• Delia Laas

What does it all mean?

Welcome back everyone, thank you for joining me once again. It has been quite a while since my last post, my sincere apologies, we have moved house, and seriously, moving with a little one is not for the faint hearted!!!

Today I would just like to give a quick and basic explanation of the different hormones and processes related to Premature Ovarian Failure and fertility, just so everyone is aware of how it all works.

So, as you all know from my previous post, I was diagnosed with Premature Ovarian Failure (POF) aka Primary Ovarian Insufficiency (POI). Now what does this all mean?

Women have two ovaries, the ovaries produce follicles, these can be seen in an internal ultrasound and known as your antral follicle count, and each follicle releases an egg every menstrual cycle (menstrual cycles are typically 28 days, but can range from 21 - 31 days), then, ta da.....ovulation. Before ovulation occurs the uterus prepares the uterine lining for fertilisation. After ovulation, if fertilisation did not occur, this thickened lining breaks down and is expelled as your monthly Aunt Flo (AF). To encourage these follicles to grow so you can ovulate, your pituitary gland releases follicle stimulating hormone (FSH). If you do not have many follicles, the pituitary gland releases more and more FSH to grow and mature the remaining follicles, therefore a high FSH level generally indicates menopause, diminished ovarian reserve (DOR) and decreased fertility or infertility. The other very important hormone is the Anti-mullerian hormone (AMH), this measures how many potential eggs you have left, referred to as your ovarian reserve. We are all born with a certain amount of eggs, this can never be increased, you get what you get, we can only improve the quality of those eggs, but never increase the supply. A low AMH indicates you have very little eggs left, known as diminished ovarian reserve (DOR). Estrogen (Oestradiol) and progesterone are also produced in the ovaries. When your ovaries are not functioning properly, such as during menopause or POF, your ovaries stop producing estrogen.

Like I mentioned, this was just a very generalised, basic explanation.

Now let's look at my blood test results. Usually if you are doing blood tests for fertility, you would have them done on CD03 (day 3 of your menstrual cycle, day 1 being the 1st day of your AF) but we had no idea where in my cycle I was, seen that I had no AF at that point.

FSH - Follicle stimulating hormone: 51.4 U/L

FSH reference range:

Follicular phase (CD01until Ovulation): 3.0 - 8.1 U/L

Midcycle (Ovulation): 2.6 - 16.7 U/L

Luteal (Ovulation until CD01): 1.4 - 5.5 U/L

Post Menopausal: 26.7 - 133.4 U/L

AMH - Anti-mullerian hormone: <0.03 ng/ml

AMH reference range:

Negligible response: <0.15 ng/ml

Reduced response: 0.15 - 1.14 ng/ml

Normal response: 1.15 - 2.56 ng/ml

Excessive response: >2.56 ng/ml

E2 - Oestradiol /Estrogen: < 37 pmol/L

Oestradiol normal ranges:

Follicular phase (CD01until Ovulation): 76.7 - 921 pmol/L

Midcycle (Ovulation): 139 - 2382 pmol/L

Luteal (Ovulation until CD01): 77 - 1145 pmol/L

Menopausal (untreated): <37 - 102 pmol/L

Menopausal (on HRT): <37 - 528 pmol/L

The above pathology results and reference ranges are as per Lancet Laboratories.

So it is clear from my blood test results that my FSH is at a Post Menopausal level. My AMH levels are at "negligible response" and this combined with my ultrasound revealing a zero antral follicle count (no follicles), it is apparent that my egg count is almost non-existent and then my Estrogen level is in the menopausal range. With test results like this it would be near impossible to fall pregnant and therefore the diagnosis of Premature Ovarian Failure, early onset menopause.

Now let's look at the big kahuna, Estrogen. Estrogen is very important for us ladies, it contributes to cognitive health, bone health, the function of the cardiovascular system, and other essential bodily processes. So a low estrogen level, such as when you are going through menopause or POF causes the following symptoms:

Irregular or no menstrual period, hot flushes, night sweats, weight gain, decreased sex drive, fatigue, mood swings, depression, anxiety and dry skin. These are just a few, there are plenty more! Now I understand why I never got any symptoms whilst I was taking my birth control pill. I was taking a combination birth control pill that contained estrogen and progesterone, so it is almost like I was on Hormone Replacement Therapy (HRT). The moment I stopped my birth control, my estrogen levels plummeted and then all of these symptoms started surfacing. So I actually don't know how long I've suffered with this condition. But let me tell you, it is no joke, I'm sure any lady who has suffered with POF or menopause will agree with me, having low Estrogen levels is like a nightmare that won't end. The mood swings, brain fog and fatigue are the pits, I honestly didn't know what was wrong with me and I did not feel like me anymore, it was like a cranky, forgetful, old cow had taken over my body (my poor partner, he was constantly in the line of fire, sorry babe!) and don't forget about those hot flushes thrown into the mix, just for your added pleasure. I started reading articles, medical reports and journals about my diagnosis and all the information came up the same, there is no cure for Premature Ovarian Failure (POF). My only option would be to start Hormone Replacement Therapy (HRT) to prevent heart problems, curb my bone density loss and rid myself of all those nasty symptoms I was having.

After going through all this information, I still just couldn't accept that this was it for me, I was absolutely overcome with grief, fear and disbelief. I just could not accept that I was in menopause and that I couldn't have a baby! I was so sure that somehow or somewhere there must be a way I can help myself. So, me always being a firm believer in doing things a bit more naturally, I started my search online for natural remedies and treatments for POF and fertility.

Then I found hope! I stumbled across a blog that was the answer to my prayers, and unbeknown to me, about to change my life forever :)

Please join me next time to hear all about the life line I found <3

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