AMH level, next step

[WonderingWorrier]

So we've been attending doctor and hospital for fertility issues. I'm 37.

All blood tests have been fine, ovulation fine, hubby's sperm fine. Was waiting on appointment coming through for laparoscopy and the nurse called me today to say my AMH level is low and it would be a waste of time having the laparoscopy. I am to go for another appointment on May 9th to discuss things further - no idea what that means, terrified of bad/worse news :-(

The AMH level is 5.4.

On the day of my AMH which was a few weeks ago, the doc referred us to the ivf hospital (2 year wait) and said we'd have 4 goes of IUI at his hospital during the waiting time for ivf. He said he done this straight away because of my age and didn't want to waste time. I'm wondering if the low AMH level will change any of this and also just generally what people's experiences of low AMH have been? Will waiting for 2 years not mean that my levels will be even lower, and so even less chance?

Thanks for reading, panicking just a little.

Hello Worrier

Didn't want your post to go unanswered, so will try to help as much as I can. I have found that some docs are unwilling to perform any procedure they feel is medically unnecessary if an alternative route is open to them. For instance, why do something diagnostic but invasive (like a hycosy or HSG) if a treatment protocol (such as IVF) has been agreed and would be unaffected by the diagnosis. Lap is proper surgery, so they are always cautious.
You didn't say what the lap is for - is this to check your tubes, look for endometriosis etc? if i were you, this procedure, while it has some risks, could give you some answers that might help you decide future treatment. IUI is only useful if eggs are getting down the tubes to meet the sperm! If they're not then you need to think about IVF and a lap could help you direct you to the best option.
As fas as AMH goes, ladies with lots lower levels (literally under 1) do go on to have children but they are right in that it's a bit of an indicator that time may not be on your side (sorry to be blunt but this is why they do the test). It's worth asking about the success rates for IUI for your age compared to IVF.
Don't panic, it's good to have the opportunity to question the clinic and explore why they are thinking about changing their recomendations. Ultimately, they want you to succeed!
Good luck, I hope it goes well :-)
L

Many thanks for your kind reply, I will be sure to ask these kinds of questions when we go next week. Thanks for the information and advice :-)

I understand how you are feeling - 5 years ago we had been TTC for 2 years already, I was just 34 and had the AMH test. It came back 10.4 so in the low category. I was devastated but decided I needed to throw everything at this issue and began acupuncture weekly, craniosacral therapy every two weeks (had it lots before TTC for other issues) herbal supplements (prescribed by Chinese/Natural medicine doc) and flower essences. We also went for our first IVF appointment (privately as did not want to wait). 2 months later just before being booked in for HSG I got a BFP.

Now I have no idea if any of the stuff I did tipped the balance or if it just would have happened anyway but honestly I did not care either way! I also did a lot of research on the AMH test and at the time found out it was only 70% correct (not sure if that is still the case) and also like any hormone test it is just a snap shot of a single moment in your body, the body changes constantly and while it is a good indicator or fertility it does not mean you cannot or will not get pregnant.

I am definitely not a very fertile person and probably should have started having a family much earlier (we have been TTC a second for three years with no joy and I know my eggs are old and few and far between!) but all you need in one good egg, one month!

So I guess I am saying be realistic but don't let this one result overwhelm you. The body is pretty miraculous and I had the attitude of trying to make it as tip-top, healthy etc as possible which even if it did not make me pregnant definitely made me feel better in every way.

Interestingly I asked the doc last year to do some tests again to see if we should keep trying or if I was not even ov'ing anymore and she told me they don't often do AMH anymore [hmmm] If you are showing good levels of progesterone to indicate ovulation this is much more positive.

The other thing I remember researching was a follicular scan (I think?) which is supposed to be much more accurate.

Sorry for the ramble I just so remember that horrible feeling of devastation and completely empathise with where you are but wanted to give you encouragement that it does not necessarily mean it's over.

Good luck x

Oh wow, what a lovely positive story! You hear lots of stories about women waiting on appointments and falling pregnant just before the appointment, which is just lovely.

It's definitely worth looking into some of those things that you tried. I'm hoping that next week he will suggest going for the scan.

But stories like yours give lots of hope so thanks for sharing and for giving me more ideas to look into

Hallo, mine is under 3 but now have a lovely baby - through IVF but worked first time. I recommend reading all you can in the subject, including the use of DHEA (controversial)...