Just had our phone consult with Dr. Surrey to discuss the results from all these tests and how they will impact our treatment plan.
Me: FSH 7.5 (awesome! I was so worried it was going to be high again); Estradiol 58 (a bit high but he's not worried about it); AMH 1.0 (low for my age which suggests low ovarian reserve); 17 baseline follies (awesome!); TSH 3.58 (subclinical hypothyroidism).
DH: turns out his 2 hour sperm rate was lower than initial rate but still normal. His chromatin assay results though suggest 15% fragmentation (i.e., the DNA is in sperm becomes fragmented once it leaves the testes).
What it all means:
Dr. S thinks it's too soon to know for sure why we haven't gotten pregs yet bc we have to wait until we see how it goes with the IVF during which they can actually see our embies, etc to see if there are problems with fertilization, division, etc. But for now it looks like there's a combination of little things -- DH's fragmentation, my low ovarian reserve. There's some data suggesting that women with subclinical hypothyroidism have lower pregnancy rates. He thinks it's probably not any one of these things but when you add them all up, it made it harder for us to get preg naturally.
How it affects our treatment:
I'm on synthroid to treat the hypothroidism. DH will start taking supplements to increase his antioxidant levels to help prevent fragmentation. As for how these results will impact our IVF -- Dr. S will be more aggressive with the stims given my AMH levels (get ready for crazy emotional hormonal me!) and they will use a different procedure to separate the sperm than their typical wash to prep DH's sperm. Otherwise it sounds as though we're all good.
Some interesting news -- looks like they probably won't have us go to RGI for the FET. When we had our phone consult with the genetic counselor at RGI (Dana), she mentioned that they would prefer to not do a 2nd biopsy at RGI to test for CF given that CCRM will be doing a biopsy for the CCS. Dana was concerned that two biopsies may increase risk to the embies so they were going to try to convince CCRM to do all the biopsying and then just send the samples to RGI for testing. Looks like they may be getting their wish. And my and DH's thinking on this is that if RGI is willing to turn away business (i.e., doing our FET) they must feel strongly that it's safer to do one biopsy than to do two. And if they feel that strongly, then we're happy they're getting their way. But the negotiations with CCRM's legal team is still underway so it's not definite yet.
This may delay starting our IVF cycle by a month (ah yes more delays -- IF treatment is truly a lesson in patience -- good prep for being parents I guess!) which puts the FET as late as August. But Dr. S said that "it's not as though you have one leaf left on your fertility tree" meaning that delaying one more month won't make a difference given my age, test results, etc.
I will be getting my calendar from my CCRM IVF nurse (Rachel) soon and will let you know the tentative plan when I do.