Low anti mullerian success stories please!

[dogtired]

Hi, I'm about to embark on IVF in a couple of days. I have an Anti Mullerian of 1.00 which is low. I've just had the results of this and I'm pretty down about it.

Presumably this was done at a private clinic. Some info about this test for you (have never had this done btw; it is still experiemental):-

Another blood hormone test that is currently being evaluated for its potential usefulness in measuring ovarian reserve is the Anti-Mullerian Hormone (AMH), which have also been referred to as the Mullerian-Inhibiting Substance (MIS) or Factor (MIF).

Although this test holds some promise, it is still being tested experimentally, has not been validated for assessment of ovarian reserve, and is not yet commercially available for use.

Another method of evaluating ovarian reserve, which does not involve testing blood hormone levels, involves ultrasound evaluation of the size of the woman's ovaries and the number of measurable small (antral) follicles during the early follicular phase of the cycle (which is typically during mentration). This test has been used by some physicians to predict ovarian response to gonadotropin stimulation.

Why has IVF been suggested?. What diagnosis do you have?

No dx, relatively high FSH at 9.5, oestrogrodal (sp?) a bit high at 232, partner's sperm slightly on the low side at 2.6million. We've been trying for about 14 months and it took about 3 years to get ds (not using op or anything until last couple of months).

The consultant weighed everything up and after the discussion yesterday with him, we all think go straight to IVF rather than IUI.

I'm gutted about my AMH.

Oh dogtired - I totally empathise - I too had the results from an AMH test done privately a few weeks ago my result was 10 - still in the low bracket and far from satisfactory or optimum. And I can honestly say it has devasted me and sent me into a total downward spiral. (I too started a thread about it but no one else who had had the test posted)
I am TTC#1 and am 34. We have been TTC for 12 months and I have been off the pill for 18months.

TBH I am really angry at the doc who did the test for me as I do no have another apointment with him until mid April and do not have a diagnosis about what the results mean for me - so obviously you fear the worst - never being able to have any children, by any means. My regular GP has never heard of the test - great .

I have spent the past three weeks trying to investigate it myself further and I did find out that the test is only 70% reliable and still very experimental (as Atilla says). But it is always something I have been worried about as my mother began her menopause at 37 so in the back of my mind the posibility has always freaked me out.

Did you have the test done by the IVF clinic - what did they tell you? I have not gotten to that stage and am waiting for a referral to an infertiliy specialist -I am going to ask for a internal scan (Antral Follicle Ultrasound Scan) to really see how many follicles there are in my ovaries and also I a hoping for an FSH test on CD3 to see if the levels are elevated - if they are its not good

Anyway sorry for the boring ramble - but know that you are not alone and of you want to chat or share questions etc I am here.

Part of me wishes I had never had the test as really it is a huge burden and I have spent the past weeks crying everytime I see babies and trying (unsuccessfully) to come to terms with the fact it may never happen for me - I think I am still a bit in shock

Realised I was so excited to see your thread title I did not really read the posts properly I see Attila mentioned the scan and that you have already had the CD3 tests - 9.5 is no too high I think

From what I have read straight to IVF does seem the best option so as not to waste anymore time.

I have a feeling we will be doing that also.

I though my biological clock ws ticking loudly before this test now it sounds like Big Ben

Had the test done last September at a private clinic in Harley St with a good reputation. We put off having fertility treatment though until I decided it was time for another consultation. I didn't realise what the significance of the AMH was though until today. Had I known then that 1.00 was so low we'd have started treatment much earlier. 10 sounds very good to me - my consultant would've been happy with 2.2+ so try not to worry too much. Know what you mean about the old body clock ticking away - it's like it's on triple time or something!! Good luck x

dogtired and seaside,

Some private clinics offer poor treatment as well as expensive and I think you've both been badly let down by the respective clinics you've attended. I think it was personally irresponsible on each of your clinics' part to offer a test which is still not fully proven. Apart from that they've never given either of you any aftercare or proper explanation beforehand re this test. You've both been left high and dry.

As said before this is still experimental and has not been fully evaluated re ovarian reserve. This needs to be borne in mind by both of you.

My advice to you both is to go to the Hfea website (which is the government's based website re such clinics) and find another clinic to work with. I would steer clear of anyone who offers experimental tests; its just another way for them to make money out of vulnerable patients.

Hey lottie - I am stil trying to get to the bottom of your question - but basically I think it means that we are not producing as many follicles each month as we should be and also the ones we are producing are not going on to become as good quality eggs as they should be. I think it is kind of like saying that our ovaries are ageing quicker than we are.
We are still ovulating but the likelihood of that one egg meeting the sperm and developing is much lower than normal. If the AMH count is higher (or in the satifactory range above 15 or optimal range above 28 I think?) then it means you are producing a good number of follicles in the ovaries which are good quality. Does that make sense?

I have found this website from a clinic in the US which I have found qute helpful re ovarian reserve

I know Atilla is right in what she says about the test being experimental - but they are developing it so that in the future it may be offered to all women in their 20's to help them assess their fertility potential and therefore their future and also they could have the option to freeze eggs. I have to say I wish I had known this info in my 20's and if I ever have a daughter it wil be something I discuss with her as it does seem to be heriditary.

Thank you Atilla for your advice as always

dogtired - did you just go back to see the consultant yesterday and discuss the AMH. Thanks for making me feel good about my 10 but honestly on the list of results it is still in the low category and when the optimal level is in the 30's it is pretty pants isn't it??

I have read about the supplement DHEA being able to increase the quality of the eggs - have you heard this? It might be worth asking your consultant. This is what I am still trying to find out -if we can improve the score or at least delay it getting any worse.

There must be someone with a success sory out there - please!!!

Hey lottie - in case your read this - yes it was a natural health clinic - but TBH I did not know he was going to do such fertility tests. I thought it would just be bloods etc.

Anyway - with hindsight I would recommend going straight to a fertility clinic for some tests if you feel you want the reassurance/information where you will get a better diagnosis and interpretation of the results - then if help is needed aproach the natural health doc etc. I think I did it a@se over t@t really as I will only have to have these tests again if we do get to a fertility centre eventually. IYSWIM.

I was trying to be all holistic and went to the natural health doc for general well being and immune system build up as was getting many infections etc while TTC but TBH it has also revealed issues that have scared me to death with no good way forward/options suggested.

I def think believe in the complimentary therapies but now think it helps if you know the exact nature of the issues you are trying to overcome first.

Went this morning to get my drugs. Attila, the clinic is a very well respected one that's been HFEA registered for 15 years. I knew at the time the AMH test wasn't officially recognised, but the prof seemed to think it was useful. I wish very much though that I had had another consultation after the test results, or at least had someone tell me clearly what an AMH of 1.00 etc meant.

Results of my blood test were worse than September - FSH is up from 9.5 to 11.5, and estrodial (sp?) is still high at 225ish. So all in all not great. Also had a scan today which showed very few follicles forming.

However, on the +ve side are the facts I'm "only" 37 (last month) and have a 21 month old son. Still on a downer though.

Seaside, gutting though this information might be, that's what IVF clinics are for, and they've successfully treated couples much worse than ourselves. You're in much better shape fertility wise than me, and I'm sure if you decide to go for IVF the clinic would tell you you're an excellent candidate. I forgot to ask about DHEA today but will ask tomorrow.

Lottie, as far as I know I am still ovulating - I've had 2 blood tests on day 21 that say so and the ov predictor tests always tell me I am? I guess all it takes is one egg... and yes, I imagine that's exactly what the AMH predicts (the end of ovulation)

dogtired - doesn't seem like we are going to get any success stories!!!

So you will have to be one for me as it sees you are further along the IVF road than me (I still have not even seen a fertility consultant - am hoping for a referral next month but in the meantime am going to try and get an appointment privately in London)

I guess I am becoming reconciled to the fact that IVF may be my only option - but it still scares me witless!!

I think the scan you had was an internal one for antral follicle count - I am hoping to be able to request one as soon as I am referred. When are you hoping to start IVF treatment?

BTW - here is a bit of info about DHEA It is a controversial supplement but might be worth asking about.

I did my first injection tonight It wasn't too bad at all. I was not looking forward to it at all I can tell you. I have to have a whopping 350 rather than the "normal" dose of 250 so I'm waiting for the insane mood swings to kick in lol. Poor dp!

I will do my very very best to be our success story!

That DHEA article is very interesting, wish I'd known about it 4 months ago!! I suppose I'll rush out to get some tomorrow

dogtired - wishing you loads and loads of luck with the IVF - will look out for your posts to see how it goes - fingers crossed for lots of good eggs and a BFP

Thanks seaside