Low AMH and low volume in left ovary - can it improve?!

[Jackson1976]

I have been desperate for kids for a long time and got seduced by one of those adverts on the tube for natural cycle IVF at the Bridge Centre even though I can't afford private treatment. I had the introductory tests (scan and AMH) and my results came back pretty bad. AMH 2.56 pmol/l, a low volume left ovary and only 5 antral follicles in total. I don't understand what it all means. The doctor was just intent on getting me my shopping list of more expense for further treatment but reading around it seems like people are able to improve follicles and AMH. I don't know what to believe and am freaking out I'm not going to be able to have kids. I'm 38 haven't looked after myself as well as I could of (just quit smoking and started exercising/changing diet). I'm in a state of despair that I've destroyed all chance of the one thing I wanted most in life. T o have a child. Have I blown it?

So sorry Jackson - fertility issues are so upsetting and confusing I know!
I'm by no means an expert but I do have low amh (1.44 at age 28 was a shock!). Your amh is linked to the number of eggs you have in your ovaries. We all start out with millions of eggs in puberty and they gradually get less and less with each period we have so the older you get the fewer eggs you have and the lower your amh gets (and fSh which is another measure of egg numbers gets higher)

The other dynamic is the quality of eggs. Again, as we age, the quality of eggs reduces and they are less likely to fertilise.

Your antri follicle count may change slightly every time you are scanned - not sure why but I had between 5-8 follicles depending on the day.

My understanding is that you can't increase the number of eggs, but there are theories about how to increase the quality of your eggs (with drugs like dhea which you have to get from America I think? I'm sure on the fertility boards they will know much more about this than I do).

I was told that with my very low amh getting pregnant naturally was not impossible but that ivf would give us our best chance. we were successful with our beautiful son on our third round with the care clinic in Nottingham whose praises I cannot sing loudly enough (we only used them for our successful cycle). In hindsight- we should have researched more the various clinics as the local options were definitely not as good.

If you were to go down the ivf route then with low amh you would expect to have a far fewer number of eggs extracted- say max 10 eggs, of which half might fertilise of which only 1-2 would make it to a decent enough grade to be implanted. So the likelihood of having spare embryos to freeze would be verY very small. But it only takes one embryo!

The other option is to go for donor eggs, but this is more expensive and obviously comes with another set of considerations. As far as I understood, your amh will have no impact on the success rate using donor eggs. There are clinics without waiting lists so you would want to find these as some have two year lists.

It sounds like you didn't have a great experience with the clinic you went to - sounds like it was more of a sales pitch than true consultation. I'd maybe try somewhere else - I'm sure there will be some mn people with recommendations in your local area. There are so many things to think about before you embark on any fertility treatment that you need advice you feel comfortable with,

Good luck with your journey

Hi Jackson. I'm 37 with a very low AMH of 1.8. I'm currently on my 4th cycle of IVF and I've had a different antral follicle count each time - it varies by month. This cycle I had 10 follicles (some months I've had as low as 4). They collected 7 eggs on Friday and I'm pleased to say that all 7 fertilised, now just waiting to see what happens at egg collection. There's nothing you can do about your AMH but I do think there are a few things you can do to help follicle count....diet, exercise, supplements.

I'm no expert but if I were you I would go for 'proper' IVF. If you've only got money to spend on one go then I would suggest you try a stimulated cycle, so you've got the best chance of growing the follicles you do have. Natural IVF is fine but personally I'd only opt for it once I'd tried and failed at regular IVF.

Thank you so much for replying Sophie and bluemoonday. This is all a roller coaster isn't it?! I've been obsessively googling all day to find out more and it turns out there may be a link between low AMH scores and vitamin d deficiency - lack of vit d causing falsely low readings. I am now pinning ALL my hopes on this being true in my case. As well as the private checks, I've had day 3 and waiting to do day 21 checks via the NHS. My initial tests said I had a vitamin d deficiency. Praying now this caused a low result for AMH. Maybe false hope but it's stopping me going insane for a little while longer at least in hope x

Hi, I have a low amh and high fsh, Antral follicle count of 10. I would recommend coq10 tablets, 600mg a day, it really helps with egg quality. I recently had ivf and they collected 8 eggs, 7 fertilised and they all made it to 5 day blastocysts. I think it helped a little bit! Good luck ??

Jackson I'd definitely make the NHS your first port of call in terms of tests etc.

Amyjojos that's where I am at the moment, very low amh and high amh. no idea about my follicle count but I'm going to pre-op for a laproscopsy in a couple of weeks. I have a cyst on my left ovary and my fallopian tube has fluid in on that side. The main thing that worried me was that I've repeated my FSH (no results yet) but the registrar suggested that 2 high FSH results mean that they won't treat me on the NHS?

Never one to give up, I've had another scan and am very pleased to say my follicle count is now 9 rather than 5. I'm waiting for new AMH results too - after 2 months of vitamin d tablets for my deficiency, accupuncture, coq10 and Dr Zhai supplements, I'm determined for an improvement there too. Lesson, always worth getting a second opinion!

Dusty - I don't know about funding, all health care trusts have different policies. I had a cyst on my last scan too but am told it's nothing to worry about. I don't know much about fsh though.

Amyjojos - hope things are going well with you and thanks for the advice!

Hurry! I did improve my Amh levels - up now to 5.74, double what it was before. The doc put me on uber strength vitamin d tablets to fix my deficiency plus I quit smoking, have been taking Dr zhai supplements and having acupuncture (but not with Dr zhai, just my local Chinese doctor). I feel loads better and am delighted things have improved. hope this info helps someone else out there have a bit of hope - I'm sure it's the vitamin d that makes the most difference, giving misleading Amh results previously.

I also want to say don't give up. I was initially given an AMH of 4 and antra follicle count of between 4 and 8. My FSH was between 8 and 11.
I had a disastrous IVF round on max stims producing 2 eggs and 2 poor quality embryos.

I then took co enzyme q10 (600mg) and DHEA for 3months and got pregnancy naturally twice in 3 months. First time a chemical pregnancy, 2nd time I am 9 weeks and so far so good (although clearly not out of the woods yet!)

I can highly recommend It All Starts with the Egg, a great book about improving egg quality. Good luck!

Oh and my AMH was retested the month before I got pregnant and was now less than 1 (!)