Tackling abnormally low AMH

[Starryeyes1984]

So I'm new to the world of mumsnet but I got some fairly bad news the other day and thought I would benefit from the wisdom of people who know more about fertility than me!

Me and my husband have been trying for over a year. Within months of coming off the pill I had a period that was 2 weeks late. Prior to going on the pill (I was only on it for a year) my periods had been like clockwork my whole life. I was extremely stressed at work so decided that was probably the reason. A couple of months later my cycle was 60+ days so I went to see the GP, told them I had just started ttc and was sent for some blood tests and an ultrasound scan. GP said everything looked fine and it was probably just stress. We carried on trying and I've had 18 months of irregular cycles ranging from 21 days to about 65 and everything in between. I went back to a different GP because I wasn't convinced I was ovulating every month but the month I did the 21 day progesterone test that also came back fine and my husband's sperm test was fine so she didn't refer us to a specialist and said keep trying. I lost patience after a few more months and went back to see a different GP who eventually agreed to refer us and we have an appointment with a consultant next week.

In the meantime, my mum mentioned this AMH test which I'd never heard of so I went and got it done privately and just got the result that my AMH levels are 0.6 - which I gather is really really bad considering I'm only 33 and otherwise healthy. From everything I've been reading it seems like I'll probably never have my own biological children which is really devastating, as if the thought of going through early menopause . I specifically asked the last GP if I was going through early menopause and she assured me that I wasn't because my FSH levels would be loads higher. I can't understand how everything else could show as normal if my AMH is so low but I wish I'd found out sooner cause I wouldn't have spent all this time ttc naturally and probably in vain.

My sister in law has suggested using egg donors but I have no idea where to start with that, whether it's worth trying IVF with my own eggs or whether I can even have IVF on the NH with such low AMH levels. I also worry, cause me and my husband are both of African descent, that there won't be many black egg donors available which means the whole process will take longer.

I don't really know what to do with this new information. The internet is such a dangerous place of half truths! I feel so anxious about seeing the specialist next week but I'd like to be prepared so that I can ask the right questions and be engaged with any treatment plan. I would love to hear stories (good and bad - preparing myself for the worst here) from people under 35 who have also had very low AMH levels, premature ovarian failure, and/or gone down the IVF or donor egg route, including other ethnic minority ladies. I have a feeling that the journey we're about to embark on isn't going to be an easy one but overall I think it's better to know what we're actually dealing with. Knowledge is power right .

Thanks in advance!

Hi @Starryeyes1984 ,

I'm sorry you're going through this. It is crap, I'm 32 with low AMH and just about to start cycle 2 of IVF.

One key question before I tackle the FET of your post is what units are your AMH in? There's two commonly used and that massively impacts how low your results really are!!

Also do you know what your FSH Ian's progesterone were?

Might be worth an ultrasound to see what you antral follicle count is.

Low and could be an indication that you won't respond very well to ivf drugs, but as you are still young any eggs you do have should be of pretty good quality... and quality is far more important than quantity.

Very sorry for this shock.

The unit is pmol/L. I know that this is really bad as they sent me info about ranges for different age groups. I'll have to ask for the results of all previous blood work at my next appointment. All the GPs said everything was normal and it was probably just stress so I didn't delve into further questions at the time. I wish I had now as I feel like I only have a small part of the jigsaw with this AMH result and nothing else.

starry I'm sorry for your terrible shock. I'm 29 and have also been diagnosed recently with very low AMH for my age (for full disclosure it is 3.7, so I appreciate not as low as yours, but still pretty bad). I had already been referred for IVF due to tubal factors, so slightly further along the path when I found this out but it is likely to change the protocol they use, chances of success etc.

The consultant will be able to talk you through what your results mean from the point of view of your chances at natural conception and through fertility treatment. If you are still ovulating regularly and your partner doesn't have any sperm issues, natural conception is still possible, even with low AMH, particularly when you are young. As you've found, GPs really have very limited information on the impact of fertility tests and the likely outcomes of fertility treatment.

They will also scan you to check your antral follicle count, which will give them a better idea of how you might respond to the IVF drugs, and whether they recommend using your own eggs, or donor eggs.

Hi starry. I don't know much about AMH but I've been looking into the donor egg route and you may have better luck finding eggs in Europe. I remember seeing on Serum's website (Athens) they specifically said they have black eggs available. It's quite a bit cheaper than in the UK if you decide to go private.

Hi Starry,

I m sorry for how hard this kind of news can be, I recieved a very similar result at 34 (0.5pmol) after 18mns ttc and was equally devasted so i ll tell you my story in case it helps.

We immendiatly arranged an ivf appt the following month. Interesting they repeated amh and it was 3.1 only 2mns later. Was different labs and done on day 3 rather than 21 of cycle but same units so either it can fluctuate or the cycle day made a difference for me (they say it shouldn t ). My fsh was about 6.0 and antral follicle count 4-5. We planned to do ivf 3mns later (at the lister as they were supposed to be good for low amh) but I was actually already pregnant and went on to have my son with no problems.

When he was two and half i did get pregnant again naturally after just 6mns ttc (amh was 2.0) but sadly miscarried. We have since tried for another 4yrs with a round of ivf at age 41 (amh was 1.9) which only produced one egg that did not fertilise and have be unsucessful in having a second child.

So what i have learnt along the way about amh is:

Low amh does not necessarily mean immenient menopause (i turn 43 next week so almost 9yrs after my 1st amh result of 0.5 and altho my cycles are a bit more irregular i m still having them!!).

Some info suggests vit d defiency can give a lower amh level so worth get tested (especially i think if you are dark skinned).

It may well mean you have a poorer response to ivf drugs and certain protocols can be better so chose a clinic that specialise in this rather than one size fit all but at age 33 your egg quality is likely to be good which can help with having fewer eggs.

Some women respond well to alternative treatments (i had been having acupuncture for 6mns before i concieved my son). Some also have sucess with traditional chinese medicine (herbs).

Look into DHEA, again quite alot of ivf clinics are now using it to improve response in low amh ladies and even people have had natural conceptions on it while awaiting ivf although as its a hormone precursor its best used under guidance.

Even really low amh does not rule out sucessful natural conception so don t consider your efforts a waste of time as there are plently of positive stories out there of this.

The infertility journey is a rough road to find yourself on and all you can do is just try and take care of yourselves and take it one step at a time and I really hope you find sucess soon.

Agree with the above poster. My amh was 2.8 when I was 34 and had no kids. I was given the impression it would be difficult to get pregnant and advised to do ivf ASAP. I then got pregnant naturally before doing the ivf but unfortunately Mc.

We then did the ivf and my response was very poor as predicted- only 2 eggs and 1 embryo. However, that embryo stuck and is now 3 years old!

When my periods came back when he was 9 months old we started ttc again. I had no expectations after the low amh score- however i somehow got a bfp straight away.

I’ve not got 2 boys with 16.5 Months between them.

Main moral of the story- low amh is only about egg numbers, and egg quality is what counts. You’re still young. I also believe that the doctors don’t really understand the effect of low amh- there are too many good stories out there.

So I got all my previous results from my GP and I've been to the fertility specialist now. Pretty much as bad as it could be. Despite 3 GPs telling me it was fine keep trying my FSH was 16 and 18 in tests months apart and then they said my 21 day bloods were fine and I had ovulated. The specialist says progesterone was actually low and I hadn't. Had the afc and couldn't find any follicles. I had an internal scan a year ago when I first went to the GP complaining about irregular periods and they told me it was fine. I now find that very hard to believe. I've basically been told everything is fine for over a year leading to months of trying and failing and the emotional stress that comes with that when actually I could have been in this state of total devastation ages ago if only my results had been looked at properly. But now it just feels like lots of tears shed over the past year and We could have been trying to find a donor egg ages ago. I feel pretty hopeless right now. I just don't know how this can happen but then I guess bad things just happen sometimes and that's life. Sorry to be negative. I know that miracles do happen. It just feels very raw right now

Hi @Starryeyes1984 ,

I've been following this thread and I am so sorry to read your latest post, I can't imagine what you're going through and how you are feeling.

Have the consultants told you to go straight to donor eggs and not even to try IVF? I don't want to offer hope where there isn't any but my low AMH hasn't been very accurate and I got so many more eggs than they thought I would so I wondered if they would even try?

My GP also coded my FSH of 12 as normal and I only found out it was raised as I asked for a copy of my notes to go see the fertility clinic when my husbands results came back abnormal. I raised this with the GP and was frustrated we'd wasted time when we should have been referred. I got a formal apology letter - it doesn't change things but it did help with the healing process a bit.

It's such a shock and so much to come to terms with - I hope you and your partner are looking after each other and you find a way forward.

Xx