Low AMH and AFC at age 30

[LivBiv]

I have always wanted to start a family, age 30 and I am now married and settled and ready to start trying. I thought I would get some tests to just get on top of any issues as I really want a baby as soon as possible now. My blood test came back saying amh of 4.9pmol which is low for my age. My other hormones were all in range (except TSH which is high, has been for a while now, and i am going to see GP tomorrow to insist on starting medication for that. FSH, LH and estrogen all looking normal though). I had a follow up pelvic scan which found 7 follicles.

I am so depressed about this and wondering if I will ever be able to have the family I wanted. I have cried a lot over the past few days and am now starting to think a bit more clearly and thinking through the next steps. Did anyone else have this and manage to either freeze some eggs or conceive naturally and how long did it take you? Any other advice welcome!

Thanks

Hello. I was in almost exactly the same place as you several years ago (slightly higher AMH (6) but lower AFC (6). I have a 2.5 year old daughter from our first round of IVF age 31 and am back on this train TTC a sibling which is proving harder work. Just replying to offer you some hope. First, that you can conceive naturally with a low AMH, just the chances are lower (I have never had a positive test in 6 years off contraception but know plenty of others on here with a worse AMH who have). Secondly, at your age your egg quality should still be very good and you are likely to create good embryos more easily if you choose to go down the IVF route, giving you a better chance of success.

It is worth reading up on things a bit now so you understand the world of infertility better. I would highly recommend Robert Winston's 'the essential fertility guide' which is pragmatic and evidence based, and the HFEA website which summarises recommendations for clinical practice based on current research. I would avoid blogs and other books purporting to have a miracle solution as in reality, there are none, and these are mostly biased and poorly evidenced anecdotal accounts which make women waste money and have unrealistic expectations.

If I were you I would go down the route of IVF when you are ready, rather than egg freezing. You can freeze lots of eggs and end up with no viable embryos to transfer. That said, if you haven't been TTC naturally very long, there really is no rush (unless you want there to be). You could easily give it 12-18 months to see what happens (there is a good chance you may conceive without assistance). Be mindful success rates with IVF are horribly low even at a young age with good eggs, NHS treatment won't kick in until you've been TTC at least 12 months (24 common in lots of places) and the bill for private treatment can quickly rack up. On average it takes 3 transfers for a successful outcome which if you only get 1 embryo per fresh cycle could set you back £20k+. Good luck with however you choose to go forward. I hope things work out for you.

Hi
At age 30 I had an AFC and it was 5. My amh was 11. 10 months later I did IVF at 31 and got 5 blastocysts out of 10 eggs so the AFC must have been better then. 1 of those blasts resulted in a healthy child. 4 years later my amh at age 35 was 3. AFC was 6. 9 eggs were collected and 3 blastocysts made. No second child as yet and we have had 5 transfers since my son. If I were to give advice, I would say do IVF as early as possible but that's because I know it can work. Age was the key factor on my side as it is for you. But you might also conceive naturally. Good luck!

I don't think those levels are too bad at all, I'm 30 and just been told my AMH IS 0.6 with zero follicles.

@Lemonem your levels are certainly lower (I'm sorry) but 4.9 is below the bottom end of a wide normal range for age 30-34.

Thank you that's really helpful, I have ordered the book you recommended. Have forked out to see a private endocrinologist today about getting my thyroid under control (unfortunately just not getting anywhere with the NHS). Will have a read of the book and see how we get on. Definitely agree would go straight to IVF rather than egg freezing having understood it a bit better. Thank you

@Lemonem Its really frustrating when your body isn't doing what we are told it should be doing. I completely get that, trust me I've felt all those feelings over past few weeks of getting a medical result that is concerning. I will be wishing/hoping/praying for us all that we get the best possible outcomes and sending love to you x

Any updates OP? Xx

Interesting seeing this come back up. I thought I'd add my update in case helpful - shortly after this post I conceived naturally for the first time ever age 35. That sadly ended in miscarriage at 10 weeks but I conceived naturally again almost immediately and am now 20 weeks with all looking well. Hoping this offers some hope and support for the point in my first reply - that conceiving naturally is perfectly possible with a low AMH, more likely when you're younger, and furthermore that there may be little rhyme or reason as to when and why it happens! It may just take longer than usual. Wishing you all well.

Thank you for your reply
That’s a wonderful story and am so happy to hear it!
Anything you did differently or just random chance haha?
I can see from your post you had IVF to conceive your first child at 31, do you mind me asking if there was anything that came up or was it unexplained?
I am heading down that route for ICSI, we have MFI and I have borderline PCOS but my AFC has been lower than previous (but still good numbers) BUT it’s impossible to not let the little demons take over my mindset at times!
I find stories like yours so helpful, just giving me the hope that I need! Xx

I am now due a Christmas baby! Once my thyroid got medicated and my TSH was brought right down I was able to conceive. Also did everything I read about online from pre natal vitamins, cutting out sugar, using fertilily cup, using pre seed, and even wearing bed socks to keep feet warm. I know there is very little evidence behind some of these things but I was willing to try anything. I think the main things that helped was getting medication for my thyroid

Wishing you all the best for your journey xx

@OneHeapedTeaspoonOfSugar the only thing they picked up on our testing was my low AMH and AFC. Everything else looked fine and husbands sperm were fine. We'd been TTC for two years by the time we had the tests. Our consultant was very clear we would likely conceive naturally and almost advised us away from fertility treatment, but I was in a rush and we decided to try IVF which we were very lucky to have work first time for our daughter. I didn't go back on contraception post birth as we knew we wanted another, but nothing happened. We had 3 failed rounds of IVF last year and then drew the line and accepted being a family of 3 at the beginning of this year, only for this to happen naturally.

I don't regret anything we've done as it has given us our wonderful daughter, but suspect we'd have got here eventually without the expense of IVF. Nothing different this year when I have conceived naturally, if anything more of all the 'wrong' things than over the last 7 years! I hate to be that person, but it really was a case of it happening once we stopped trying 🤦‍♀️

Wishing you all the luck on the road ahead. I think you just have to do what feels right for you at the time, no point regretting decisions later x

@LivBiv wonderful news, so pleased for you x