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Low AMH, high FSH, two miscarriages, told donor eggs were her only option. At 43, she conceived naturally. Here's what her clinic missed before the donor egg recommendation.
This episode is for the woman sitting with a donor egg recommendation. Low AMH or high FSH on the chart. Failed IVF or recurrent miscarriage in the history. A clinic that said the numbers leave you no other options.
Sarah Clark walks through the case of a 43-year-old client whose REI told her IVF or donor eggs were her only realistic path. Her FSH was 13.6. Her AMH was low. She had two pregnancy losses behind her. The diagnosis of diminished ovarian reserve was not wrong. The numbers were what they were. What had not happened was a structured investigation of why those numbers looked the way they did and whether the rest of the picture had been missed.
Eighteen months later, she was pregnant naturally with her own eggs.
What the clinic had not investigated was a long list. Her TSH was 3. Accepted as normal, but well above the range her own REI would have flagged before IVF prep. A full thyroid panel was never run.
Her stool DNA test showed H. pylori, an infection that impairs nutrient absorption and drives inflammation. She had been gluten-free everywhere else for years, but she had been taking a weekly communion wafer every Sunday without realizing it counted. The cabergoline she was on was lowering her cholesterol and impairing her ability to make sex hormones.
Her male partner had not been worked up. His semen analysis showed low volume and low concentration. His blood sugar was elevated. His kidney markers showed stress.
The vaginal microbiome had not been tested. The seminal microbiome had not been tested. Her night sweats and disrupted sleep had been mentioned and dismissed.
Her case is not a guarantee that anyone else will get the same outcome. Every case is different. The patterns we found in hers may not be the patterns in yours. But the principle holds: a diagnosis of diminished ovarian reserve, low AMH, or high FSH is a starting point for further investigation, not a complete picture of what is possible.
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