From Type A to Type D-

I'm a few days off from my consult with the RE, and trying to understand why my recent test results are impacting me (mentally) the way they are. That low AMH number is really eating at me. AMH is a gauge of ovarian reserve. It gives you a ballpark idea of how long you have until perimenopause. If you need IVF, it also predicts how your ovaries will respond to stimulation. A few studies have shown that independent of these things, low AMH also correlates with lower live birth rates, but the correlation is relatively small and hasn't been consistently reported.

All it takes to get pregnant is a single egg and I've proven, three times now, that I ovulate and produce eggs. So why does my low AMH bother me?

I can come up with two reasons. Number one is that I just wanted some tiny piece of good news amidst the shit show that is this process. I really wanted to be able to say 'cool, I don't have to worry about that!' or 'groovy - I'm normal in at least one respect.' Instead, I'm so far off normal that I just have to pray we don't need IVF, because my ovaries are not likely to respond well.

On reflection, reason number two is pretty embarrassing. You see, if you haven't noticed from earlier posts, I've been an overachiever for most of my life. I'm a Type A personality that's gradually relaxed into a Type A-. I graduated magna cum laude. I went to a top PhD program in my field. I moved up the career ladder quickly. When I decided to run for the first time, I set my sights on a half marathon, and completed it. My first organized bike ride was a century (100 miles). I screwed my left knee up so badly during the century that I couldn't put pressure on it after mile 70. But I don't like to fail, so I rode the last 30 miles only my right leg. Like I said, I achieve.

I achieve, but my ovaries don't. My ovaries apparently missed out on the overachieving message. Despite the fact that I went 15 years without periods, and therefore spent 15 years not drawing down my ovarian like a normal woman, I am still running out of eggs. In other words, my ovaries are underachieving. As much as I'd like to say that I don't care, that the only thing that matters is getting one good egg, apparently that isn't true. Given the mild desire to hyperventilate that appears whenever I think about my test results, I must care a lot.

We'll see what the RE says. My numbers are slightly mysterious. AMH is low, but so is estradiol, and FSH is normal for my age. That's an unusual combination. Usually low AMH correlates with high FSH. In cases where FSH is not high, it's often suppressed due to high estradiol. Having both low estradiol and normal FSH, along with low AMH appears to be atypical. Maybe there will be some logical explanation and I'll feel better. Maybe not. Here's hoping I can elicit a bit more Type A out of the old ovaries!