Low AMH, normal FSH, and high prolactin

[glf777]

I have recently had all of my hormones tested.

My AMH was showing as 3.16 pmol in November but is now showing as 4.6pmol which is still low - as I am 26.

My other hormones have come back. I expected my FSH to be very high, but it’s at 6.34 I/UL. Which is definitely in the normal category (day 2 of period). My LH, oestradiol, testosterone, SHBG, and thyroid are all normal. However, my prolactin is high. The normal range is 102-496 mu/l - and mine is 524.

I’m not sure what any of this means? Has anyone else had a similar experience. I am not really sure where to go from here.

I am having these tests following two early miscarriages. I previously had a normal pregnancy in 2019. So I’m confused.

@glf777 Your prolactin is only a tiny bit out of range so not really enough to be a problem. Mine was over 1000 and that's when it can cause issues. Stress can cause it to rise, even the stress of having the blood test!

Funnily enough, I did a blood test two days ago and just got the results back today and my prolactin is 554mIU/L - so like yours, it's borderline-high. I think it may have been high in cycles prior to this one as I've had a case of leaky nipples before (which is what prompted me to get it tested. (And I've never been pregnant.))

I have a suspicion that this may be the cause of my short luteal phase and borderline-low progesterone. As our results aren't that high I wouldn't worry about a pituitary tumour but it is easily fixable with medication.

I've booked an appointment with my GP (for Feb 😪) to discuss the results and it's potential link to my infertility. I will be starting IUI next cycle so it probably won't even matter anymore.

@unCliche I’m just jumping in here to say I had a similar prolactin result recently. No leaky nipple issues, but very much subfertile and starting ivf next week. I’m getting it redone tomorrow and see what it comes back as. I should have got it redone earlier but kept forgetting to pick up the blood test form.

What’s your luteal phase length (mine is 13 days so not too short) and progesterone level? No one can explain what’s up with my ovulation but it seems regular in terms of getting periods, but the progesterone has been 17 and 10 when tested.

Have you noticed that you are having headaches more as well? I have had them quite bad in the last few months.

I’m hoping that it’s nothing major and easily curable for us both fingers crossed 🤞🏻 x

@MabelG I am hoping that it is nothing major because of the fact it’s not wildly out! 🤞🏻 did you manage to get yours within the normal range? X

@thislittlebird good luck with IVF! Did you ever try progesterone pessaries before deciding on IVF? If a medicated IUI isn't successful for us, we'll be moving on to IVF too. I'm hoping all we need is medication to strengthen ovulation and increase my LP.

My LP averages 10 days but my progesterone is higher than yours. My levels are always in the mid-high 20s but never over 30nmol/L. Even when I hyperovulate, with two corpus luteums, my body still struggles to get my progesterone over 30!
It's really curious that your progesterone is so low yet your LP is pretty normal. Maybe your corpus luteums hang on longer than mine does while the increased prolactin suppresses your progesterone. And your body responds easily to progesterone despite the low levels. Have you charted bbt?

@glf777 no headaches here. I've had acupuncture recently which I feel may have helped reduce my prolactin levels because I can't imagine my leaky nipples being caused by borderline prolactin results, so it must have been higher before! Plus my temps this cycle have been amazing, so I'm thinking my prolactin could have been much higher in previous cycles. I'm sure things will work out for us 😊

@unCliche we did three months of ovulation induction and that included cyclogest, and I took it when we tried naturally for a couple of months and that also didn’t work. Granted my husband has low motility so the odds were never great. I’m hoping ivf will work and it’s a sperm meets egg problem.

That’s weird that you don’t get increased progesterone. Are they definitely popping out of the follicle? 🤔

I did chart BBT but found it anxiety inducing tbh. Only did it for a couple of months and didn’t get much clarity from it. Weirdly I did get a normal OPK positive this month which never ever happens, maybe the drugs I’ve been on have helped my hormones, no idea.

I’ve had headaches since my mid 20s, hormonal migraines really, they’ve got less common recently and I assume it’s an age thing.

@thislittlebird IVF removes a whole host of obstacles so I'm sure regardless of what the issues are, that it'll all work out for you 😄

I have no idea what's going on in there tbh! I always have mature follicles, 20mm+, but my progesterone refuses to cooperate! Probably my prolactin levels causing havoc!

Ah, I use a fertility bracelet to monitor my body temps so that I don't have to wake up early to do it manually 😜 but even with that I still get super anxious and suffer with terrible sleep so I've had many months where I've just not tracked. Congrats on your positive OPK! Ovulating is already half the battle won.

How did you find your PMS symptoms on meds? I'll be starting letrozole as soon as AF starts.

@unClicheY You'll find out what's happening soon enough (or maybe not if you're lucky!), keep me posted if you do get there and have high AMH and AFC, it's interesting to see similarities.

I considered that bracelet and then couldn't be bothered!

I was sadly excited about the OPK, it's been a 2 years without seeing that off of drugs.

I was absolutely fine on the meds, no symptoms on Letrozole, Ovitrelle or Cyclogest whatsoever. But then I mostly don't get any PMS anyway, other than migraines so I'm not sure if it's consistent for others too?

Hi. Just joining this thread as you girls seem to know what you’re talking about. I had my FSH measured as part of my day 3 tests and it came back as 9.6 so on the high side. I went for my initial fertility appt the other day and they told me everything looks normal. I had 8 follicles plus a dominant follicle (18mm) on one ovary and didn’t catch what they said about the other ovary but assuming it was similar. Anyway, they said everything looks normal but I’ve been TTC my third baby for 10 months now, the other two were conceived easily. Does anyone know the connection between AFC and FSH? I was expecting my AFC to be really low given my high ish FSH but actually it seemed quite good. Now I’m confused x

@Hoping43 If it makes you feel better, My FSH is 8.3 but my AMH is pretty high at 40.5 and I always have 20+ follicles between both ovaries. FSH is just one number and what matters most is its relationship with LH - so you're looking for a 1:1 ratio. Did you get a LH test done as well?

@thislittlebird Haha the bracelet has been great! It's pretty reliable, I got mine secondhand from eBay for half the price as it's just so expensive!

It sucks when you try to be proactive while TTC and things don't work the way they're supposed to! OPKs can be fun until the anxiety kicks in!

That's lucky! I'm hoping that's the case for me too! I'm thinking about taking the letrozole before sleep so that I can avoid most of the symptoms. I ovulate every cycle so I just hope that I can produce stronger eggs with the meds. Hopefully my IUI works!!

@Hoping43 sorry, I'm not very familiar with high FSH but the numbers do seem to be variable between AFC and AMH, mine has ranged between 28 follicles and an AMH of 36 and 38 follicles with an AMH of 31.

@unCliche I thought about getting a second hand one recently and then decided ivf was so close that it wasn't worth it. I'm selling my Clearblue fertility monitor on eBay at the moment, with my unreliable ovulation it wasn't worthwhile for me. Hopefully someone else will find it useful.

I took Letrozole each morning and it was fine. My understanding is clomid has more side effects, and Letrozole not so much and that was definitely the case for me. I even booked myself in for a progesterone test and guessed roughly which day was day 21 (and got it right) because I needed evidence it was all working, I really did expect to get side effects from the drugs. When my progesterone score came back at 108 I nearly fell over lol.