Hello doctor, I am 38 years old and got married 12 years ago. Underwent 3 fresh IVF cycles and 3 FET cycles during the last four years. Underwent tubal pregnancy four years back. For the past two years with medium endometriosis. My present AMH value is 1.1 ng/ml. A blood test was taken last week. Shall I still proceed for a fresh IVF/ICSI cycle?
Hi. How are you doing? Definitely, IVF would be the best option. Let me start by mentioning the risk factors, one is your age, AMH is lower limit and endometriosis. As you cross 35 years, most of the good eggs get exhausted. So it is very good to keep getting lots of egg and embryos for transfer. The best part of your history is that you did get pregnant twice, unfortunately, the final result was not good. Hope semen report is normal. Options, if I may suggest: 1. Have IVF again, but let the doctor try different hormones and altering the doses. 2. Have IVF from a different center. The grading you are mentioning is what the doctor suggested. I had a patient. Husband had testis FNAC, they had mentioned of getting 8 blasts and 3 morulae. They told her that two blasts are being transferred every cycle, but negative results. It is impossible to get so many blasts from TEFNA sample as sperms are so unhealthy. 3. Repeat AMH within 14 days of period again from a different laboratory. 4. If AMH is below 1 ng/ ml think about a donor egg. Main advantages are endometriosis and your age would not affect the quality of eggs. Do not lose hope, you have lost two pregnancies between cup and lip, if you will not retry now, your good age and remaining eggs will be exhausted. So do try IVF again.