Low AMH, 41 - IVF worth considering?

[Sayulita]

I have just discovered I have an AMH of 3.2, which is low. I had a mc four weeks ago. I have a DS (age 2) and I tried for a year for the pregnancy I lost. The news of my low AMH has hit me hard as I suddenly feel that just getting pregnant again may be risky if this AMH result actually also indicates poor egg quality.

Does anyone know the correlation between bad quality eggs and low AMH at my age?

Is it worth considering IVF with some kind of genetic screening to try and get a decent egg?

Would IVF even work with such a low AMH (I have read some clinics wouldn't accept me with such low levels as the stimms wouldn't harvest much)?

Lastly, does anyone have any tips on where I should turn for advice? The world of IVF seems daunting and I don't know where to start spending money for assessment appointments.

Thanks all x

Hello! I'm so sorry to hear about your recent loss.

AMH gives a general indication of your likely egg reserve (and, as a corollary, how well you might respond to drugs intended to stimulate your ovaries during fertility treatment). It doesn't tell you about egg quality, though.

The main predictor of egg quality is actually age. Probably around 80% of your eggs are chromosomally abnormal by your early 40s, however healthy you are otherwise. So, it's not uncommon that it might take longer to get pregnant, and sadly miscarriages do become more common with age.

It's possible to do PGS with IVF, but it's very expensive, and as you've noted, you might not have a large number of eggs retrieved, so it's not a guaranteed route to success. If you want to explore your options, you could have an initial consultation with a clinic and see what they suggest - in your position, if be asking about likely success rates, as these can be quite low for women in their forties. (Sorry, I know it sounds like I'm going on about age - if it helps, I'm the same age as you.) Or, many places do free open evenings and the like, so you can suss out whether they offer the kinds of treatments you're seeking.

You may well find that clinics suggest considering donor eggs, so this is something to think through. And, you might also want to think about whether you'd consider having treatment abroad, as this can have a big impact on costs.

I know it's a lot to think about! Please look after yourself, and please do ask if there are things we can all help with.

Hi sayulita i’m also 41 and my amh is 1.7.
Regarding donor eggs the consultant told me that if amh was under 1 then they would suggest donor eggs straightaway. I have just had et of my 2nd ivf cycle. The first one failed last year. My (new clinic) consultant advised me to take dhea for 3 months before starting this cycle which I have done. I only got 2 eggs at collection, only one of which fertilised. Today they said it was looking to be top grade. I can only hope and pray that this has worked. Good luck with whatever you decide x

thank you for this advice.

bjonesreborn - have you found that it's been hard to find clinics to treat you with your AMH level? Any tips on where is good?

and best of luck with the embryo you have. It only takes one good egg! x

sayulita depends where you are obviously! I’m in south east and now on second clinic. Incidentally it was nothing the first clinic did ‘wrong’ I just couldn’t go back to the city ever again, let alone the clinic!! Neither of the clinics seemed to have a problem with low amh. Obviously the older we get there are less eggs and the quality is lower.
Thank you for your good wishes - terrifying to be in this postion again...I’m sorry for your loss, that must be awful 💐

Hi Sayulita,

Sorry to hear about your miscarriage. That’s really tough. Though clinics have different guidelines im sure there are many who would treat you with low AMH. Although egg quality is likely to be worse at 41 they look at all indicators in the round - FSH, Antral Follice Count and AMH. AMH is not always an accurate reflection of how you will respond either. Mine is 2.3 and I’m an otherwise healthy 34 year old. My first round I got 5 eggs, on 225 of menopur which is a pretty average dose. 5 eggs might not be brilliant but it’s enough. I guess what I’m saying is you won’t know till you try.

All the best

T x

Hi, just wanted to add that although AMH can give you a guide to how many eggs you have - going for IVF is the only thing that will really tell you how many eggs. I have an AMH of 8 and got 20 eggs! They were shocked and just concluded AMH isn't always accurate.

There is no test for egg quality but age is a guide for this which is why getting more eggs is so important as increases your chances of a good one x

My amh was 2.8 when I️ was 34. I️ was advised to do ivf and told that my response would likely be poor.

It was- they only retrieved 2 eggs ;I️ was 35 by this point).

However-it still worked! Ds is 3 now. Egg quality is far far more important and there are things you can do to help with this.

Hi Sayulita,

I hope you don't mind me linking to an external article, but I think you might find it helpful! It covers everything to do with AMH, how AMH levels relate to age and egg quality, and whether IVF treatment is worth it (if you have low AMH levels).

You can read it here: theduff.co.uk/amh-levels-ivf/

You might also be interested in this article on age, ovarian reserve and egg quality: theduff.co.uk/egg-quality-quantity-ovarian-reserve/

I really hope that helps!

Mish

The Duff information was sobering (and very helpful) reading. Thank you. And thank you all for sharing info and encouragement.

I am 41 next week and just finished my first cycle (pregnancy test is in my 41st birthday)
I knew nothing about fertility before I started and have learnt a lot along the way but still confused!
My AMH was 2.1 they weren't concerned about it at all. Have you had a day 2 scan to see how many follicles are there?
I ended up with with 14 mature eggs and 6 good quality blastocyst embryos. They put two in and froze 4.