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Patient's Query
Hello doctor,
I am a 34-year-old woman, who had her first child naturally without any external help five years ago. Six months back, I started trying for my second baby but found out that my AMH level was 0.116, and all other tests were normal (including FSH and my fallopian tubes). My doctor started the treatment two months back by giving fertility vitamins (proxy fem) and putting me on Gonal F75 for five days and then a trigger shoot. I had sex twice after 36 hours of the shoot and the other try was two days later, but got my period later on. For this month the doctor suggested continuing with the vitamins and putting me on gonal F100 for eight days and a trigger shoot. I also had sex twice after 36 hours and two days later. I am now 11 days after the shoot and not feeling any pregnancy symptoms. I am afraid that this cycle will fail too. Should I quit trying and start IVF treatment?
Please note that my spouse's tests are normal.
Please help.
Hello,
Welcome to icliniq.com
I understand your concern.
The low AMH (Anti-Müllerian Hormone) indicates that the chances of conception would be better with stimulation. However, the dose of Gonal F (hormone injection) and the time for administering the trigger varies. For now, you can only wait to know if you are pregnant or not. Also, continue your vitamins. My opinion is that using Gonal F alone can result in premature LH ( Luteinizing hormone) surge and sometimes causes ovulation before the intended time of ovulation. Most individual prefers to give Gonal f with the tablet Letrazole (aromatase inhibitor) to prevent premature LH surge. Also, it is better to do follicular tracking with transvaginal ultrasound and give the trigger shot when the dominant follicular is between 0.71-0.79 inches. Sex can start 36 hours after the trigger shot.
You can discuss this option with your gynecologist.
I hope this helps.
Kindly follow up if you have more concerns.
Regards.
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Obstetrics and Gynecology
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