Just found out I have a low ovarian reserve - need advice

[charmingpony]

Hi ladies,

I've just received some difficult test results. I'm 32 and healthy. A doctor told me that I have a pretty low AMH level (I think about 6.8 pmol - I need to get the official letter). He said that this was concerning but that every other test - FSH, hormone levels (oestrogen, prolactin) were good. I had an ultrasound done recently and all looked normal.

I'm feeling very shocked and concerned that my chances of getting pregnant are low. I will now start egg freezing. I don't have a partner despite my efforts with dating so this is really compounding everything.

Have any of you had low AMHs and successfully conceived? Was it difficult to conceive?

I had/have low ovarian reserves at 31 which was discovered during ivf after 5 years trying to conceive. I’ve never conceived naturally, but do have DTs from my one and only round of ivf with two more in the freezer.

I did, far less than yours — basically 1 then under that over the course of a few years as everything takes so long. Freeze your eggs asap. Don’t wait for it to get worse. Two things then happen in your 30s, the ovarian reserve decreases and everyone automatically starts telling you that less eggs means they are of rubbish quality and IVF won’t work. Some clinics wouldn’t help me at all with IVF and instead pushed me toward egg donation which is such a difficult decision. The other issue is age. As soon as you hit 35 they then tell you you’re old and that the chances of success are lower. There may be some truth to that but against the odds with a 0.something AMH over the age of 35 I conceived a very healthy girl. But it was one of the biggest fights of my life to get there refusing to give up and letting everyone tell me it would fail!

I'm sorry to hear that OP. Egg quality is also an important factor. My AMH was actually high/very good for my age- late 30's when tested. I lost 3 pregnancies, 2 of which had genetic testing done which showed issues consistent with poor egg quality. You might have good egg quality as a bit younger then when I started TTC at 34 though. All the best x

At 32 I went for a fertility MOT as husband was dragging his heels about having kids and I wanted some reassurance. I and was told mine was 9.3 but the doctor told me not to worry unnecessarily as I was still quite young and the eggs may well be of good quality. He did however tell me to get a move on with ttc within the next year. I was very lucky - fell pregnant on the 5th cycle and 2 years after my first was born I fell pregnant accidentally with my second.

Sending you all the best wishes.

to clarify, by ‘accidentally’ I mean the first month we dtd without using contraception.

My ovarian reserve is low for my age. I've had IVF as I'm a lesbian. At 29, mine was 8.2. With that, I ended up with 10 eggs retrieved. Final numbers were 4 top quality blasts, one of which is now my 2yo DD, and I have 3 still frozen.

Having low reserve thankfully doesn't say anything about quality. You are under 35 so the chances of your embryos being genetically normal and good quality is good.

I fell pregnant at 40 with an AMH of 3.2.

The AMH test isn’t massively useful when trying to conceive naturally. It measures quantity, not quality and you only need one good egg. Of course higher is better, but it’s most useful during IVF to understand what drugs levels/protocols to use.

I did lots of research (am an academic so have access to publications) and the only over the counter supplement I could find evidence based support for was Q10 supplements. You could consider taking those to help preserve your egg quality.

This isn’t an indication you can’t have a baby. None of us can predict the future and you are doing all the right things to help yourself.

I had a fertility MOT at your age and I can't remember my AMH but I remember it not being great. A GP told me she doesn't recommend getting these fertility MOTs because they can give false hope- a high AMH does not necessarily mean conception will be easy as it just means lots of eggs available, not that they are good quality ones and a low AMH does not necessarily mean that pregnancy is nlt achievable- It only takes one good quality egg to get pregnant and at your age yours are likely to be of reasonable quality. As it happens I conceived spontaneously, quickly and accidentally a few years after my fertility MOT despite my AMH not being great. By all means research your options but it is not a definitive sign that pregnancy can't or won't happen for you naturally.

The cynic in me wonders if these clinics doing fertility MOTs encourage women to freeze eggs based on AMH level for money making reasons as opposed to it being actually necessary.

I have very low ovarian reserve and had great success with mild IVF. We did three cycles of egg collection with Create and though I only got a few eggs each time we were lucky enough to have a high fertilisation and development rate. I ended up with 6 embryos total, we transferred two and amazingly both took! I have two gorgeous children now and I’m so grateful to the advances that made that possible.

My AMH was similar to yours - 6.4 at 30. I was pregnant a month after getting that result, again when she was 7 months old and am currently 35 weeks with my third at 37! I had my AMH retested just before we started trying and it was 1.8 pmol. The consultant’s words to me when I was 30 were ‘don’t wait’ and she was right to say that, but I had more time than I/we thought. Freezing your eggs now seems sensible but try not to worry as AMH is only part one part of it all.

Thank you for everyone who responded. You've helped me a lot. It seems that fertility is a complex system. Having a low AMH isn't great but I feel reassured that I have options. I'm going to get on egg freezing right away.