Low AMH at 25, absolutely in a state of shock and desperation

[acaciabluebell]

I had my AMH tested privately and it was 9.2pmol.

The normal range for my age is 8.7 - 83.2pmol. So 9.2 is extremely low, just about scraping 'normal'

I'm only 25. My FSH on day 3 was 7 iu/l.

I never expected this, I can't stop crying. There's no family history of early menopause or anything. If anything my family are all extremely fertile, my grandmother had 11 kids and had her last kid at 45.

Does anyone have any sort of advice or experience to impart? We have been TTC without any luck for 12 months. Day 21 progesterone showed I wasn't ovulating. Dr thinks I may have endometriosis. We are being referred to NHS fertility clinic but it's taking ages.

We don't have any sort of money for private IVF. Are we absolutely screwed with these sort of numbers? Please help 😭

Sorry you are worried but I hope you can get some reassurance from your dr soon - are you under a fertility clinic?

I was told age is much more important than AMH and you are only 25 so that's really good sign - also your number is still within normal range even though lower than average for your age (again my consultant said the range is really huge and often skewed by those with PCOS having vvv high amh)

My AMH was on lower range of normal too and I got pregnant naturally

Sorry just read you are being referred to the clinic - that is good but I know the wait is frustrating

It doesn't sound like your level falls into very low category so there's def hope !

www.createfertility.co.uk/blog/are-amh-tests-reliable

I'm so sorry you're going through this. I'm 31 and was told last year I had an AMH of 6.3 (so v low for my age also). Age is definitely an important factor for TTC as this is what mostly determines egg quality. Ie you might have a lower number of eggs than the norm but those you have should be great quality at your age. This has a big impact on IVF success rates.

A low AMH doesn't mean you can't conceive naturally, it just may take longer. Definitely don't give up hope on the natural route but pursuing intervention through fertility services sounds sensible given you've been trying for 12 months.

Another thing to bear in mind is that a one off reading only tells you what your AMH is now. It doesn't tell you whether your AMH is declining faster than usual or whether you were just unfortunate to have a low baseline compared to the norm.

Assuming you have no other issues contributing to your difficulty TTC (the endometriosis might but sounds like this is unconfirmed) and your partners sperm analysis was okay, you are likely to be a really good responder to IVF. It might be worth starting to save to fund a private cycle if you can (if you don't need it you'll need the money for the baby anyway)! Waiting times for NHS services can be very variable depending on where you are in the country.

I am almost 16 weeks pregnant now following our first IVF cycle which resulted in 1 viable embryo for transfer. We may have just got very lucky but our consultant was always optimistic we had good chances because of our age, and you're a lot younger than me!! Our cycle cost approx £6500 at a London clinic for context on cost.

Things you could do now (if you haven't already) are get yourself, your eggs and your partner in good shape! Cut out caffeine and alcohol (and smoking if you need to) and follow a balanced healthy diet with lots of fresh fruit and veg. Suggested supplements which have some (weak) evidence are vitamin D and Ubiquinol to support egg quality. Also take folic acid if you haven't started already. Regular exercise and maintaining your weight within normal BMI range are also important factors. You will then be setting yourself up for best chance of success either naturally or with treatment (sorry if you already know all this)! Best of luck 🤞

@acaciabluebell hi there, I was in your position not too long ago. I'm 32 with an AMH of 3.3pmol. I'm currently going through IVF. If I could advise anyone with low AMH, it would be don't despair. AMH is not everything, antral follicle count (AFH) is a much better indicator of how you'll get on with IVF. I had an AFC of 3 when I first started this cycle, and at egg collection after a low dose of stims, I got 8 eggs! I know it'll feel horrible at the moment and like there's no hope, but please don't be sad, there are plenty of people who have got pregnant naturally with lower AMH numbers!

@ohsheglows Thank you so much, really glad to hear that you managed to get 8 eggs. I was considering getting a private scan to check my antral follicles but I'm not sure. It would probably just make me feel so much worse and I already feel despair. When you had your AMH result did you go straight to IVF?

@MGee123 I really appreciate your reply thank you so much. Do you think I should get my AMH retested or should I leave it for now? My FSH was also 7 which is normal, so I'm surprised my AMH is so low (well, borderline).

My DH's sperm analysis is next week and fingers crossed after that we can get referred to the fertility clinic. Should I tell my GP my AMH score? I want the fertility clinic to be aware. I got the test done privately with one of those online companies that do blood tests at home. So not sure if GP will accept it.

I'm currently eating healthier and losing weight my BMI is around 30 but I want to reduce it to 25. I plan to continue this. I initially started dieting as I originally thought I had PCOS (hence the weight issues and lack of ovulation) but given my very low AMH score that seems unlikely.

@Dandelion3 Thank you for the reassurance. Yes we're currently waiting for DH's sperm analysis to be referred. I'm hoping that my egg quality is good despite the reduced number of eggs

@acaciabluebell well I got my AMH tested on the NHS and they advised to continue trying naturally for 6-12 months. So we tried for a further 6 months and we just knew it wasn't going to happen naturally so we got a private scan and are undergoing IVF privately. It all happened very quickly.

I would definitely go for a scan if you can, I feel like that would reassure you. Also your AFC can fluctuate from month to month - I had 6 one month, then 3 the other. So don't worry if the numbers do change. It's good you're so young! Egg quality is everything - not necessarily quantity!

Does anyone know if IVF is likely to be the only solution in my case? I initially thought I might have PCOS (day 21 test showed I didn't ovulate) so I was thinking Clomid or Metformin might be the first port of call. Would this be the same now? Or straight to IVF?

@ohsheglows Thanks for explaining, had you already been trying for 12 months before your AMH test? Or did you try afterwards? I don't know what to do r.e treatment as I would probably qualify for NHS IVF but don't know how long that would take.

Hi OP, my AMH was 5 at 31 which came as a bit of a shock! Please don't worry, it's actually highly unusual for a GP to test AMH. Even upon referral to the fertility clinic they usually only test it when IVF is the plan. It's actually not a very good indicator of fertility and just looks at ovarian reserve for how you would respond to stimulation drugs for IVF. As others have said it's quality that is important and at your age you are highly likely to have good quality eggs still. If you are not ovulating a fertility Dr will probably want to try ovulation induction first. Which is much less stressful and could well do the trick. I had this for 6 cycles before IVF and I actually over responded to the clomid and letrozole! Another reason the low AMH was such a shock. Anyway if it comes to it and you do need IVF you should do fine. I'm now 17weeks pregnant. For my first 2 rounds of IVF I got 8/7 eggs and it didn't work. For the successful round I only got 2 eggs and that was the successful round-proof that numbers aren't everything. I also have confirmed (via laparoscopy) endometriosis which is a possible cause of my low ovarian reserve but they can't say for certain. Best of luck x

@SpyroC Thank you soooo much xxx I feel calmer having read your message

No there isn't a reason to re-test it now. I was just trying to reassure you it might not keep dropping!

I would pass on any test results you have to your GP and they may either pass those on to the fertility clinic or re-do the tests themselves (sometimes they prefer to do this for some reason).

That's great you're looking at your diet. Without wanting to sound patronising, being overweight is known to affect fertility so getting your weight down into normal range if you can is sure to help. Regular exercise is important alongside dieting, walking counts!

It sounds like you need to have a proper consultation with a fertility specialist as there could be a few things at play (AMH, ?PCOS ?enodmetriosis). They will need to get to the bottom of what your key issues are before being able to advise on treatment. You can do this via the NHS referral or privately.

In terms of treatment, if it is an ovulation issue they may suggest clomid or trial metformin. However, if the issue is thought to be your AMH/AFC then IVF is the recommended treatment route. A consultation and more tests are probably the first step to get to the bottom of exactly what the problems are.

Try not to despair, at your age you will almost certainly find a route to successfully having a child! The frustrating bit is the waiting and the timeframes unfortunately but try to take it step by step.

Really appreciate the reply @MGee123 thanks so much. Definitely will speak to my GP about this.

Hi my AMH was 6.5 I'm 32. I
Got 12 eggs all mature. I'm currently 21 weeks with my first go of icsi and one in the freezer. Try not to stress too much about it.

That's amazing @Mrsmch123 congratulations xx

Had to respond. My amh was 2.8 but I was 34 when I got this information and my fsh was 12 so not good!

However, I’ve been pregnant 3 times since. I miscarriage, I Ivf baby (first ivf) and one baby conceived immediately after stopping breastfeeding the ivf baby. It really isn’t everything. Especially at 25.

@Ilikeviognier That's amazing, I hope I get to be as lucky one day X

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