AMH 2.6 pmo/l

[secondtimelucky87]

Hello,

I had some detailed fertility bloods done with Randox on cd3 as I'm struggling to conceive. My AMH was 2.6 pmo/l. My next step is obviously to book in a consultation with a fertility clinic to discuss my options in next few days. I've always found it really supportive here though so while I'm sorting that out I wondered if anyone has any insight into how bad this result is? I'm 37 and have one 3 year old conceived naturally. Does anyone know if ivf is feasible with this number? We also have some male factor so would likely need ICSI. Any insight at all gratefully received. I'm so drained from it all. 😔

Sorry to hear of your plight. It’ll be difficult to conceive but not impossible. I have an AMH or around 4 and I’m having a shit time with IVF presently.

Hi there. Sorry to hear all of this. I just wanted to message and wish you the best of luck in your journey.

my AMH was 3.2 when I last had it checked which was about a year ago. We had one round of IVF. I got a positive but had an early loss shortly after. The low AMH resulted in only 3 follicles which they managed to retrieve 2 eggs from and 1 fertilised. We will be starting our next round next month some 9 months later. I believe everything is possible just the amount of eggs and the quality may not be as good - which is why we are having IVF help :)

Hi @secondtimelucky87, My result recently was similar, 2.5 pmo/l. I was told that this is within the normal range. I was also told that the quality of the eggs is more important than the quantity. I've had one cycle so far which failed, but we did manage to collect 6 eggs, 3 fertilised, 2 embryos were good quality. Tbh I didn't expect anything better because of my age (41 yo). You are likely to have a better outcome because you're younger! There's a lot of factors to IVF success so I wouldn't be discouraged if I were you. Also, my AMH somehow got higher since last year which is a mystery, it makes me wonder how accurate these test results are!!

I’m 35 and have an AMH of 2.7 pmol/L. I’m having IVF currently and got 3 eggs the first round then 4 eggs collected in the second round. Bear in mind statistically you need 15 eggs collected for a live birth as not all eggs can become embryos. So low AMH means you’ll likely need more rounds of IVF to get embryos. You might be lucky though and your eggs are few in number but of a good quality. If you get embryos then your chances of live birth are the same as someone with normal AMH levels! Good luck!

Thanks so much for all your replies. I'm sorry to hear of the difficult journeys others have been on. I've been in tears again tonight and think i need to look into some counselling as I'm really struggling. It doesn't seem like the odds are hugely in my favour (especially with male factor which we're working on). One thing I'm struggling with is understanding which clinics would actually work with this AMH Level as unless I'm missing something they don't advertise this? I just attended a webinar with ABC and they said they tend to work with AMH 12. I'm in London. Does anyone happen to any personal experience of London clinics and low AMH?

Thanks so much.

And what are others doing for egg quality? I've had everything checked bloods wise and I'm low on iron (but not ferritin). So on GP advice I've stated 200mg ferrous sulphate today on top of Proceive Max and omega 3. I eat well, exercise moderately and normal BMI. I'm a total stress head but trying to find the calm where I can.

I'm so sorry to hear this. I truly wish you the best of luck with it all. X

I'm so sorry for your loss. Thanks for your kind words and I hope this round works out for you x

I'm sorry to hear your round wasn't successful. I hope everything works out for you. Thanks so much for your encouragement x

If only there was some way of knowing what your egg quality was like! I feel like I'm doing everything I possibly can to ensure good quality but who knows if it's enough. I wish you all the best with your current round X

Sorry to hear you’re struggling @secondtimelucky87 ! It is so hard and unfair, I understand. Bourn Hall I believe accept patients with low AMH, but it’d be best to check with them. They’re not in London but have a clinic near Cambridge. They have a monthly fertility support group that you can attend: https://www.bournhall.co.uk/news-events/fertility-support-group-meeting/ You don’t have to be a patient to attend these. I do hope you find a clinic in London though. I think counselling is a good idea, I’ve started it myself a couple of months ago when I was going through a difficult time. If you’re feeling stressed, there’s various Youtube channels for IVF meditation and yoga which have helped me. Also, we’re doing a Duo Stim (2 back to back egg collections) with PGT-A soon, it increases the chances of having at least 1 good quality embryo and is recommended for low AMH. I’m keeping you in my thoughts x

I'm thinking of booking a consultation with Create as they seem to specialise in low AMH and the mild IVF does appeal. I wanted to get it booked in now but my other half has been unwell so have been advised to push it back as fever can affect interpretation of his SA results. We've obviously had done before but its been over 3 months now. Trying to remember it's just a matter of weeks to count down.

That monthly support group is a great idea. Thank you for sharing. I hope the counselling has been helpful for you too. I often feel like I have no one to talk to about all of this (besides the lovely people here!) so it's worth exploring for sure.

I'll look into the duo stim too thanks. At this point I'm not sure what route we will go down. I must admit I'm hoping there might be other things to try before IVF but I also know that given our ages and how long it to conceive our daughter it's realistically going to be the best option. Just a bit overwhelmed!

A low AMH doesn't mean you can't conceive naturally, it just means your egg reserve is lower so you have less eggs with which to achieve that. Assuming nothing else is wrong there is no reason to think you won't eventually conceive naturally, especially given you have before, it may just take longer. It's unlikely your AMH has fallen off a cliff in the last couple of years, it was likely low before as well, you just didn't know.

The reason people have IVF for low AMH is usually time related ie they are wanting a baby now and want treatment to try and speed things up (common misconception that it will, it may not) or they are older with lower chance of successful pregnancy anyway and less time to play with in terms of length of time it may take to conceive. I was in the former category - we had IVF for our daughter after two years failing to conceive naturally in my early 30s, and I was fed up and impatient. All other tests fine. AMH was 6. We conceived our daughter from our only embryo of our first round. Subsequent rounds for a sibling (3) had the same result of one embryo each, all transfers unsuccessful. We drew a line under treatment after this only for me to conceive naturally for the first time in 7 years this year, age 35. That sadly ended in miscarriage but I conceived naturally again immediately and this pregnancy is going well.

We had our treatment at Kings fertility and I would highly recommend them if you go down that route. The essential fertility guide by Robert Winston is a must read in my book before going into treatment, as is a good scan through his website the genesis research trust and the HFEA website. Both give you the current status of best evidenced practice in fertility treatment. Don't lose sight that private clinics are first and foremost money making enterprises for the most part. It's best to do your own research as to what is likely to help you (and what won't) alongside hearing recommendations from consultants.

Re egg quality - nothing has been robustly demonstrated to improve this. I personally wouldn't waste money on expensive supplements etc. Vitamin D and folic acid are sensible to take when TTC as most people are deficient in vit d and folic acid as recommended by the NHS. Otherwise a normal healthy lifestyle (not smoking, regular exercise, maintain weight within normal BMI) is fine with the usual occasional treats etc perfectly acceptable. Limiting alcohol and caffeine as per usual NHS guidance is again sensible but you don't need to eliminate completely unless you want to.

Wishing you luck going forwards.

Thanks so much for taking the time to write such a detailed message. This is really helpful. Huge congratulations on your pregnancy and I wish you well with it!

I think sadly Kings is going to be too far for me. I'm in North London and work in Central so ideally I want somewhere that's not too far from work or home. I'm hoping Create could work for me but will do some more research as it's such an important decision.

Yes absolutely hoping there's still a chance of it happening naturally but I too am getting impatient. It took 3 years to conceive my daughter and I think we're close to 1.5 years now. My results (other than lower AMH) are all good. I had some really detailed bloods which showed I have low iron so I've started taking 200mg ferrous sulphate along with Proceive Max and omega 3. My husband's results aren't great. His last SA a few months ago put him in the 27th percentile overall and he is late 40s. So it will ne good to get the more recent SA results and to see what we're advised to do at a consultation. My recent pelvic scan was fine too. Neither of us smoke, we drink moderately (him) and not at all (me), we follow the Mediterranean diet and try to exercise when we can. So yeah I agree there's probably not a huge amount more we can be doing lifestyle wise. I suspect we're not actually trying enough but truthfully it can be hard to find the energy to do so more than in the fertile window. A stressful active job and a toddler kind of take it out of you!

Thanks again for your advice - much appreciated 😊

I really do understand how you feel, it is really hard wanting something to happen so badly and feeling so out of control with it. Your husband can definitely make some changes to improve his sperm results (they regenerate approx every 3 months). There will be good advice in some threads on here but no alcohol or hot baths, healthy diet, low caffeine a good starting point. Again I'd be sceptical whether expensive supplements make any difference, lifestyle stuff is probably sufficient.

I totally understand the impatience but it really is worth taking a few months to read and plan before you start any engagement with treatment. These months won't make any difference to your outcome but may help you avoid spending unnecessary money. It can be very hard to get off the train once you start and tens of thousands of pounds can quickly evaporate. The resources I mentioned are good starting points. Be cautious of anything highly promoted that offers solutions that sound too good be true - it is probably poorly evidenced. It starts with the egg is a common one quoted but what it recommends has no robust evidence supporting it.

It is also worth bearing in mind all the time you're having treatment, you are losing opportunities to try naturally, which may give you as likely a probability of a successful outcome. IVF success rates even when you have a viable embryo to transfer (which is not in itself always an easy point to get to) are pretty rubbish so it's worth reading about these and really understanding what they mean. I've learned a lot on our journey and whilst I don't for a second regret our choices, as they gave us our daughter, in hindsight and with better understanding, I do suspect we would have got here eventually anyway without spending the large amount of money we have. It's much easier to be philosophical with hindsight though, and as I said, I do understand your reasons for considering treatment, and fundamentally you have to do whatever you feel is right for you.

@secondtimelucky87 My AMH was 2.1 pmol. That is just one result though, you need your AFC checked too. My AFC was only ever 2 or 3 and I was 39. I did eventually have a baby (I was with Create) but it took 5 egg collections to get there.

Thank you for sharing. I feel like we can barely afford one cycle - let alone 5. 😔 It does make sense though that with an AMH this low it would likely take multiple rounds. I think if that's what we're told at the consultation it's unlikely we'll go ahead. I still want to do the consultation though to see what is said. Yeah they didn't check AFC on the NHS one so will book the baseline scan/consultation with Create once we've got my husband's repeat SA results. Am I thinking that for follicle count it's best to do it on CD2-5? How did you find Create and do you mind me asking what type of cycle you did? Ive read the Mild IVF is less time consuming and just thinking of timing it around work etc if we do go down this road. Thank you 😊

P.S. I am really glad you got your baby in the end 😊

Thanks so much again. One thing that is probably not great for sperm health in our context is the fact that my husband works from home so a lot of time sat down. It's not an easy thing to change though. Obviously we both go to the gym when we can fit it in around work and parenting but yes he does have a more sedentary role. He's just been advised to get up and walk around as often as possible and he takes Vitamin D on top of other supplements.

I will definitely commit to doing a little more research before settling on Create, as tempting as it is to go with them (payment plan, apparently good with low AMH and easy to reach from work/home). How we proceed after the consultation I guess will depend on how successful they reckon we'll be and the financial implications.

Thanks for all your advice 😊

I am with bourn hall with the AMH being low. They have been really good but like I said, we had to wait 9 months (and counting) between treatment but that’s because I needed a colposcopy and biopsy due to smear results on the nhs before bourn hall would continue. We got the ok at the start of this month to continue trying, but the gods seem to be against us as I have now missed my period (due two weeks ago) for the first time ever.

if we do eventually start again I can tell you that we couldn’t get certain funding at the clinic due to the low AMH although some funding was possible. In the end with the help of parents we are able to self fund 2 rounds which is the package we will go for. Now we wait to see if the period ever comes! It’s all so hard

I'm wishing you all the best with everything! 😊 We had a set back in that my husband was unwell and had a high temp which meant we couldn't do another SA for him (you need to wait 3 months when there's been a fever). Would obviously need recent results of that before booking a consultation. So in limbo until December. I don't qualify for any NHS as have one child and just not 100% sure how I even feel about going through with IVF/let alone affordability! Our plan in December is to first go an see an andrologist as we figured that it made sense to address our male factor issues first. Not sure what next steps will be but we'll see!

I'm sorry, this is so stressful. I had fertility testing back in 2020 after two miscarriages while trying to conceive my 2nd child - and was shocked that my AMH was only 2.0 (at 32). I was under Bourne Hall in Norwich and was told that IVF was an option for me.

As it was, I was lucky enough to get pregnant the next month with my daughter who is now 3. 18 months after she was born (when I thought my ovaries must be completely empty!) I somewhat surprisingly got pregnant with number 3 - heaven only knows what my AMH would have been then. I guess what I'm trying to say is please don't stop trying, and don't give up hope. Fingers crossed the changes you've made help with the male factor issues too. I scoured the internet for positive stories, trying to match them up with my circumstances so wanted to share just in case it does help - although ultimately, IVF was an option for me even with these AMH results.

Wishing you the best of luck.

Thanks so much for your lovely reply. Much appreciated. Amazing that you went on to have two natural pregnancies! I really really don't want to have to go down the IVF route if it can possibly be avoided. I hate the thought of going through something so intrusive and emotionally draining, not to mention the cost! I just don't know if it's going to happen naturally for us at 37 and 48. One good thing is that my luteal phase has lengthened back to 12 days after a few months at 9 (since I started on Proceive Max). Just willing December to hurry up so we can get my DH's SA repeated and go for a consultation (he was asked to wait a few months post fever). I'm really struggling with being in limbo. 😢