Low AMH...what are me chances of success in IVF?

[Littlemeadow26]

Hi,
I am due to start my first round of NHS funded IVF with ICSI on my September period.
We have been TTC since Oct 2019 and were originally referred for IVF due to MFI. My husband suffered with mumps in his teens and has low sperm motility.
During these investigations we found that my AMH was in the low fertility bracket which we were not expecting.
Our consultant said that this would not have impacted us conceiving naturally (if it wasn't for the MFI). I am 33 and my husband is 30.
I am concerned about the impact of low sperm motility coupled with low ovarian reserve.
Had anyone has this experience and has success with IVF or is going through this themselves and have equal concerns? Would love your insight. TIA xx

Hi@Littlemeadow26
At 36 my AMH was described as low (7) (FSH 6) and my partner had reduced motility - we got pregnant on our first cycle of ICSI IVF and have a wonderful 4 year old son.
At 38 my AMH was 5 (FSH 7 or 8), my partners sperm had doubled in motility (yay!) but morphology normal forms were now low! (3%) but we still got our beautiful almost 2 year old daughter (ICSI again).
I have just had a failed FET and am currently going through tests to see if I have anything left, but I have been prewarned that my last FSH result indicates game over for us (it was 15.2).

Hope this info helps x

@firefly37 Thank you so much for sharing! It's great to hear that someone has had such great success with IVF with ICSI.
I'm 33 and my AMH was just over the threshold for getting NHS funded IVF at between 5 and 6 which is much lower than I expected and a shock to us as we felt we'd already been dealt the hand of MFI so now we have something else to contend with that would impact our chances of success. My LH and FSH were slightly on the lower range of normal but nothing to be concerned about so I'm ovulating as expected.
My husband's count at the sperm sample was 14 mil but low motility, however we have frozen sperm and this has been given the go ahead for ICSI with 6 straws in the freezer so that's a weight off our minds for now.
Sorry to hear about your failed FET. I hope that your next set of results indicate that another round would be a success. If not would you consider donor eggs? X

@Littlemeadow26 ... AMH of 5/6 is still good, yes its lower than average for age but you are very much in the game. Some ladies are still trying with significantly less. Its good that you have found out now and can crack on ! We felt hard done by when my partners sperm had issues as well as me having limited eggs so I know how you feel, but we are a success story with both and you can be too ! You are younger than me so you will possibly have better quality eggs too :)
I have started taking lots of supplements and vitamins as recommended all over the internet for aging/diminishing ovarian reserve ... gonna give them another few weeks to kick in and then do another blood test for my clinic (in Prague) with everything crossed. I am undecided re donor eggs ... (the clinic has already mentioned it) ... mainly as we already have two full genetic children. I would worry how the "donor" child would feel about it all :( ... my partner is not keen at all but we are not fully discussing it at the moment. Although my FSH was high, I haven't had my AMH tested since 2018 so it will be interesting to get both results. Elevated FSH often indicates low AMH but it could still be workable ... I hope! Apparently AMH reduces by 2ish yearly ... so 2016 I was 7, 2018 was 5 so 2021 would be 2ish maybe. May I ask why the decision to freeze sperm? xx

I think it's the concern that at my age the AMH levels are already low, however it's not exactly a linear decline so I could remain at this level for a while longer! My hope is as you suggested that although my ovarian reserve is low the quality of my eggs will still be good enough to get us to embryo stage. It's reassuring to hear that within the realms of low AMH it's still treatable and I should feel hopeful, so thank you!
I hope you have success with the suppliments and that even with AMH at a predicted level of 2 that you could have continued success.
How are you finding the treatment in Prague? I've heard some great things about them and definitely a consideration for us if our NHS rounds fail, particularly if we go down the route of donor eggs.
I can completely empathise that you want to continue to grow your family but don't want any donor conceived children to feel any negative impact of that. It a decision that has lots of moving parts that only you and your family know if it's right. Maybe having these tests will confirm one way or another if you open up that discussion?
Of course! My husband went for a physical with our consultant after the first sperm sample. This was to check for varicosele (which was fine and no signs of this!) The consultant decided to do my husband's blood work at this time and discovered his LH and FSH were low which would indicate that his sperm count would be lower than that of the first sample. Instead of my husband having months of drug treatment to try to improve this and prolonging the IVF which was inevitable, we agreed that freezing sperm would mitigate any risk of providing a fresh sample on egg collection day xx

@Littlemeadow26 ... ahh I see, that makes sense. I dont think my partner ever had his blood levels checked ... I find sperm analysis very confusing! My partner produces around 8 to 9mls (apparently the "norm" is anything over 1.5ml!) ... his count ranges from 15 to 17 million per ml (normal) ... his motility improved from 26% in 2016 to 46% in 2018 (so had become normal) but his morphology normal forms had decreased from 5% to 3%! So that was now the issue and teratozoospermia was diagnosed HOWEVER as he is producing a much larger count in mls then surely his "normal form morphology" numbers are higher than someone who produces a "normal" 1.5 mls! This does baffle me somewhat lol.
Your AMH will not drop drastically for a long while yet so you have time and age is on your side for quality so you should not worry. What I would say is if you are successful, don't hang around too long for number 2 or 3 ... I wish we had tried again sooner but we are lucky with where we are. I think once my new bloods are done we will then review our situation and options ... I am taking a number of vitamins but notably DHEA, COQ10 and wheatgrass which are suppose to really help egg quality which in turn can lower FSH.
We were really happy with our clinic which was originally Reprofit in Brno, Cz however I have consulted with a new clinic which is in Prague purely as its easier to get to and was interested to see what a new Doctor thought would help for us. The cost is significantly lower to go abroad which was ultimately our reason for going. I did a lot of research. Always happy to help or advise if you did decide to travel for treatment x

@firefly37 Honestly my husband got the feeling the bloods were simply a 'tick box' exercise on behalf of our consultant who did them on a whim because he has my husband sitting in front of him! All it did for us was put us into a negotiating phase with our consultant whereby he was concerned that the bloods and the sperm sample were at odds with one another and we needed a safety net going into IVF. So we agreed on the sperm freezing to keep things moving along! My husband doesn't drink or smoke, is active and maintains a healthy weight and is only 30 years old so aside from suppliments for oxidative stress he didn't feel like there was much he could do lifestyle wise to improve his sample which would warrant us delaying IVF.

Honestly sounds like you have a much better grasp of the sperm sample situation than us! Haha. All we know is that he produced a 5ml sample and the count was slightly lower than normal at 14 mil but the motility within that was just below 10% of the overall sample so we were ideal candidates for ICSI. I understand exactly what you're saying, if the volume produced is three times the average like in my husband's case, or more like five times for yours, then surely it would indicate a higher ratio of either motility or morphology than that of someone only producting the normal 1.5ml??

I am currently taking COQ10 and was advised DHEA by my consultant but was concerned due to lack of good quality research, however I'm totally open minded about trying anything. Thanks for sharing what you're taking currently and thank you for being willing to talk about your experiences abroad. It is definitely a strong consideration for us if we don't have success with these two NHS funded rounds however we are going into it with a positive mindset.
Wishing you the best from your blood results xx

Hi OP, don't have any advice on your specific issue, just wanted to wish you good luck with IVF! Fingers crossed you will have positive results really soon!

@IsabelHerna Thank you that's really kind of you!! I have my baseline scan tomorrow so hoping for some feedback on the AFC which might give me an idea of expectations xx

Hi @Littlemeadow26
Can I join? I am also 33 I had my AMH tested back in February and it came back in the low range of 7.5. I had AFC of 10. I am assuming it will be lower by now. My OH had low morphology of 1% and we have had 4 MC in the last 6 years. We had are due to start our first IVF cycle on the NHS end of this month. I have a been told to lose 4lb to fall within the BMI range and to take folic acid, pregnacare, CQ10 and vitamin D. The closer it is getting the more anxious I am getting, I am worried taht even if this is successful I will miscarry again. Any tips anyone has on supplements would be greatly appreciated.

@LARBB0707 The more the merrier!! I had my AMH tested in May at the age of 33 and it was 5.5 (just above the 5.4 threshold for NHS funding!) I had my baseline scan last Thurs and my AFC was 14 on day 22. They only did this because I asked and seemed surprised given my AMH that the follicle count was so high. I don't know if having a good AFC would indicate success, they didn't really say. I do know that the decline in AMH isn't linear and mine could have possibly always been low and not that id experienced a recent drop off.
I'm sorry to hear about your experience with miscarriage and can completely understand why would would be concerned about the outcome of IVF. If it's ok to ask did they do any testing after your MC'S? I know it's not standard until after 3(?!?!) And if they did did it indicate any reason why you may have had them?
Have you clinic suggested anything like PCT/G to see if there are any abnormalities with the embryos that may cause MC?
Ill be honest, I haven't even got as far as thinking about that! 27 periods in a row since we've been trying and not a single pregnancy.
Good luck losing the 4lbs! Good job it's only a small amount (although I'm sure I've out about that on since I submitted my weight on our application!) I've been taking COQ-10, folic acid and vit D for 3 months and will be starting my down regulation the week after next. How about you? Xx

Thanks for you reply… they did do some tests after the last MC but just general bloods and scans all came back normal… apart from OH sperm morphology at 1% but they didn’t seem to worried about that just advise to start taking wellman. My clinic are putting me on short protocol 450 menopur. I have a scan and weight in booked for the 13th September and all being well I should start the injections on my next cycle which would be around 20th September. Xx

Hi @Littlemeadow26 just wondering how you got on? We have similarities in the fact I have low AMH and my DH has both low sperm motility and morphology (but a good count). I go in for egg collection tomorrow and feeling a little apprehensive!

Hope everything your end went well! ❤️xxx

Hi @Littlemeadow26 I know this post is old and hope you don’t mind me asking how you get on? Due to start ivf with ICSI partner has low motility and I have low amh of 9.5 just turned 30. If anyone has any success stories would be great to hear

@Flowers07 Just to reassure you...I did my first round of IVF with ICSI. we got 8 eggs and 2 embryos. We transferred the first embryo and we now have a healthy little boy who will be three in July. Sending you all the good luck in the world that it is a success for you and you bring home your baby xx

Amazing news and so lovely to hear a successful outcome. So happy you got your baby in the end gives me hope xx