Low AMH please does anyone know more?

[lamby12]

Wondering if anyone can shed any light on AMH that might help me understand my result better than google.

I was sent my result at 5pm via email from the consultants secretary and it's just the results sheet, no context. It's 2.7pmol and says 'low'. I'm only 29.

Background, been TTC for 18months and recently had an early miscarriage. I'd just got over things and was getting on well mainly because I've been repositioning my mindset that there's no rush, it'll happen, it may just take years, etc.

But from what I can google (I know, deadly) this is a shockingly low AMH for 29, the recently lost pregnancy was maybe some miracle and now I feel in a very low place until I can talk to the consultant. Will they even take us for IVF or is it too low, what are our options or what if they say there's no options?!

Has anyone had AMH results similarly low that they can explain? I've read obviously what it all means medically online. But what does this mean about our options?

I’m sorry to hear you are going through this lamby- it’s hard isn’t it. As far as I know, the AMH test doesn’t test quality of eggs and you have had one egg that was good enough previously to fertalise. So that is positive.

That is a low AMH but your young age gives you lots of positives in the conceiving stakes. AMH isn’t the sole indicator of whether you will get pregnant, it’s just and indicator.

I had an AMH of 3.2 at 40. The special told me I was unlikely to conceive naturally due to my age. I did, twice (the first ended in miscarriage). My eggs would be much older/poorer quality than yours, and yet I have a gorgeous two year old.

There are many options you can explore. I’m sorry for your loss

Thanks @Ticklyrain for responding. Thanks for sharing your story.

I feel like I'm on a sinking ship since I've read more about the result. I know that sounds dramatic but I just really need to understand what options this means for us. I have been reading about IVF but don't want to even get too much down that rabbit hole in case they say IVF is not an option.

Whilst I know it can always happen anyway there's lots of defying the odds stories, I will really struggle to accept the approach of doing nothing and it's unlikely but just hope we might be one of those success stories. That just feels like they'd be saying we're a lost cause, but try anyway and you might be lucky.

I know I need to just wait to speak to the consultant but until I can call on Monday I don't even know how long we'll have to wait for that. We weren't having another consultation yet as we're waiting for the GP to do some standard tests which the consultant requested. But the GP says they won't do anything right now (been the case since Nov) so I want to just move forward with the consultant based on what we know.

Hi,
I had low AMH at the age of 31, we had been trying for a year with no success.
Have you seen the consultant yet? Did they scan you? They won’t just look at your AMH level (it’s not an exact science as it can fluctuate!) they look at your antral follicles too. I had an AMH of 6.3, only one Antral follicle one side, four the other and we were still accepted for ivf. We managed to get eight eggs at egg collection. Your age means that you may have less eggs but the quality should be good!
Hope you get another consultant appointment soon x

Thanks @ellesbellesxxx we had one initial appointment with the consultant. She ordered fertility scan and amh test with then, wrote to the GP for standard blood test, swab, basic stuff to get a full picture (but the go won't do these at the moment).

I had the scan 1st Dec, all was ok according to the lady who did the scan, she said lots of follicles at both sides (didn't say how many) and one big egg ready to ovulate, then I got pregnant that month but miscarried recently. I therefore hadn't been that focussed on following up the AMH result or GP tests.

Since the miscarriage I've followed up with the GP and they won't do the tests right now re Covid. I followed up with the fertility clinic. She said she can't send me the scan results, but unless the scanner didn't tell me something it was all apparently ok. But she emailed me the amh at 5pm yesterday.

I have emailed back asking if we can have a follow up consultation now based on the scan and amh - I am not willing to wait for the GP and also I think those tests were just the broad stuff like checking for any STIs, general bloods, etc. I'm not sure if they can proceed without that or not.

I have been reading about create which is a more natural ivf approach maybe suitable for low AMH. I know I should take one number on it's own and go into panic mode but I really wish someone could properly explain what it means about options because all I have is '2.7pmol' 'very low' and google to help me... !

Argh how annoying. I remember years ago at the start of our IVF journey we received a diagnosis on a Friday and had to wait weeks to have a doctor actually explain it to us!

Your AMH is on the low side however I have heard of ladies with lower who have conceived with it. If you go down the IVF route they will monitor you closely as you 'may' only get a small amount of follicles and eggs when you stimulate.

Tbh I don't believe the AMH is an exact science when it comes to guaranteeing a pregnancy. I have a really high AMH but when we do IVF I get a "good" amount of eggs but haven't ever had lots to freeze.

Good luck x

I would recommend reading 'it starts with the egg'. I credit it with having much better results on my second ivf successful cycle at 39. It gives you a 3 month plan to get your eggs in the best possible condition. It gave me so much hope and I think it really helped.
I read up on lots of promising reports for DHEA and this is recommended in the book. I spoke to my consultant about it ahead of the second round. A patient of his with low amh had taken it without his knowledge. However, she admitted using it when her results improved dramatically from 1 cycle to the next. He started taking it himself.
My friend had low amh and went on to have 2 children using the donor eggs route. This may not be the right approach for you.
At 29, you have good quality eggs. It's the environmental which surrounds them that may need a little help.

Don't despair! I know it's a really devastating blow. I had amh of 1.44 at 28 so not dissimilar to yours. As a pp said it doesn't measure egg quality and at your age your eggs should be in decent shape.
I have 2 kids now from 4 rounds of ivf. It was the two last rounds that were successful.

It will likely mean that instead of getting 15-20 eggs from a cycle you will only get 5-6. But it does only take one! We had 4 eggs in the final cycle and only one was of a decent grade by the time they had been fertilised and left to grow. But the one they put back was successful.

We made the mistake of taking the recommendation of the gp to the local ivf clinic for the first two rounds, but if you are going private I really recommend you do some research on success rates as they wildly differ between clinics.

And remember that with ivf often the first (and sometimes the second) round can be more about learning which drugs work for you and in what doses. Although plenty of people do get lucky on the first go.

What is it with doctors giving out AMH results so terribly. Mine told me I was peri menopausal! ) I’m not. My OB told me that AMH tests aren’t completely reliable and give a ballpark indicator. Like a previous poster I have a friend with high AMH who wound up with average egg collections.

You have some positive news - you are ovulating, and have a good antral follicle count.

The support you are getting sounds a bit average. Have your doctors suggested any interim steps like clomid/femara? They may not want you to go down that route as you are ovaluting but my doctor started me there as the drugs also help with getting eggs to mature to the point where they can be fertilised. If you need to wait for IVF maybe it could be an interim possibility.

I know you will be feeling so fearful right now. It’s natural to jump to the worst conclusion. But you still have lots of options. And none of us can predict the future

Thanks @palmleafsinwinter yes I think that's the worst thing is having no context, to be fair I requested to be sent the result but I wasn't expecting it to not be normal. Or not to be at the low end of low. I can read all about what AMH numbers mean but I suppose it's what does it mean for me against other results.

@sweetheartyparty thanks for the info on DHEA, I've come across this in my googling so it's useful to hear your experience. I am taking some comfort in the fact that I'm hopefully still blessed with some good eggs versus if I was older. Hopefully anyway.

@whensmynexthol1day thank you that's really encouraging to hear. I did read somewhere that lots of clinics don't do IVF with under 5 AMH (don't know where now!) and that sent me into panic mode that they might say 'sorry there's nothing we can do' so it's good to know your outcome.

Thank you @Ticklyrain my doctors really haven't been helpful. To be honest the receptionists have pretty much blocked me speaking further with the doctors as when I ring to follow up having the GP tests (requested via letter by the consultant following our private consultation) the receptionist just says they aren't doing routine tests at the moment and to wait. So I haven't even been able to discuss anything with the doctor. I may call again on Monday and say I need a phone appointment but don't want to disclose, just so I can speak to an actual doctor about getting the tests.

The private clinic have come back to me to say they wouldn't recommend another consultation until I have all tests recommended by the consultant. But I can pay to have them there if I like. So it's a swab test to check for any STIs or other infections and general bloods to check vitamin D, hormone levels and an FSH day 1-3 test. I am going to call on Monday to enquire the cost and call the docs at a last ditch before paying for them.

Thanks for all the replies making me feel slightly better that this is just a number rather than a doomed outcome. X

Just bumping to see if anyone else has any experience of this??? I'm swinging between it being the end of the world or just one figure to be taken with a pinch of salt... we can't see the consultant until I've had day 1-3 FSH as well, so probably another month before I get a proper explanation and I info.
Any experience appreciated