Infertility

Annnnd another AMH question...

I didn't want to hijack the other thread. Stick out tongue Is there anyone who understands the different AMH ranges? I've always used the chart on this link: http://www.advancedfertility.com/amh-fertility-test.htm

I get confused when someone is worried about their AMH when it's 1 or above because, according to the above link, that's a good number. But then I find charts like the one here: http://www.drmalpani.com/amh.htm (Not sure how reputable that site is...)

I ask because my initial AMH was .38 which, using the first site's chart, is "low". Then my 2nd AMH which was drawn less than a year later was .97 which would be almost normal on the 1st link, but still low on the 2nd link.

Also, this info is on the 1st link..."There are some problems involved with interpretation of AMH hormone levels. Because the test has not been in routine use for many years, the levels considered to be "normal" are not yet clarified and agreed on by the experts. Also, not all current commercial assays give equivalent results."

So how do you know what to go by and what is the point of AMH anyway if no one seems to know what the results really mean?


***signature & ticker warning***


Me: 30 ~ Stage IV Endo ~ AMH .38 ~ AFC 8
AMH .97 as of 4/2012! ~ AMH 1.63 as of 4/2013!?!

Him: 29 ~ perfect swimmers

Laparotomy w/partial oophorectomy 8/2009 to remove cysts/endo.
Stopped BCP 4/2010.
Multiple clomid rounds from 11/2010 to 6/2011. ~ All BFN
IUI w/clomid 7/2011. IUI w/clomid & injectables 11/2011 & 1/2012. ~ All BFN

IVF:EPP 5/2012 ~ (4R, 3M, 2F w/ICSI). Both embryos txfrd. ~ BFN
BCP to manage endo from 10/2012 to 12/2012.
FET w/donor embryos #1: 10/2013 Cancelled
FET w/donor embryos #1.2: 11/2013
~ ET of 2 beautiful blasts on 11/27.
Beta 1: 503(12dp5dt) Beta 2: 1035(14dpt) Beta 3: 3001(16dpt)
Beta 4: 8503(19dpt)
Twins with an EDD of 8/15/14! Team Purple
G&B born 6/30/14 at 33w3d via emergency c/s.


If you're wondering about my avatar...it's a fried pickle chip shaped like a fetus!


image

Re: Annnnd another AMH question...

  • I think there's two different units of measure used pmol/L and ng/mL. I think most people in the US use ng/mL, those are the lower set of of numbers.

    And yes it's a relatively new test and there is a lot of uncertainty about it and what it really means.

    image

    BFP#1 1/31/12, EDD 10/6/12  Harrison Gray born sleeping @ 18w6d on 5/11/12. You changed our lives little guy.

    BFP#2 EDD 10/29/13, C/P 2/25/13, Bye little Ish, we barely got to know you.

    BFP#3 EDD 12/21/13, Baby Boots born 11/23/13 My rainbow baby!


    image image image

    November PAL siggy challenge: Dance Fails

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  • image BootsOrHearts:

    I think there's two different units of measure used pmol/L and ng/mL. I think most people in the US use ng/mL, those are the lower set of of numbers.

    And yes it's a relatively new test and there is a lot of uncertainty about it and what it really means.

    Both links have ng/mL charts and the ranges are different.


    ***signature & ticker warning***


    Me: 30 ~ Stage IV Endo ~ AMH .38 ~ AFC 8
    AMH .97 as of 4/2012! ~ AMH 1.63 as of 4/2013!?!

    Him: 29 ~ perfect swimmers

    Laparotomy w/partial oophorectomy 8/2009 to remove cysts/endo.
    Stopped BCP 4/2010.
    Multiple clomid rounds from 11/2010 to 6/2011. ~ All BFN
    IUI w/clomid 7/2011. IUI w/clomid & injectables 11/2011 & 1/2012. ~ All BFN

    IVF:EPP 5/2012 ~ (4R, 3M, 2F w/ICSI). Both embryos txfrd. ~ BFN
    BCP to manage endo from 10/2012 to 12/2012.
    FET w/donor embryos #1: 10/2013 Cancelled
    FET w/donor embryos #1.2: 11/2013
    ~ ET of 2 beautiful blasts on 11/27.
    Beta 1: 503(12dp5dt) Beta 2: 1035(14dpt) Beta 3: 3001(16dpt)
    Beta 4: 8503(19dpt)
    Twins with an EDD of 8/15/14! Team Purple
    G&B born 6/30/14 at 33w3d via emergency c/s.


    If you're wondering about my avatar...it's a fried pickle chip shaped like a fetus!


    image
  • Thanks for posting this. I have to have mine drawn next week and I am scared.  It would just be another thing to go wrong.
     36 DH 33 TTC for over 3 years
    First mini-IVF Sept 2011... Only 1 egg! ... BFN
    Switching RE
    IVF#2 May 2012 9 eggs and only 2 sperm, WTH!
    BFN
    IVF #3 March 2013~Tesa with back-up Donor Sperm,Tesa, unsuccessful used DS~ Chemical :(   

    Switching RE's within practice

    2 frosties waiting for us, November 2013!!!!!   Transferred 2 "average" blasts 11/20/2013
    BFP!!!!!!!  Boy/Girl Twins!!!!!! Due 08/08/2014

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    *~God gives his hardest battles to his toughest solders. Unknown.
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  • image firesiren:
    Thanks for posting this. I have to have mine drawn next week and I am scared.  It would just be another thing to go wrong.

    I hope your results are good!


    ***signature & ticker warning***


    Me: 30 ~ Stage IV Endo ~ AMH .38 ~ AFC 8
    AMH .97 as of 4/2012! ~ AMH 1.63 as of 4/2013!?!

    Him: 29 ~ perfect swimmers

    Laparotomy w/partial oophorectomy 8/2009 to remove cysts/endo.
    Stopped BCP 4/2010.
    Multiple clomid rounds from 11/2010 to 6/2011. ~ All BFN
    IUI w/clomid 7/2011. IUI w/clomid & injectables 11/2011 & 1/2012. ~ All BFN

    IVF:EPP 5/2012 ~ (4R, 3M, 2F w/ICSI). Both embryos txfrd. ~ BFN
    BCP to manage endo from 10/2012 to 12/2012.
    FET w/donor embryos #1: 10/2013 Cancelled
    FET w/donor embryos #1.2: 11/2013
    ~ ET of 2 beautiful blasts on 11/27.
    Beta 1: 503(12dp5dt) Beta 2: 1035(14dpt) Beta 3: 3001(16dpt)
    Beta 4: 8503(19dpt)
    Twins with an EDD of 8/15/14! Team Purple
    G&B born 6/30/14 at 33w3d via emergency c/s.


    If you're wondering about my avatar...it's a fried pickle chip shaped like a fetus!


    image
  • image DoublePortion:
    image BootsOrHearts:

    I think there's two different units of measure used pmol/L and ng/mL. I think most people in the US use ng/mL, those are the lower set of of numbers.

    And yes it's a relatively new test and there is a lot of uncertainty about it and what it really means.

    Both links have ng/mL charts and the ranges are different.

    Hmmm then I don't know, except that I have read there is a lot of disagreement on what 'normal' levels are so maybe that's it?

    image

    BFP#1 1/31/12, EDD 10/6/12  Harrison Gray born sleeping @ 18w6d on 5/11/12. You changed our lives little guy.

    BFP#2 EDD 10/29/13, C/P 2/25/13, Bye little Ish, we barely got to know you.

    BFP#3 EDD 12/21/13, Baby Boots born 11/23/13 My rainbow baby!


    image image image

    November PAL siggy challenge: Dance Fails

    image

  • As with anything in IF, I think your AMH level is all relative to everything else. Like you can have high FSH but a normal/great AMH and be ok....or low AMH and normal FSH or AFC and there are so many combinations I think it just is one piece of the puzzle honestly. Other than that gem of advice, I'm no help , LOLStick out tongue
    Me: 33, Endocrine issues & FVL       DH: 32, Nothing 
    NTNP 2009-2012         TTC since 2012:
    • Clomid, 2 IUI cycles, and 5 IVF cycles = BFN
    • FET #1   August 2013 = BFP!     EDD 5/11/14
    • Jack dx at 19w1d with Dandy Walker on 12/16/13
    • Severe Pre-e /HELLP set in Jack born sleeping at 20w1d on 12/23/13
    • FET #2 --July 2014  BFP!  ---  EDD  4/5/15

    Jack has handpicked his sibling up there :)

    My blog about IF and loss ... Kate's IF Blog

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  • Hi there, DP. :). So, the first link you posted for AFC.OC, that's my RE.  And he explains AMH exactly as it is reported on the clinic's page.  When I first tested there, he did say that he considers anything 1.0 and over to be good.  My best was .92, which he wasn't that worried about.  Problem was that when you look at my other factors, FSH/AFC, the picture became more clear. Yes, there's uncertainty around AMH values, but it shouldn't be considered in a vacuum. AMH alone isn't enough to predict your chances of responding well and having a successful cycle.  And truly, the bottom line is that you just don't know til you try. Even when my AMH didn't totally suck, I didn't respond well and was cancelled twice. The proof is in the pudding, as they say. 
    After almost 11 years of marriage and four IVF attempts, our baby was born in June 2013.
  • Was your first AMH level taken shortly after (or even a few monhts) after cessation of birth control pills?

    "Recent findings of Nelson et al. are in accordance with the assumption of a suppressive effect of hormonal changes on AMH levels: They reported declining AMH levels during second and third trimesters of pregnancy [18], contradicting prior observations that claimed AMH to be stable during pregnancy and puerperium [19,20]. Also contrary to prior reports [21], AMH may also be suppressed with oral contraceptives [22]. Van den Berg et al. recently reported that AMH on day seven of contraception free intervals does not correspond to AMH values in subsequent natural cycles. They reported not only increasing AMH levels immediately after cessation of contraception, but even higher levels after two months from cessation [22]."

    The quote above is from the above medical journal article:

     http://www.rbej.com/content/9/1/98

    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

    May 2014 January Siggy Challenge:
    image
    image
  • Was your first AMH level taken shortly after (or even a few monhts) after cessation of birth control pills?

    "Recent findings of Nelson et al. are in accordance with the assumption of a suppressive effect of hormonal changes on AMH levels: They reported declining AMH levels during second and third trimesters of pregnancy [18], contradicting prior observations that claimed AMH to be stable during pregnancy and puerperium [19,20]. Also contrary to prior reports [21], AMH may also be suppressed with oral contraceptives [22]. Van den Berg et al. recently reported that AMH on day seven of contraception free intervals does not correspond to AMH values in subsequent natural cycles. They reported not only increasing AMH levels immediately after cessation of contraception, but even higher levels after two months from cessation [22]."

    The quote above is from the above medical journal article:

     http://www.rbej.com/content/9/1/98

    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

    May 2014 January Siggy Challenge:
    image
    image
  • image kflynn81:
    As with anything in IF, I think your AMH level is all relative to everything else. Like you can have high FSH but a normal/great AMH and be ok....or low AMH and normal FSH or AFC and there are so many combinations I think it just is one piece of the puzzle honestly. Other than that gem of advice, I'm no help , LOLStick out tongue

    I agree. Sure the "normal" range of AMH is in question but it can still give you some good info. For example, an AMH level of .02 would be low by anyones standard. It's more about the level that a particular RE sees differences in success rates with and other factors like FSH and resting follicle count. My REs office likes to see at least a 1.4.


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