Low AMH? What’s next?

[Sunshine19]

Hiya hope someone can help me out here. Had my bloods taken over a month ago and got a letter from the hospital stating ‘AMH has come back predictive of a reduced response and because of this a higher dose of stimulating hormone is recommended.’ Ok I get that it means it’s low but what’s next? The letter also says that my doctor will assess the result, along with other individual factors (?) to determine best drug treatment?? No clue what these individual factors could mean?
Does this mean my local GP or the doctor at the fertility hospital is telling me what’s happening next?
Sorry with all the questions but this letter is so generic and I’m clueless and worried.

Thanks for reading xox

[physicskate]

What stage are you at? Have you been to the fertility clinic at all? What other tests have been done?

[Botanica]

It's important you get copies of your results and record the actual numbers. You need to know what these are, and how they change over time, so you can take ownership of decisions along the way.

Think of the doctors and clinics as your advisors but ultimately you need to be asking the right questions and doing the necessary research and taking accountability for what happens yourself.

Be assertive from day 1, start learning about what's happening and what your options are, and don't be afraid to keep asking them questions until you 100% understand everything. Don't just be a passenger.

[Sunshine19]

Hi @physicskate @Botanica thanks for replying. We had all basic fertility investigations (21 day bloods/ urine / ultrasound done last year which came back unexplained fertility. We were only referred for IVF in June this year and the consultant went over my previous tests and didn’t seem too concerned. We had a pregnancy after what I believed was the success of the HSG, but sadly I miscarried after 11 wks. Then had my first appt at the hospital last month. The doctor explained the process of IVF and I done some reading beforehand. The doctor wanted to take the bloods to decide what protocol and the HIV / Hep B for my man. They came back negative but my AMH is obviously a concern. I remember my fertility nurse saying my egg count was good especially for my age (I’m 38) last year. But things are so out of whack since the MC, including my periods. Could this be a factor too? The letter is so generic it could mean anything. I was thinking of making an appt with my GP to see if they have a copy of the actual results and what could happen from there? Is there anything I can do in the meantime to try and improve AMH? I did just leave a very stressful job at the time the bloods were taken, could this be a factor too?

[Botanica]

So sorry to hear you have had such a rough time of it, and sorry to hear about your MC. I also had one at 11 weeks and it took some time for my body to get back to 'normal'.

AMH is generally reliable and tends to trend downwards with age but it is by no means the whole story, and as many people will attest, quality of eggs is just as important as quantity.

AMH, together with FSH and antral follicle count gives the clinic the best idea what protocol to put you on and how you might best respond to which particular drugs.

Whilst you may not be able to reverse AMH decline, I do believe you can hold it off and also get your remaining eggs healthier with lowering your stress, better sleep, exercise, lifestyle, diet and supplementation.
Highly recommended is the book 'it starts with the egg'.

Sounds like you've made some big changes already and I'm doing the same as you in terms of removing work stress. Three weeks to go for me now before I go on a sabbatical from my ridiculously stressful globetrotting job. I hope it makes a difference.

Good luck with your next steps x

[physicskate]

You asked what's next? What's next is the doc will decide dosage and protocol for your ivf cycle...

But I agree with getting your results and knowing what they mean!! Also that book was very helpful to me too!!