Day 2 results:

FSH: 12 (apparently should have been between 0.5 and 5
LH: 4.3

With regard to the others, I cannot remember which day these were taken so will not add them as it may just confuse the issue!

I think if your FSH is slightly raised it will be in line with your low AMH (hope that makes sense) although. Mr Diakos at Bourn told me something about LH levels having to be between 1 and 1.5 of FSH but I cannot recall entirely what he said. Sorry not being very helpful here am I.

My AMH is also low at 3.12 but my FSH seems to fluctuate, although nearly always higher than normal.

My friend had an AMH of 0.8 or something (after ttc for three years after her little girl was born) and was told she would have to have IVF.......she is now about 24 weeks pregnant (naturally)!
3 X ICSI
Jessica Mae Duffety born sleeping on 9 January 2011 (21+2) - TS and HLHS
Holly and Elliot Duffety born on 16 October 2011 (25+6)
Natural Surprise - Matthew Evan Duffety born sleeping on 11 October 2013 (15+5)

Maria72

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Thursday, December 30th 2010, 4:19pm

My last FSH was lower, it was 5 :( It was 2 years ago though...
I think the LH is probably low and I presume progesterone is supposed to be low on day 3 ???????? Don't know :(

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Thursday, December 30th 2010, 4:29pm

Hi Maria,

Sorry that I can't be of anymore help - as I say, my other test results were on differing days throughout the month so would just confuse things even more. I know that I was surprised at my high FSH - I was only 29 at the time! It does fluctuate each month though apparently. Who knows why I never got pregnant naturally........they just told me at Bourn that I looked to have premature ovarian failure.
3 X ICSI
Jessica Mae Duffety born sleeping on 9 January 2011 (21+2) - TS and HLHS
Holly and Elliot Duffety born on 16 October 2011 (25+6)
Natural Surprise - Matthew Evan Duffety born sleeping on 11 October 2013 (15+5)

Maria72

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Thursday, December 30th 2010, 4:32pm

Thanks Hayley blowkiss Hopefully Paul will come and help. I know I need to wait, I just want to go with a better idea at my consultation.

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Thursday, December 30th 2010, 5:02pm

Hey Maria72. You FSH level sounds good to me. Mine was 10.2 :-( I needed to be below 8 to egg share in the midlands. Luckily London go on AMH results instead. Your AMH does sound on the lower end but that only gives an idea of quantity not quality where as the lower your FSH the better xxxx Good luck hun xfingers
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Thursday, December 30th 2010, 5:17pm

Hi hun

I am just logging off in a rush (sorry!) but wanted to post a previous post below (from Paul) which may help explain the FSH/LH relationship and also have a look at my post HERE as it has lots of links in and an explanation about FSH levels. My clinic's guide for FSH is that a 'normal' FSH level is usually under 10 (under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate) Mine varied over the last couple of years from 3 to 30, with the EST levels also changing and showed at 946 on my reading where the FSH was 3, so it was a false low.

Have a look at the threads/post below and I am sure Paul will be along soon to help further

x







Quoted

Originally posted by Paul Entwistle
Hi y'all,

FSH and LH are two of the various hormones released from the pituitary gland (in the front portion of the brain) and they are transported through the blood stream to the ovaries and to the testicles (but not usually in the same person). Here they stimulate follicle and egg developement (FSH) and egg release (LH), in the female; and sperm production in the male. These are called the target or end-organs for these hormones.

These end-organs in turn release chemicals and hormones which travel back to the pituitary to let the pituitary have some feedback as to their response to the LH and FSH. If the output of the end-organs drops then more FSH or LH is sent to them. In the female, increasing age causes the ovaries start to become resistant to stimulation and become less likely to ovulate, probably in part because there are fewer primordial (immature) follicles left/fewer eggs to be released. When the pituitary senses this reduced response it sends down even more FSH/LH to push them into working. So the levels of these hormones in the blood stream gradually rise with age as the poor old ovaries get pushed more and more - until they say nuff's enuff and stop working. There are several reasons for poor ovarian response but the result is the same, high FSH and LH.

Where the FSH/LH are very high in the woman then she is in the menopause or peri-menopause, with an ovarian failure either appropriate to her age, or she may have a premature menopause/ovarian failure. She has problem therefore and will probably respond poorly to ovulation induction including IVF, and may even have to resort to egg donation. Measuring these hormone levels is what's known as measuring the ovarian reserve, and is used as an indication of how near to/far from/far in to, the menopause the woman is. It is only an approximate guide and works best in assessing the response to IVF ovulation induction and less well in predicting future, naturally ttc chances.

So what are normal levels of FSH and LH? Opinions vary amongst the experts, surprise! surprise! The test must be done very early in the cycle as the levels rise through the first phase of the cycle (the "proliferative phase" you will remember - Wake up you at the back), and false values will be obtained. In women with reasonably regular cycles this means day 1,2,3 of the cycle; with very irregular or no cycles, it has to be just a guess; - and in men with cycles it becomes a totally different syndrome.

FSH and LH will rise slowly with age whilst still being within normal, and fertile levels. Any result therefore has to be considered along with the age of the woman, but values of 5 - 14 iu/L are normal for women under say 38 yrs. Values greater than 18 or so suggest possible approaching ovarian running down, and values greater than 25 predict reduced success with IVF, although natural pregnancies can still occur from occasional spontaneous ovulations, so don't give up trying. FSH can vary from month to month to a degree so get it repeated if the first result is high. However it is not clear what this means and which result is the most predictive. The most predictive value is from a series of FSH results say over an 18 month period. A faster than normal rise suggests a rapidly approaching problem.

LH levels have a less predictive value but are normally lower (or should be) - with 4 - 8 iu/L being normal but then rising as the menopause approaches. The two hormones usually rise in tandem as the ovaries wind down. However an exception is in polycystic ovarian disease or syndrome (PCOD or PCOS) where the LH rises to levels 2.5 - 4 times that of the FSH, the FSH usually remaining within normal limits.

For men the LH is not usually measured and I confess to having forgotten the usual range. Most importantly the FSH will be in excess of 12 - 15 iu/L in end-organ testicular failure. Where this level is normal, say values down to 3,4,5 iu, but with azoospermia, then a bilateral absence or blockage of the vasa is indicated ie an involuntary vasectomy and this should be investigated with ultrasound or dye instillation. Very low levels of FSH suggests secondary organ failure with the grand diagnostic title of hypogonadotrophic hypogonadism, which can be treated hormonally.

And finally - to complete the story:

The pituitary is not its own master. It is only the foreman or shift manager. Further over in the brain is the hypothalamus. This organ which is an important part of the brain's functioning - the executive director as it were- keeps an eye on the activity of the pituitary gland, giving it a poke if it is not doing its job properly, and holding back any over-enthusiasm. But the Top Dog - the chairman of the board of directors - is the unconscious mind. This ultimately determines what happens around the body. This is the agent that stops ovulation or sperm production when you are stressed, or acts to prevent conception where there are unresolved anxieties or issues from the past.

This is why I have used counselling and hypnothereapy for many years for fertility enhancement in my practice and this has been written up in various magazines and newspapers (see me for the references!).

Good luck

Paul
xxx

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Thursday, December 30th 2010, 5:23pm

My last FSH was lower, it was 5 :( It was 2 years ago though...


They do fluctuate. I have heard that at ARGC they sometimes wait for a "good month", as in a good FSH level, before starting a cycle. But I think that's for when FSH is fluctuating above 10.

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Maria72

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Thursday, December 30th 2010, 5:27pm

Thanks Blue and Eeyore blowkiss

Maria72

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Thursday, December 30th 2010, 5:33pm

ps- Eetore when I click on your link and then try to get into the various threads it says I haven't got permission. Can you help?

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Thursday, December 30th 2010, 5:44pm

mm, if it is only on some of the links then they have been merged into the main FSH questions thread I think

As Blue said, the FSH results can fluctuate and my clinic wanted to do them over a period of many months before they would read the results with any confidence x

Maria72

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Thursday, December 30th 2010, 6:17pm

THanks blowkiss

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Friday, December 31st 2010, 4:28pm

Hi hun

CARE also wait for a "good month" and that's why your start date can be delayed. And my FSH did fluctuate between the 2 months I was due to start and the month I actually started. And bizarrely it was lower than a test I had last year!

xxx

Me 40 DH 35 TTC 10yr
peritoneal mesothelioma, cystectomy 97 & 00
peritonectomy, lost both tubes & most of left ovary Aug 07


Dec 07 BFP b/ov m/c 9.6wk
July 08 BFN
Dec 08 BFP b/ov m/c 9.6wk

July 09 BFN
Nov 09 BFP 2 x sacs 1 b/o 1 no hrtbt m/c 9.2wk
May10 BFP at 8+4 m/mc @10wk scan ERPC

Found: High NK cells, DQ Alpha match, LAD neg & PAI-1 pos...

NOV 2010 - Immune IVF at CARE Manchester
:BFP: [zx076] :girl: born 25/8/11

OCT 2012 - Immune IVF at CARE Manchester
:BFP: [zx076] :boy: born 24/6/13

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Saturday, January 1st 2011, 7:12am

Maria, all what I can say that when I did my tests for my 1st IVF my FSH was 7 and I was told that it is quite good - (very) good in fact...
Hopefully you will get your answers and soon, I know how awful is to wait to find out....
Happy New Year Maria, hope this year will bring you what you deserve so much! babydust

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Sept 09 Thanks to God - Scrumptious baby girl is here. Please grow healthy and happy.

Maria72

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Saturday, January 1st 2011, 11:04am

Thanks girls blowkiss
The thing is that FSH may be artificially low cos of the estrogen. But my results seem to be ok from what I can see. So maybe there is a bit more hope than I thought. I just have to wait and see what ARGC says now xfingers

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