Getting pregnant naturally with low amh

[Chattycat78]

Hi guys,

I was lucky enough to have a baby 8 months ago through ivf, which was recommended to us as I have low amh (2.8- probably less now I imagine).
However, although I know I have been mega lucky, I would like to try for a sibling. Ideally I would like to try naturally for a while before jumping on the ivf bandwagon again. Does anyone know if this is possible? Am I delusional?
My logic is that if I'm ovulating and I can improve egg quality theough supplements etc then surely there is a chance? I'm 36. Also I have been pregnant before naturally (after 4 months trying) but unfortunately it was a mmc. There are no other infertility issues- partners sperm is normal. Any thoughts from anyone?

[Shellster52]

My AMH was low at 2.5 back when I was 34. I too managed to conceive with IVF and am now 15 weeks pregnant. I agree with your theory that AMH would not reduce your chance of trying naturally. Whether you have 5 follicles on your ovaries at the start of each cycle, or 20, as long as you ovulate one genetically normal egg. And the important factor for a normal egg is age rather than AMH. So your theory makes perfect sense to me.

How long were you trying naturally for baby number 1 before you went down the IVF route? We tried for 4 years without a hint of a BFP, however my husband has only 2% normal sperm morphology that then went down to 0%. So I assumed that was the reason rather than my low AMH.

The only thing I have found with having premature low AMH is that along with it, I find my periods are very very light and I wondered if my thin lining would not help an embryo implant. I had the scratch before my successful IVF cycle which thickened my lining.

[Chattycat78]

Oh hi shellster- how are u doing? Congrats again on the pregnancy btw!

We tried for a year before the ivf. However, in that time, I had a mmc which messed up my cycle for a few months so we were trying for more like 9 or 10 months I suppose, and if the pregnancy had worked out we wouldn't have needed the Ivf.

Thanks for validating my thinking. Maybe I'll try for a while naturally and see if anything happens.

[farfallarocks]

I managed to get pregnant naturally with an AMH of less than 1.

We had had a failed round of IVF (2 eggs on max stims!) and then I started a supplement regime of high dose Co-enzyme Q10 and DHEA (micronized). After 18 months of nothing I got pregnant twice in 3 months! First time did not work out but I am now 33 weeks pregnant so fingers crossed there will be a baby in a few weeks time.

The way the consultant explained it to me was that you can still pregnant (DH always had excellent SA) but that probably only 1 egg in every 10 was now viable so to focus on improving egg quality. There are lots of things you can do in that regard including diet and exercise. I did not give up coffee or wine but did cut down. Good luck!

[cloudjumper]

My AMH is also much less than 1, but I have never had any problems falling pg - regular cycles, ovulating, good progesterone levels - I've never had IVF. My issues is with staying pg.
Like farfalle said, egg quality is really important, and I also took DHEA and CoQ10 for about 3 months before falling pg with this one, which managed to stay put (currently 28 weeks after 4 miscarriages).

[Chattycat78]

Thanks for the input guys. Farfalle- are u saying that the consultant said that only 1 in 10 eggs were viable because of the low amh but that you can do something about that- ie increase the number of viable ones with supplements/diet etc? Sorry just want to make sure I understand properly. Also where did u get the DHEA? I'm a bit worried about ordering It due to possible side effects. Did u have any?

[Shellster52]

Yes, I too would be interested in knowing more details about what your consultant said farfallarocks if you are still looking here. Was it purely your low AMH that made him think only 1 in 10 eggs were viable, or was it rather that you were maternally older which happened to result in the low AMH? And did he think egg quality could be improved. I took DHEA and CoQ10 and changed diet to improve egg quality, but it was more just enabling any ones that happened to be geneticalyl normal have the ability to grow to day 5 and then implant, rather than increasing the number of normal ones which I did not think was possible?

Chatty, I must say after I first replied, that I have thought at certain points in my fertility journey how upset I was when breast feeding DC1 did not work out, but that perhaps it was a blessing in disguise because it meant we started tying for number two when DC1 was just 3 months old. I was 38 when IVF finally worked and if I had of breast fed for a year or two before realising the secondary infertility issues, I might have been trying IVF at 40 instead of 38 and had less chance. So it got me thinking that while I certainly agree with your logic that natural conception is possible with low AMH as long as one normal egg is being released each month, I would hate to be the one deterring you from seeking help sooner and then later regretting that you did not start IVF sooner while your odds of IVF success are statistically higher if natural does not work out.

[Chattycat78]

Thanks shell- yeah I have thought of that too- ie it would be better to do ivf again sooner rather than later. i might give it a few months and then start talking to the clinic again. It's a difficult one.

[sparechange]

I know you asked farfelle but my consultant also explained this to me so I'll chip in if that's ok!

In any woman, only around 1 in 10 eggs is chromosonally normal. When you have good AMH and anteral follicle count, your body will start maturing around 20 eggs. The body seems to know which one (or occasionally two) will be threat quality and that is the one that becomes the lead follicle and then is ovulated.

The better eggs get used first so as you get older, the ratio drops to 1 in 15, 20 etc.

With low AMH, the AFC will be lower. If you've only got 5 follicles at the start of th cycle, there is a chance that none of those 5 will be chromosonally normal, so there is no chance of a normal pregnancy. Of course there is a chance that all 5 will be normal, so a natural pregnancy could happen, but the odds start moving against you.

It is also the reason that over-stimulated rounds of IVF, where 15-20 eggs are collected, are falling out of favour. Collecting 20 eggs doesn't mean those will be good quality and capable of creating viable embryos as plenty of them will be chromosonally abnormal, and the clinic can't tell by looking at them which are the good ones.

[Chattycat78]

Thanks for the explanation- I see. So presumably I have less months where a normal egg is dropped- yes? However, It may be that say every other month or every couple of months there is a normal egg- so I need to assume each month that "this will be the one" and try to catch it I guess. In that case though, I don't see how supplments like co q10 can improve the number which are normal- surely that's impossible?

[sparechange]

chatty
Yes I think that is essentially it.
Do you know what your AFC is? Is your DHs sperm normal?

Co-q10 is an antioxidant. The theoretical role is that every cell in your body is constantly aging through attacks by free radicals. By taking antioxidants that soak up those free radicals, you are slowing down the aging process and therefor slowing the rate at which your eggs are declining. This won't improve them but it could mean that ones which would otherwise have died off in a few months time, are otherwise ok.
Clearly it isn't failsafe, or we wouldn't get wrinkles while taking co-q10!
The function of the ovaries in 'incubating' the follicles is very important so the coq10 may also have a function in keeping the full system going.
I think I'd want a blood profile done in an average cycle to check things are working OK as well. Low anteral count can mean low oestrogen levels which can mean you ovulate late and then have a short lutal phase, which can in itself cause issues, but is fairly easily helped with patches etc. You'd need to see a fertility clinic but it would be to support ttc naturally rather than going down the assisted conception route straight away.

[eurochick]

Shellster! I haven't been lurking round the IVF threads for a while but I am thrilled to see that you are pregnant!

How many rounds did you do?

Good luck to all those on the fertility train.

[Chattycat78]

Spare change- I didn't know you could do that (see a clinic to support ttc naturally). Thanks for the info- I'm going to start on the co q10 anyway (as well as other supplements). Your mention of short luteal phase- what are the patches you refer to? I'm not sure when I ovulate In a cycle to tell if I have a luteal phase defect- how would a clinic find out? I Got normal results in the day 21 progesterone test if that's how.

And yes I do have a low AFC- 6 or 7 when it was checked for ivf, and my dh has normal SA. Do you have low amh too?

[sparechange]

A clinic will do more or less whatever you want if you pay them!
Quite often before starting an IVF cycle, they'll do a monitoring cycle, where they scan you and do blood tests as if they were doing ivf, but without any of the actual drugs or egg collections, obviously.
They could then look at when you ovulate, and how good your lining is, then potentially blood tests after that (including the day 21 progesterone test?).
One way of helping things along is oestrogen patches, but that would be for a clinic to decide whether that is appropriate. There are other things they can do as well…

It might be worth phoning them up and asking how much a monitoring cycle would be, or even just a couple of scans and blood tests to see what your cycle is doing. They would then be able to pin point when you are ovulating although have you tried sticks?

[Chattycat78]

Not exactly- I've used a few opk this month (only twice admittedly) and never got a positive result but I don't think I've ovulated yet this month if I'm going to. However, I have only recently finished b feeding and only had one period since finishing, so I'm not sure if it would take a while to start ovulating again and get back to a regular cycle or not. I've got a clear blue digital ovulation monitor so I might start using that again next month to see if I can get an idea what's going on.

[Shellster52]

Thank you euro. Lovely to hear from you! I did 11 rounds. Can't believe that now I say it - if I heard someone else put them through it 11 times, I would think they were obsessed. Oh yes, I was. But I got there. Hope all is well with you.

Chatty, while I was also curious to hear from farfallarocks about her FS's opnion, I already have my own from my understanding based on my obsessive research during my cycles. So since sparechange is also weighing in, I thought I may as well too. The studies on embryos that are genetically tested in IVF show that age is factor for the number of genetically normal embryos. Co-Q10 provides energy for the cells mitochondria, and is what the embryos need to divide. I took it during my IVF to give the embryos the ability to continue dividing and not die before transfer in case they were genetically normal and 'the one'.

I fel for you Chatty. It's hard for infertility sufferers. Others wouldn't even have to think about it, but you are forced to get straight back to business after finishing b/fing, knowing that it might be a journey. I too started TTC no 2 straight after stopping b/fing and the four years it took to conceive again really stopped me being able to enjoy DS.

[Chattycat78]

Thanks shell- yeah it does feel like that, and I feel guilty to be honest- like I'm not enjoying my ds because I'm busy thinking about ttc again! At least u got there in the end. Tbh I'm not sure I have 4 years available to ttc anyway, so if it's going to take that long for me then it won't be possible. ??

[Chattycat78]

Sorry that ? Was meant to be a

[Shellster52]

I can very much relate to the feeling guilty spending so much time devoted to the imaginary baby instead of enjoying the one I already had. And the feeling wasn't helped by the well meaning but very annoying comment people say 'be grateful you have one'. Of course we are grateful, and a large part of the reason I endured IVF after IVF was to give DS a sibling. When a cycle failed, I felt like I was failing him the most and even felt guilty looking him in the eye afterwards! I assume that your name indicates your age - I was born in 77 so I also get the added stress of limited time remaining. Have you come to any decision about what path you will take?

[Chattycat78]

DH doesn't want to go straight into ivf again, so we might try naturally for a few months and just see where we get to if anywhere. Yeah I'm 36, so I know the clock is ticking!

[Shellster52]

Good luck Chatty. I remember trying naturally and while it was fine for hubby, it was harder for me. I was on a 28 day clock. I knew when ovulation was approaching and I thought that just because I knew it was TTC time, I didn't want to make it a chore for hubby too. So I would have to make the initiative, then I couldn't help but symptom spot and then of course get depressed every time my period arrived. I hope you can manage to be a bit less mentally obsessed about it than I was!

I wonder if your AMH has not dropped as much as you think. Surely it would only drop with each cycle when eggs are being formed on the ovaries with one being released and the rest dying away each month. The fact that you were pregnant for 40 weeks followed by breastfeeding until just recently I would think means that your AMH hasn't really dropped?

I remember reading that we are 'more fertile' in the year after having a baby, so I really hope that having a baby has got your hormones on high and that the supplements help and you miraculously find yourself pregnant soon so you don't have to go through the saga again.

[Chattycat78]

Thanks- I appreciate that. Who knows! Re the AMH- unfortunately I think you still lose the same amount of eggs when pg and breastfeeding- you just don't ovulate, so I suspect it will have lowered to whatever level it is now. I daren't get tested again- don't want to know for now at least!

[Shellster52]

I honestly can't see how you lose the same amount of eggs when pg and b/fing. Your body isn't going through the hormone cycle at all - my FSH is really low now that I am pregnant so there is no follicle stimulating hormone to stimulate my ovaries and make the eggs grow. They just go into hibernation. So I really hope you are wrong and get a pleasant surprise if you do need to get your AMH tested. Although, even if they aren't being lost, they are still succumbing to the aging process just like every other cel in our body, so I really hope the 'a la naturale' method works soon and you don't have to worry about it much longer. Infertility really is a nightmare.

[Chattycat78]

Thanks shell. Bet you're glad u won't have to think about all this again! X

[Everhopeful76]

Hi everyone
I was wondering...those ladies who are/were on COQ10 if you could tell me what dosage you took? I have got a rather modest plastic container from a health food shop (30mg) but I ve seen people taking much higher but not sure exactly.
I'm 39, have an AMH of 1.2, got diagnosed with endometriosis last year, had a cyst removed this year, and starting IVF next month with a view of damage limitation before more endometrial cysts occur and this ends up wiping my remaining follicles.
Still being told am sub fertile, whatever that means. But I have hope.
Thanks so much

[Shellster52]

Yes, definitely glad I don't have to worry about all this any more Chatty (although after 10 IVF failures I am still paranoid that the wheels will fall off with this 11th IVF and am fearful of my upcoming 20 week ultrasound so I shouldn't speak too soon!)

Everhopeful, I was on 600mg of CoQ10. It wasn't an official dosage given to my by a doctor or IVF clinic. I took 300 in am and 300 in pm. I had an overseas IVF email penal that I met online and she was taking this dose, and websites I read recommended this dose, so that's why I took this amount. Have you also done research on DHEA? There are many research articles online that show very promising results for women with low AMH - increased number of eggs retrieved as well as better quality. Sounds like you've really been through a hard time with this - low amh, endo, cysts. I hope the IVF goes well for you. Sounds like you deserve some luck.