29 years old - should I be worried about these fertility results?

[AnxiousMinty]

Hi everyone,

I'm 29, have always wanted children, this week I had a fertility assessment and would like to get a sense check or hear others’ experiences with similar results.

Age: 29
Contraception history: Had a Nexplanon implant for a few years, removed on 5th August 2025 (so about 2½ months ago).
Cycle: Regular periods since removal, clear ovulation signs (cervical mucus, mild mid-cycle twinges).
Recent scan: Normal uterus and ovaries, no fibroids or adhesions, ovaries easily visualised and accessible.
AFC: 21
AMH: 9.9 pmol/L / 1.4 ng/ml
Everything else: Normal.

I was told the scan was a “good” result, but I keep seeing charts online that make 9.9 pmol/L / 1.4 ng/ml look low for my age, which has confused me and made me incredibly anxious. I know hormonal contraception can temporarily suppress AMH - could that still be affecting it after 2½ months? My AFC seems much higher than what a “low” AMH would usually suggest, so I’m not sure how to interpret that balance.

Would love to hear from anyone with similar numbers, or from people who’ve tested soon after coming off hormonal contraception - did your AMH go up later on? Should I be concerned?

Implants and other contraception do not damage your fertility, it returns to what it was before you had the implant. Listen knowledge is power but not always. Most people who get pregnant likely had something not 100% perfect, but they didn't know so it didn't affect them, you are getting way to anxious over nothing and it's not going to help you. Everything looks really good, so take that and try and see how it goes.

Also a systematic review study found that 75% of people became pregnant within 12 months of removing their Nexplanon implant. Some of the users had other issues which also impacted fertility. https://pmc.ncbi.nlm.nih.gov/articles/PMC6055351/

Use-of-Nexplanon-Subdermal-Contraceptive-Implant-G23-v5.pdf - Google that and a useful short document comes up.

On the temporary effects most guidelines say fertility is fully restored within 3 weeks of removal, so your fine on that. The longest (small scale study) was just shy of 3 months for AMH levels. But that is not the be all and end all at all. Implants have a quicker return than things like injections
Finally, AMH looks at the* small ovarian follicles and reflects the number of eggs remaining. It’s not a measure of* the ability to conceive naturally or egg quality etc. That's why it's mainly useful for IVF. Also as you are 29 you are moving into the early 30 range which is a good way to judge it as well. You don't need to be concerned, your doctors clearly aren't. Just start trying, if you haven't, when you are ready to.https://www.theguardian.com/society/2025/feb/27/social-media-influencers-are-fearmongering-to-promote-health-tests-with-limited-evidence-study-finds?

Thank you, this has made me feel much better. Perhaps I should have researched more into AMH before I had it tested, because it’s clearly not helped my anxiety/stress levels

I think you'll be fine, it's nerve-wracking, especially because you want it so much because you know the things that can go wrong but also there's lots which can go right. I think genuinely discuss anything you can with the docyors who did the tests, but at the same time, just try.

Also at 29 the levels seem pretty fine, have you had fertility issues?

Yes your AMH does look low….at 36 mine was 12.9 I was told that was low when I did IVF

No, I was purely doing it for peace of mind. I’m single currently, and want children when I’m 33/34

It’s lower in the context of IVF, which is what it’s a marker for - how successful IVF may or may not be

@AnxiousMinty totally agree that it’s useful in the context of ivf.

But, at 29, you’d have wayyyy more chance than someone with a high amh at 39. Also, sure, it indicates good numbers in ivf. But if you look at the women who produce loads of eggs, I so often see the story of:
loads of eggs-> a smaller % mature (usable) -> an even smaller % fertilise -> an even smaller % make it to blast (a day 5 developed embryo) to the point that someone might get 26 eggs and 2 embryos.

When you compare that to women with much lower numbers, the drop off tends to be much much smaller, so that say, 9 eggs makes 4 blasts.

I’ve got extremely low amh, the most eggs I’ve had collected in a round was 5, and none made blast (though we have mfi as well as my age) then my last round we intentionally made one egg focussing on quality, and it became a top quality blast that has so far implanted. So you see, higher numbers might generally mean better success, but highest numbers don’t seem to translate in the same way. Age and lifestyle are much more important factors anyway (I was 38 by my first round). If I’d met my good man earlier, I’d have tried earlier.

oh and, as far as you know, you’ve always had and always will have a lower, but steady amh. I had mine tested at 37, and at 39 it’s still (pretty much) the same. If rapid decline in ovarian reserve had been an issue, it would drop off much faster. It’s likely that I just always had a lower number of eggs.

I didn’t have those specific tests done, but I have been diagnosed with endometriosis and had surgery to treat it.

I was on Nexplanon continuously for almost nine years. After having it removed, I switched to the mini pill for about six to nine months. I eventually stopped taking the mini pill and became pregnant on my second cycle at 32. I’m 33 now and currently 18 weeks pregnant.

After stopping contraception, the only thing I did differently was track my ovulation using test strips and the PreMom app. I started testing twice a day from cycle day 1 because I wanted a complete picture of my cycle and to understand exactly when my fertile window began.

During my first cycle, I missed my ovulation peak my levels never reached the “high” threshold that indicates the best chance of conceiving. On my second cycle, I noticed my levels increasing, but again, they never went above that standard peak level.

In the meantime, after doing some research, I learned that for some women, the fertile window can be extremely short sometimes just a few hours, and their hormone levels may never reach the “peak” threshold, even though they still ovulate. That insight helped me understand why I never got pregnant when I was younger and less careful (definitely not my proudest moments, but we live and learn).

For a long time, I assumed my chances of getting pregnant were very slim but never felt the need to investigate further. But as it turns out, that wasn’t the case at all. :)

@AnxiousMinty yes I know …I did 5 rounds of IVF