Low AMH Levels 32

[Bloop123]

I’ve just had a check up after trying to conceive for a while and bloods have come back as low Amh levels for my age (32) they were around 5.

Naturally, i’m devastated and catastrophising. Does anyone know what this really means?

Am I going into early menopause? Will I ever be able to conceive?

the consultant kept reassuring me, saying that he would be more worried if I was older with good AMH levels. But everywhere I read tells me it’s an indicator of early menopause.

just looking for a bit of support I guess

Hey. Sorry you are going through this. My AMH when i was 30 was 6.1 so low for my age too. My antral follical count was also pretty pants at 9. My first round of IVF (added male factor as well) wasn't great and I only got one embryo which didn't implant. My next round I made some changes, was put on thyroxine, made sure my vitamin D level was much better, I took DHEA too although that was against my clinics advice. Second round I got 5 embryos. So making little differences can help.
The point is though, I'm 35 nearly 36 now and my periods are still totally regular and no real signs of menopause any time soon. I'm about to have a FET and the clinic are happy with all bloods etc.
So whilst a low AMH may indicate things are heading towards earlier menopause, it doesn't mean it's around the corner! You might have a good few years left. Fingers crossed for you

Hi OP, assuming you’re still having regular periods then you’re absolutely not going through early menopause now and probably won’t for years yet. Like the previous poster I’ve been going through IVF not because of my low AMH but because of my partner having a problem.

I’m 34, I haven’t tested my AMH in a couple of years now but it was measured at 3.3pmol, 5.3pmol and then 2.4pmol when I was 31-32 years old, my AFC was about 7. So lower than you. I still have regular periods.

I’ve been freezing the last couple of years as we have MFI as well. Our 3rd frozen embryo transfer looks like it’s stuck and I’m now 18 weeks pregnant. Low AMH alone does not impact your ability to conceive, it just means don’t leave it too long as you’re unlikely to be one of those lucky few that get pregnant at 40+! It’s all about egg quality and age is by far the biggest factor in that, and you’re young.

I remember it being a shock originally but now I just look at it as a good kick up the bum to be proactive. Which it sounds like you already are.

AMH 1.9pmol, follicle count 3 at 36. Consultant explained that if wasn’t for male factor infertility, a level that low wouldn’t stop natural conceiving as you only need one egg being released a month. It makes IVF more tricky as obviously want more follicles. Due to start stims for first round so let’s see how many the drugs can make!

Hi @ivfjourneyandme @Mseddy @Zypig , thanks so much for your replies. That is really reassuring and wishing you all the luck in all your next steps ❤️🤞please keep me updated.

So my partner has around 2.5% morphology, so there’s also MFI involved. So I imagine I have a long road ahead of me.

How tricky does the AMH levels make IVF? What scares me is that we couldn’t afford to go private, so I think we’ll only have one shot at it if it gets to that stage.

all my friends are getting pregnant very quickly and easily around me so it’s really good to speak to people who are going through/have been through a similar thing! Xxx

Hi OP,

I figured it might help to show you my journey as was pretty much exactly where you were a few years ago but with slightly worse numbers. AMH as above was lower than yours, MFI as well (1-2% morphology).

Round 1 - started with 9 follicles, 5 eggs collected, ICSI 1 embryo made it to freeze

Round 2 - start 8 follicles, 5 eggs collected, ICSI & PIMSI, 1 embryo made it to freeze

Round 3 - start 7 follicles, cancelled cycle, poor response, looked like max 1-2 eggs would make it if any.

-changed protocols to slightly different drugs -

Round 4 - start 18 follicles, 12 eggs collected, ICSI, 5 embryos made it to freeze.

Round 5 - start 9 follicles, cancelled cycle, same issue as round 3 despite new protocol.

moved on to frozen transfers:

• x1 on board, BFP MMC at 8+5, growth was behind from 6 weeks
• x1 on board, BFN
• x1 on board, BFP, now 18 weeks pregnant and all looks great!

My first 2 cycles were private as the NHS list in my area took ages. Round 5 was also a last ditch private attempt given how well round 4 went. But we stopped it before spending more money when the first monitoring scan was so crap!

Cycles can vary massively. If you’re moving to IVF then try reading “it all starts with the egg” and ensure your partner starts taking supplements as well to put yourselves in the best position.

good luck!

What is PIMSI?

hi, PIMSI, is this: https://crgh.co.uk/directory/treatments/ivf-with-imsi/

Basically a more powerful camera is used to select the sperm for ICSI - it’s not an approved HEFA add on - in hindsight probably a total waste of money but we were naive at the time!

Hi @ivfjourneyandme @Mseddy @Zypig , sorry to message again I’m just getting myself into a bit of a state about it all still and I don’t really have anyone to talk to who understands.

They’ve told me about this AMH level and now I’m just left to try to process it, I feel so horrible in my body and I’ve still got so many questions running through my head.

Did you get any clarity as to why your AMH level would be low? Is it just genetic?

And does it definitely mean you’ve got less eggs?

I still have regular periods, but I’ve been experiencing spotting before my periods and cramping pain over the last few years. I’ve been consistently told by my GP that “it’s nothing to worry about” but now I’m wondering if it’s all linked and my ovaries are just giving up

@Bloop123, sadly I just think it’s one of those things. Have you had an internal scan to count your follicles? AMH is honestly just one part of the jigsaw. Mine is much lower than yours and I’m about to start IVF so I’ll let you know how many follicles they find xx

I’ve had an internal scan and she said everything looked normal, apart from the follicles looked smaller than she’d expect at the point in my cycle, and apparently she said she could find a “dominant” one - do you think this I’m not ovulating? But she didn’t actually mention follicle count which seems strange.

Sorry - that meant to say she *couldn’t find a dominant one

Where was you in your cycle? Have they said what your next steps are?

Hi @Bloop123, I have a lower AMH than you at 4.2 (I am also 32) and am about to start IVF. I was initially worried but my consultant really wasn’t bothered, she said it just tells her what level of medication I need to be on. She said it’s all about egg quality which will be high as I am young. Trust the drs they know what they are doing!!

My consultant is one of the leading in the UK.

Thank you for your replies, it is reassuring to hear from you :).

In terms of next steps, they are going to do a number of ultrasounds as they suspect I may not be ovulating properly. And then they said if they confirm this they’re going to start me on Letrozole. Have any of you tried letrozole?

good luck with both your IVF ❤️🤞 please keep me updated. They said in 4 months I’ll be eligible for NHS funding and recommended I go for IVF when this comes round. Xx

I was told l had a low AMH at 31 after 2 years failing to conceive naturally, although no male factor in our case. No it doesn't mean you will have an early menopause - you may have just always had a low AMH, it could stay really static for years. With the male factor as well you may need some help to conceive but due to your age your chances in the long run are really good. That said, there is quite a lot your husband could do to try and help his sperm quality - there are some good threads on here. Your eggs should be good quality, and that is to some extent more important than number (which AMH reflects). It only takes one good one.

We had IVF and our only embryo from our first round resulted in our daughter. We had 3 fresh cycles with 4 transfers to try and have a second which all failed. Drew a line under it only to conceive naturally twice this year age 36. First ended in miscarriage, currently 24 weeks with the second. Fertility is so complex, there is so much we don't understand, and the longer I've been in this game the more I think a lot of it just comes down to numbers (in terms of how many embryos you transfer) and luck despite us maybe thinking we are having a positive effect with various add on treatments. The HFEA website and Robert Winston's book The Essential Fertility Guide (plus his website the genesis research trust) are great resources for pragmatic, evidence based advice that can stop you teetering into the field of spending thousands on unproven additional treatment. Very best of luck,

Hi @SErunner thanks for your reply and sorry for my slow response. It’s reassuring to hear your story and success first time round - and congratulations on your pregnancy. ❤️

Can I ask what your AFC was? I found out today that mine was 7 between both ovaries in the last ultrascan - is this very low?

my next steps are that they are going to do a HSG to check my tubes. But otherwise go straight for IVF.

I’m really struggling emotionally with it all to be honest. We only get one IVF cycle funded in our area and it makes me feel sick with anxiety that I may not even stand a good chance of this working with my AFC. xx

@Bloop123
My AMH was 1.9 and my baseline AFC was 3

My first scan on treatment for IVF showed 6 follicles, repeat scan today shows 5 - 3 going well, 2 lagging behind. I’m on maximum dose of stims.

it’s really tough relying on such few follicles but it does only take one. That’s what I’m trying to remind myself anyway!

Hi @ivfjourneyandme that sounds really positive if 3 are going well? I’m keeping everything crossed for you. ❤️

what are the next steps for you now after today? I’m sorry I’m so new to all of this I really don’t know anything about IVF and the timeline when you start treatment.

I hope you’re okay, it sounds like it can be really tough when you’re going through it xxx

@Bloop123 I’m struggling with it emotionally - it’s hard reading so many stories where ladies get so many follicles and I’m struggling to get three. My next scan is in 5 days. If they manage to get to 17mm then I’ll be scheduled for egg collection. I hate all the waiting. This is my first cycle too xx

My AMH and AFC were both 6. 6/7 is on the low side for age (10-14 I think I is more normal but don't quote me as it's been a while) but not terrible. AFC does fluctuate month to month. You can expect to get roughly the same amount of eggs in a fresh cycle as your AMH level - amazing I mapped to this on all our fresh cycles bar 1, with 6 collected each time except for 1 where they got 5. I only got 1 viable embryo each round except for 1 round when I had two, but both those were slow growers so I didn't feel optimistic about their chances and both did fail.

Is the NHS covering your HSG? If so go for it as no harm but I wouldn't pay for it privately unless there is a reason to think you'd have an issue with patency (history of STI, in particular chlamydia, being the most common reason I think).

Did you get any more advice re your husbands male factor issues? As this may well be more of a problem for you than your AMH. As I said, it is perfectly possible if not probable to conceive with a low AMH at your age with time, it just may take longer. Appreciate how hard that is to believe though when you're in it. We pushed ahead with IVF because we didn't want to wait any longer for it to happen, but were in a privileged position to be able to fund a few rounds privately. In hindsight, I think we'd have ended up where we are now without doing it in terms of conceiving naturally, although I of course don't regret the IVF that gave us our daughter!

I think positively you do have options in terms of you could put some work into improving your husbands sperm - from recollection low morphology is the least concerning of the sperm quality indicators although again, I could be wrong. Annoyingly it takes 3 months for them to regenerate so it would result in more time being lost, which appreciate you may not want. You also could of course go straight ahead with IVF but it is unfortunate you don't get more than 1 round funded (our area is the same).

I understand your worry, but you can't predict the future and at this point I think you have reason to be hopeful, however hard that may feel. You're young, your eggs should be good quality and some of the MFI may be rectifiable through diet and lifestyle changes. You can still conceive with a low AMH but also have your one round of IVF as a back up (although appreciate this seems a rather pitiful offer).

Three chances are so much better than one, and like you said it only takes one to get pregnant. I’ll be keeping everything crossed for you, the waiting in between everything is just so hard though isn’t it. Are you getting good emotional support from your clinic? I feel as though I need a personal counsellor already and I haven’t even started it all. Sending lots of hugs xxx

@Bloop123 I suffer from really bad anxiety (health related) so have a councellor I see already but so far I haven’t found her helpful at all for fertility discussions like I normally do. Find it hard to accept the ‘it is what it is, wait and see etc etc’ mantras she’s giving me

@SErunner Thanks for your reply, yes they’re doing the HSG on nhs, I think because I am experiencing some pain perhaps and they are querying endometriosis.

yes they didn’t seem too worried about my partners morphology - like you said - they essentially told us it would be more worrying if he has the morphology plus low mobility etc, but morphology on its own isn’t too much of a worry. He has been told to take Coq10 and he’s started taking well man conception too 🤞

Trying to stay hopeful and it really makes me feel so much less alone speaking to all of you, so thank you. Xx

@ivfjourneyandme yeah it’s not really what we want to hear is it, I actually think that speaking to people on here going through the same thing could be more therapeutic than a speaking to a trained counsellor who perhaps doesn’t truly understand…but I haven’t actually tried going down that route yet

It's no problem. I'm sorry you're here, it is really hard and it's okay for it to feel raw and difficult. I found talking with people both here and in person really helpful.

Do look up threads on here re improving MFI - there is more he can do in addition to their suggestions but I'm not that knowledgable on it as it wasn't an issue for us.

@ivfjourneyandme and @Bloop123 there are specialist psychologists/counsellors etc in the field of fertility and I'd say it's definitely worth seeking someone experienced in that area if you are going down that route. I dipped in and out of therapy during our fertility journey and did find it helpful.