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Dr. Norm S.
Dr. Norm S., Doctor
Category: Medical
Satisfied Customers: 11252
Experience:  Over 30 years of experience in OB/GYN practice.
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I'm 38 and been ttc year after I lost a baby at 14

Resolved Question:

Hi, I'm 38 and been ttc for a year after I lost a baby at 14 weeks following a listeria infection. I've just been told that as they could only see 1 follicle and my amh is low at less than 2.1 I have only 5% chance of conceiving naturally. I also have a small uterine polyp about 5mm. They said they would only remove this if I was having ivf which I'm not. I've read that polyps can cause infertility, should I push to have it removed?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Norm S. replied 1 year ago.
Do you know exactly what your amh level was?Do you have regular periods?Where were you in your cycle when they could only see 1 follicle? How large was the follicle? Thank you.
Customer: replied 1 year ago.
They said amh was less than 2.1. I'm not sure if they did the count at the first scan which was day 10 or the Aqua scan which was day 12. They did not mention the size of the follicle. My periods have been very irregular for last 6 months they range from the shortest at 15 which was my last cycle (it was following this cycle that they took my day 3 bloods which made me wonder if the info would be valid/accurate) longest cycle is 40.
Thanks
Expert:  Dr. Norm S. replied 1 year ago.
There are some difference is labs, but often an abnormally low amh is less than 1. Normal is 1.5 to 4.0. Your irregular periods suggest that your main problem is not ovulating regularly.The uterine polyp may or may not be significant. It might be better to remove it, but I don't think anyone can say for sure.The single follicle also suggests that your eggs aren't developing normally. However, there are pills (Clomid) that can often help you to ovulate regularly.If possible, I would try to get another opinion. A hysteroscopy to remove the polyp is fairly easy, and Clomid may help you to become pregnant.
Customer: replied 1 year ago.
Thanks that is helpful. The doctor told me she would expect to see an amh of 8 in a woman of my age. They thought my ovarian reserve is too low for them to prescribe chlomid? I'm not sure where to look for a second opinion, i can't afford massive fees, where would I start to look? I'm trying to increase my chances by starting acupuncture taking vit d and drinking loads of whole milk. Is there anything else you would recommend.
Thank you
Expert:  Dr. Norm S. replied 1 year ago.
As far as a second opinion, you could seek any doctor with a special interest in infertility, which would usually include an good OB/GYN doctor.There are various tests of low ovarian reserve, and amh is only one of them. There is also ultrasound for antral follicle count (AFC) and the clomiphene sitrate challenge test (CCCT). But it's not an exact science. If you do have low ovarian reserve, IVF may be your best chance, but it still may be worthwhile to try Clomid for 2-3 months, especially if your last pregnancy was only a year or so ago.As far as trying anything else, I think that the main thing to try would be Clomid, which is fairly simple and not very expensive.
Customer: replied 1 year ago.
Thanks. We don't want to do ivf and they said at the hospital they wouldn't offer it anyway. Do i need to see another doctor to get chlomid or can I just get it on my own?
Expert:  Dr. Norm S. replied 1 year ago.
I believe that you need to see another doctor. It might be possible to get clomid on line, but it's really necessary to take it under the supervision of a doctor. In the US a doctor prescription is required. I'm not sure about in the UK.
Customer: replied 1 year ago.
Ok thanks you've been very helpful. My final question is do you think we have a chance of conceiving naturally? 5% seems very low and quite devastating
Expert:  Dr. Norm S. replied 1 year ago.
I have just realized that they record amh differently in the UK than where I am in the US.We use ng/ml, and 2 is normal.In the UK, they use pmol/L, and 2 is very low.So going by this test, you may have a 5% chance of conceiving naturally. I'm sorry. I would still try Clomid, but perhaps wouldn't get your hopes up too much.
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