Fertility Treatment Plan for Low AMH (42-Year-Old)

Question
Hello doctor..What can you advise as a plan of treatment for my situation? I have norm 28 day cycles no issues.  Myself age42, CD3 blood: FSH 7.5 AMH 0.17 and other levels norm. Normal weight 130lbs. 1st cycle of Femara 5mg cd 3-7. CD 14 Follies  17, 20 and 21mm. CD15 Ovidrel shot. CD 16 iui(post wash 18mil), CD 17 progest, 200 mg 2x daily. CD 21 progesterone 41.  Hubby age 35, semen analysis: vol-3.0, total count: 161.1, total motility: 116.0, progression: 2+, NORMAL FORMS: 3.5% with 90.5% having Amorphous heads. IVF is not an option. Should continue this course along with IUI?  If not, what do you recommend?

Answer
Hello Lauren from the U.S.(New Jersey),

The treatment of choice for you is IVF because of your age and your husband's decreased morphology (ICSI is recommended#.  Since that is not an option for you, the only option is to continue trying with IUI.  Keep in mind, however, that you are near the probable end of your reproductive or fertile life #pregnancies are rare after 42 years old even with IVF).  So, you chances of pregnancy with IUI is less than 1% per month attempt, whereas with IVF it is 30% per month attempt.  But ultimately it is your decision as to how badly you want to have a child, which then determines to what extent you will go through to have one.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate