Questions for those going through IVF

[LizzeyBenett]

I'm currently awaiting a fertility clinic appointment in March , Ttc since 2021, I'm 36 in the next few months. I feel like I'm headed for IVF . What role does your AMH Play or what's considered "low" Amh ? Any questions I need to specifically ask when I am seen in clinic ?

Amh gives an indication of egg reserve and is important as well as the antral follicle count (which they check via a transvaginal ultrasound) in knowing what quanitity and type of meds to use to stimulate your ovaries in your cycle. A high AMH can signal polycyclic ovaries, so the meds would be lower to avoid OHSS, and a low AMH would be higher meds.
Off the top of my head not sure regarding AMH levels but there's alot of info online about the normal thresholds by age, as of course it lowers as you get older. I was 34 when I did IVF and my AMH was between 16 and 20 I think. What fluctuated was my follicle count, went from 21 the month before IVF to 11! But got 7 eggs, all fertilised and got 6 embryos, now 17 weeks pregnant from the 2nd transfer :)
Has partner had a semen analysis? We had IVF due to male factor and often it seems overlooked. You'll have a HyCoSy before IVF referral to check your fallopian tubes are open too most likely.

Polycystic*

I think anything under 12 for amh is considered low if you're under 35. I'm 27, my amh was 5 then went 7, I had one round of ivf (4 embryos) but the embryo transfer failed (June 2022) however I found out I was pregnant naturally literally days before I was due to start a medicated cycle for another embryo transfer. I also ttc for a year before ivf, but when we had our fertility tests, we found out I had low amh and husband had low sperm motility so we did icsi ivf. I'm now 22 weeks pregnant with my little rainbow baby! I hope your ivf journey is successful and don't lose hope!!

My Gp checked my AMH and it was 7.24 only now realising how low that is .

@LizzeyBenett it's still in the threshold where IVF can work though, it's below 1 I think some clinics don't do it. Your clinic when you have one, will be able to make a tailor made plan for you based on that, and I learned its quality of the eggs not quanitity from my round. Because we have male factor I was freaked by the rate of attrition in embryo drop off during the 5 days they grow them in the clinic, so was disappointed with 7 eggs when I thought I'd get nearer 20, but 6 of the 7 became top and good quality embryos so it doesn't always need to be quantity.

I read It Starts With the Egg and found that so eye opening regarding things I could do to improve egg quality, and my DH took loads of vitamins and did lots of life style changes in the months leading to IVF to give us the best chance of healthy embryos. It might help to start making some changes now so you feel totally prepped when IVF does come around, hope it goes really well for you x

My AMH was 9 at 30 years old. Was told it was a little low by fertility clinic but that it wasn't massive cause for concern.

It did take us 18 months to conceive, and did so naturally in the end just before a round of IVF.

I know people that have got pregnant naturally on AMH of 2

Just to add, it's much more about egg quality than quantity to be honest. We were recommended to take IMPRYL to improve sperm and egg quality. It said on the packet it takes 3 months to take effect, and almost exactly after 3 months of taking it, we fell pregnant.

I highly recommend taking it, although a little expensive, as I believe that's what worked for us in the end.

AMH is very inaccurate tbh. it is usually a rough indication but not always. AFC and age are actually much better indicators of what quality eggs you will produce. Mine was 5.6 at 32 years old, my AFC was similar at 5. no idea why that was low but what can you do. We were doing ivf for male factor. We decided to do two rounds. between them i think we got 11 eggs and 7 blasts. 5 of which passed PGS testing and graded 6aa. We went for transfer only to find i was pregnant with twins. i have a strong family history of twins so thoughts were i may just release two eggs a month

I know people with much higher AMH but lower AFC and vice versa. Unfortunately it's just a game of luck

Thank you all , can't help but worry but your positive stories have really helped .

@Imisscoffee2021 thank you so much , yes we have made lots of lifestyle changes but I could definitely do a bit more so this is the kick up the bum I needed.

I am calling the fertility clinic tomorrow to get the ball rolling. We are dealing with a vasectomy and a low AMH of 4.99 at 34 so going for ICSI. I am very clueless at the mo but hoping the clinic make it all clear.

My understanding with my AMH is I have far fewer eggs than I should so it will be harder to get a decent number for ICSI but that their quality should be that of a 34 year old so still good.

@Hopingforno2in2023 don't get too hung up on the overall numbers. you may not get as many eggs but better more eggs doesn't neccessarily mean more good quality blasts. the AMH is more used to choose a good protocol for you and they'll pick meds that focus on producing a few very good quality eggs.

good luck

Thank you Bells