Very low AMH but everything else totally normal - confused

[redwhitestar]

Have posted this elsewhere but am trying to get as many opinions as possible..

I had chemo last year. Pre-chemo my AMH levels were good/normal.

Chemo finished 3m ago. Since then, I've ovulated twice and had two light periods.

I'm in the middle of a monitored cycle at the moment. Everything looks lovely/normal according to the (very experienced) sonographer - I only have one ovary but there are at least 7 follicles on it (likely more, since there's currently a 22mm dominant follicle obscuring the sonographer's view). However my AMH has come back at 0.3. I'm 29 and utterly devastated. The sonographer was really shocked since she was expecting a totally normal result based on what she saw. She said that she could almost believe the lab had messed up, and that I'd have near to zero follicular activity if I really did had such a low AMH.

Is it possible that the AMH was taken too soon post-chemo (I had hormones to shut everything down - Zoladex) or that it's wrong for any other reason? I just don't understand how the follicle count and the AMH could be so so different: everything I've read said that they correlate.

Am trying to be positive and rely on what she saw, but am not really succeeding.

Any help appreciated. Thanks.

Poor you - that sounds very hard to cope with especially after treatment like chemo - you've had a v rough time. I would say - without any scientific knowledge - that your body is recovering and hormone levels may be skewed for some time?

The antral follicle count sounds promising. Take it as a good sign and remain hopeful.

If it's any consolation I had quite a good follicle count of 11 but what is described as low fertility amh (9.5). But I'm 40 and not in your boat. I think focus on the good news and be as positive as you can - 7 egglets in one ovary sounds excellent.

I wish you the very best red.

Thanks bean - that's my gut feeling too (particularly considering how my chemo doesn't affect fertility - my oncologist wasn't expecting it to and he's pretty damn good at what he does, plus I've read multiple scientific papers to the same effect), in which case I'm furious at my consultant for making me have the test so soon. We've been through enough in the last year...

Hope you get the BFP you want bean :) xx

Hi red - yes, I'm not sure that taking the test was a helpful suggestion. I sometimes wonder at the compassion of doctors, or even the common sense.

I think in life we sometimes have to believe in magic and put aside the science and numbers. I conceived my first child well after 37 and had a natural water birth at home and now have the loveliest healthiest baby nearly 2yo. I am v lucky. My amh may have been quite low back then as well (I'll never know) but the magic stepped in - DP had only been living together 2 months!

I feel really positive for you that even after all you've been through you have eggs waiting to pop. And you are young so there will be a way to get you that baby for sure even if your amh isn't what it should be.

Lots of love to you and keep at it!

That's a lovely story :)

The sceptic in me believes it's a lot about the money - fertility is big business and if they can get you to pay for an extra blood test, they probably often will...

I already have a daughter (18m) so I'll be happy with just one more. Don't care about being fertile when I'm 40: just for the next few years.. Just one more egg :)

Well - you don't need to think about 40 if you're 29 so that's all good!

Wonderful that you have a LO already; I'm sure you're not far off the next but give your body a chance to heal .

And - yes, best to be sceptical. I don't care what anyone says about amh or fsh and rushing into IVF, I'm a healthy woman who is still of reproductive age for a year or two more so I stand a chance. Bit tired of having to have loads of sex though!

Hi redwhitestar I'm sorry to hear of what you've been through.

If it helps at all I have an extremely low AMH level (0.2) but other tests have been fine. We are going through IVF primarily for other reasons, and I've had one egg collection so far where they retrieved 8 eggs. Not bad for someone with such a terrible AMH result! 6 of them fertilised and five were good enough to use/freeze so they must've been okay (although no BFP so far...) I did query this with the hospital as I would've expected to get very few eggs, if any, and they said to basically ignore the AMH result. I'm not sure quite why they did the test in the first place!

Anyway, I think you should just try to concentrate on your AFC for now, which seems very good considering you only have one ovary. Wishing you lots of luck x

Thanks monkeysbum - that's so encouraging. Don't get why they suggest all these tests if they're not reliable: TTC is stressful enough...

Best wishes for your BFP :)

xx

from what I can gather the AMH test can be a little misleading.
I think some clinics use it as an indicator of how well you might respond to ovarian stimulation drugs. FSH results determine this too.
It's all a bit new to me, so definitely not the expert.
I've had similar results, all ok, except for AMH, which is 0.4.

redwhitestar what a year. AMH useful for giving an idea how much stimulation drugs are needed. On a positive friend 43 AMH 0.53 is currently 11+6 scan last week all ok. So do not dispair all her other tests ok

Thanks guys - appreciate the positive stories :)

As an update, we met today with our consultant. He was pleased with my scans/matched what we expected, but said that the AMH was 'cause for concern' if it was a true reflection of my reserve. However he's cautiously optimistic that the AMH level is so low due to the chemo/Zoladex, and will increase over time (he stated definitively that AMH can change). I'm having another test in a few weeks (start of next cycle) together with a proper AFC, ovarian volume test etc and we'll take things from there.

So not great, but pretty much what we were expecting: not much more he could say really.