AMH of 3.5 (36 y/o)

[Pep1952]

Hi all,
I got a call from my fertility clinic at Guy’s today, unfortunately my AMH is 3.5 and will not qualify for NHS IVF funding. This all came as a shock because my cycles are regular like clockwork and I ovulate every month. My FSH is normal (forgot to ask the exact number) so I will be scheduled for an ultrasound to count the follicles and also check my tubes. I am obviously devastated and was crying all morning. I am 36 y/o and was told that i can still conceive naturally (DH’s sperm results all good), but that my chances for successful IVF is diminished significantly compared to others who have AMH within normal range. We are scheduled to speak to the dr but I would appreciate advice from women who were on the same boat please. We can afford to do IVF privately but it won’t be comfortable if that makes sense. We only have just enough in savings. We’re not sure if we should keep trying for the rest of the year and re-assess in January but worried it’ll all be too late but then. Equally, also worried we will be spending monies on IVF when my chances aren’t great to begin with. Just confused right now tbh!

i believe you have a great opportunity! Keep working on that lifestyle for fertility, I honestly believe that’s how I got pregnant older than you and with lower stats. Did they tell you your FSH? xx

Just about to start another (long protocol) cycle. How's everyone else?

Hi everyone,

I hope you don't mind me hopping on this thread? I've just turned 36, found out I had Diminished Ovarian Reserve at 35 with an AMH of 3.8pmol, 4-6 AFC, and 8-10 FSH. I already have a child conceived first try back in 2020 and I have been trying for a second for a year.

I've attempted 2 rounds of Mild IVF with Create so far. The first was cancelled due to a lead follicle, the second I only got two eggs - one fertilised and frozen at Day 3. I have two retrievals left on my package and I'm about to start stims again.😅

This journey has nearly broken me a few times already, but I'm pushing forward and hoping to get one blast.

@SErunner sorry I know this is old. I'm currently dealing with recurring MC and I got amh tested (I was 9 weeks 2 days pregnant) but knew pregnancy was missed mc, so had bloods done and went home and took miscarriage pills.

My amh was 5.26 pmol so I'm below NHS threshold for IVF (5.4) my fsh is 8 though so they said they might be able to goo off that. But I've heard pregnancy can lower it so going to try and get re tested once I get my cycle back after mc.

I'm really confused with regards to poor embryos on IVF with low amh, and TTC naturaly. Will they not all be poor if we TTC naturally as well and just keep leading to miscarriage? It always confuses me when people say it only matters for IVF, cos surely no good embryos through IVF means no good embryos TTC naturally? I'm just trying to weigh up odds of haw many more miscarriages I might have to have before I have success/ give up.

Xxx

Hi there, I’m so sorry to read what you have and are going through. At your age, you can yield good eggs. When they say AMH is important for IVF, AMH usually correlates with your antral follicle count, that’s why it’s good information to have for ivf. You then get an idea of how many eggs you might retrieve, whether you can go right ahead, consider embryo banking, or try naturally/drug assisted cycles first.

I conceived my daughter much older than you, my AMH was 0.252 so much lower than yours (natural conception). Please don’t think it isn’t possible. You know your AMH can change slightly? Mine has gone up slightly so a retest might put you within the threshold (I’d check this is an actual requirement because it didn’t used to be). My FSH was 9 on my first test, then I tested at random a few months later and it was 5.5.

get yourself on that fertility lifestyle in terms of food, BMI, avoid plastic, perfumes etc, make sure the sperm size is being tested and keep at those doctors! I’m really hopeful for you xx

Thank you, I have been constantly on at the Drs but I think me jumping the gun with my amh blood test has caused me to be more stressed! My next apt isn't til the end of October, and you can't get through to anyone on the phone but I might leave a message and see if I can do the medicated cycles before full blown ivf. All they have given me different this time is progesterone but I don't think that will do much as my first loss was growing well til 11.3 weeks and that was edwards, and I think the second was chromosonal too just from the pattern of the miscarriage/ slow growth / measuring behind. Both times I didn't bleed and needed an op or pills to expel the tissue so I don't know what progesterone will actually help with. It all feels like box ticking xxxx

How are you getting on Oranges2025?

I looked briefly and it depends on the area you live in if AMH is a determining threshold. You are SO close I’d be getting some acupuncture and retesting. I agree about the progesterone, it’s great to have that extra support but you seem to implant and carry, you need that good egg! It Starts With The Egg is a great read whilst you are waiting for some extra help. 😊

Oh yeah I've read that book twice in the last couple of weeks 🤣 ordered some melatonin but I'm a bit scared to take it but taking coq10 , ALA, NAC , omegas , folic, B12, d, iodine, zinc, iron, vit c ... I think that's all 🤣

Intrigued by dhea too but don't want to throw my hormones off so I'll ask the nurse about that, aspirin, and medicated TTC naturally xxx

Also, some stuff online says amh drops when your pregnant by 20 to 50 percent but there's loads of conflicting info, so I'm hoping once I get my cycle back and re test it has gone up a decent amount but I might just be wishful thinking ! Xxx

It’s a great book isn’t it! Melatonin is quite a standard thing in America but we don’t really use it here. I’ve taken it and felt ok. DHEA is getting a lot of attention, a New York clinic is writing a lot of papers on it, but the lead Dr also has huge investment in a certain type so it lost a lot of credibility. That’s not to say it does or doesn’t work, but it needs testing for a lot longer before the U.K. champions it. If you haven’t had your DHEA-S levels checked, the current status is you shouldn’t take it. It’s being mostly tested in ladies over 40 as testosterone drops off and affects egg final maturation process.
id be working on getting a test that puts you on the funding list and see if you can get a plan for tested embryos, and try naturally/drug assisted before you move on that if you want to.

Yeah I did ask my gp if they could test my dhea-s and testosterone but they said you have to go through the fertility clinic and everything is a slowww process with them. I'm being impatient but I feel the time pressure even more now and just want to feel more confident TTC again. I initially wanted the pgt testing but after seeing my amh numbers I don't know if I'd realistically get enough eggs. I'll just have to wait for my cycle to come back and wait for the NHS to let me have a follicle count and go from there!

Did you take melatonin for a long time? I'm thinking maybe every other night as I've already been sleeping amazingly after this miscarriage shockingly, I wasn't sleeping at all after the last one . X

You can do a private test with youthrevisited.co.uk if you want to. They do a build your own blood test service, or you can choose a full test with add-ons.
They are great for advice if you need something specific, they will tell you what you need in your basket.
I took melatonin for a few months but i wasn’t sleeping at the time.
if you can get funding on the nhs just have it in your back pocket, go on the list and try in the meantime. I’m not sure how old you are exactly? (I read an age on the lady who replied to you earlier and realised it wasn’t yours) but assumed 30s. You can ask them about embryo banking if your AFC response is low.

Yes that was the plan to get on the list and try while we wait cos we have got pregnant twice just keep having chromosonal mcs. Then I thought it might be better to TTC with medicated cycles so there's more mature eggs and better chance of a good quality one? But now I'm not even sure if I have DOR since the bloods were taken while I was pregnant and it could all be solely egg quality issues. It's a minefield! I think I am going to wait til I've had one of 2 periods then do some more tests because I don't want the pregnancy to skew my results. I'm still testing positive 10 days after medical MC so it's definitely too early to do any more hormone related bloods 😣 . I'm 37 , started TTC at 35 and just had the 2 misscarriages xxx

I find the best coping mechanism is a robust plan, and you are all over it! The sperm side is also important which I’m sure you are on top of.

AFC with triggered ovulation is a useful tool. You want one/two, max three mature eggs to trigger and hopefully your body picks the right one. It’s obviously keen to get pregnant, you have real positives that you can implant and carry, it’s just that good egg! Do keep us updated!

Haha thanks, I think I'm too keen, jumping the gun! But yes I need a plan of action to keep me going!

Yes I think the sperms ok as we're getting pregnant, my boyfriend is healthy in every aspect except he used to drink at the weekend but he's now stopped. Waiting for sperm referral on NHS but I know they don't look at DNA fragmentation , then I'm not sure anything can be done about that apart from lifestyle which he's already on top of!

Yes I think the medicated ovulation would be my treatment of choice before IVF. I will see what they say at my next apt.

Thanks for your replies and support, it's such a shitty time but keep telling myself life will still be good even if we can't have a baby, just need to focus on this for the next couple of years and miss out on girls holidays and bottomless brunches and the likes, but it will be worth the sacrifice if we can have a healthy pregnancy! X x x

Update. TW success.

I thought i’d give an update as I always appreciated it when I see old posts and OP provides an outcome update.

My first ICSI cycle (short protocol) didn’t work. 5 eggs collected and only one average /poorly graded day 6 blastocyst made it (none at day 5). Fresh transferred this on day 6 and was unsuccessful.

Husband referred to private urologist as sperm dna fragmentation is a little bit on the high side. Diagnosed with bilateral varicoceles which were embolised at the NHS. He was also put on anastrozole to help with testosterone level. Urologist suggested we wait 3 mos after embolisation before going for another cycle.

Meanwhile I also started ubiquinol 300mg twice a day.

For the second ICSI cycle, we did long protocol plus growth hormone (I suggested the GH and consultant said it wouldn’t hurt). We also used zymot filter. We collected 4 eggs so even less than the first one. I was heartbroken and crying at the hospital. However from those 4, 1 made it to a high grade day 5 blastocyst who is now my gorgeous son and currently feeding on my boob!

Thanks for reading up to this point and I wish everyone who is still right in the thick of it the very best of luck. Sending you all my love.

Aw @Pep1952 thats beautiful to read! congratulations on your wee boy! Must feel amazing. You’re right, it’s good to read success after long journeys as it does bring eventual hope.

i see from my last message it was nov 24 and i was beginning round 2 long protocol highest stims. Only collected 1 egg, transferred as a good quality but only day 3 embryo, failed. Spontaneous pregnancy after that, but was ectopic. (Previous spontaneous between round one and two was MMC).

went to create for 3 lower stim short protocol rounds. Def short protocol was better for egg numbers for me. Mild ivf (much lower stims) Round one 5 eggs, round two 4eggs. All fertilised and lots of good lookers at day 3 but not one made it to blastocyst. Round 3 natural modified (very very low stims) got one egg, made it to blast as 4AB, first good quality blast in 5 rounds (only one other low quality on round one). Currently 19 weeks. Sadly found out at 16 weeks that a surgeon removed my entire external cervix (telling me he’d only removed 1/4). So dealing with risk of late loss/preterm babe, however that’s nothing to do with amh. Feeling a mixture of fear and gratefulness. But I hope it further gives hope that with tenacity there is hope for low amh and ivf.

I wanted to come back and share a positivs story as i used to trawl through these forums.

I had an Amh of 4 age 34 - paid privately for Letrozole via Kings fertility and my second round worked resulted in my beautiful son.

It is possible, even when it feels like nothing’s ever gonna work or is everyone but you. Keep going.