Please please offer me some hope

77abbi77

Hi ladies,

congrats on your pregnancies! 

I am 31, have a 21 month old daughter that was conceived after 6 months of trying and one round of 50 mg clomid.  Fast forward to when she was 6 months I started TTC number 2 and have not had luck so just went to a fertility specialist for testing.  All looked good till they tested my AMH and it is a .33  so not good.  This all just happened and I need to talk to my dr and get the details but anyone with this issue and at this extreme?  What did you do?  How long did it take?  Please offer me some hope.

PennyLane26

I haven't had an issue with AMH (we are MFI) but just sending (((hugs))). I hope some ladies on here will have some good info for you. 

Also, you may find some support on Secondary IF. It's primarily people who had an easy time of conceiving #1, but are having trouble TTC #2. GL!

IBackBevo

There are a lot of women with low AMH who have had success.  I got pregnant on Clomid/IUI with an AMH of 0.5 at 31.  I was encouraged to go straight to IVF by my RE at that time, but we wanted to try lesser methods first.  I am now 33 and my AMH is undetectable. 

First, AMH is just one number.  You have to look at it in conjunction with your FSH, your age (probably the most important), your AFC, your response to meds (if you go that route), etc.

There is also a lot that is unknown about AMH. It has not been around that long.  In fact, if you were to actually get a copy of the lab results themselves, I bet it says on your lab results that the normal range has not been established and it is to be used for research purposes only. 

Also, if not properly stores and kept at the right temperature, it can affect the results. Also, studies have shown that if you are deficient in Vitamin D that that can affect levels and I've heard at least a couple of anecdotal stories of women taking Vitamin D and have their AMH levels improving slightly.  However, with the above said, I don't think either situation would affect it to the point that you would read at 0.33 if there truly was not some sort of reduced ovarian reserve.   

I have even read studies that in young women (under 30), it doesn't appear to affect time to conception or fertility at all--which probably makes sense because all it likely means is that you are recruiting fewer follicles but if you are young most of them are going to be genetically normal anyway.  I think it matters more as we age and start having more and more genetically abnormal eggs.  The way I have explained it to people before is to imagine if you are trying to pick a good basketball player for your team. If you are 25 and have low AMH, it would be the equivalent of picking from just a few division 1 college basketball players.  You have fewer to choose from, but you are still probably likely to get a pretty darn good player because even if the initial cohort you are choosing from is small, the quality is there.  However, if you are mid-40's, even if you have excellent AMH and a high AFC, you are still are probably going to be like picking from the junior high boy's team.  For those of us a little older and with really low AMH's, we are somewhere in between.

I also think the place it makes a difference is in IVF--if you have low AMH, you most likely have a lower AFC and are not likely to get as many eggs at retrieval which can affect your chances of success.  However, many people still have success.

I definitely think you have every reason to be encouraged because of your age.  If Clomid worked last time, I would encourage you to try it again if you have not already. If it doesn't work, maybe try femara. Then maybe move on to an IUI.  If that doesn't work, then the next course of action would be IVF.  I would not jump straight into IVF...but that is just me. I only say this because I know I had an RE push it heavily on me acting like that was my only decent shot when I was ttc #1 and I suspect that was because he knew he could get me pregnant.  You might also try acupuncture and some supplements.  I know ladies who have had success with that route, too.

Also, the fact that you have conceived before is a big plus, too.

RE's really have all sorts of different reactions to this. I've heard of some acting like low AMH is NBD.  I've heard of others telling women they need to pursue donor eggs.  I really think the truth is somewhere in between. 

Saraevh

IBack has a wealth of knowledge in this area and I feel like she knows more than most RE's so I think she gave you some great information.  

The last time my AMH was tested it was .68 and that was when I was 28 years old.  I too got the 'gloom and doom' speech, however I am now 29 and pregnant with my 3rd child.  I had success getting pregnant with my first child after a lap surgery (for really bad Endometriosis), IUI and Clomid (my husband also has MFI).  My second child came after only a lap surgery and was a complete surprise (my AMH was .7 at that time and I was told IVF would likely be our only option if we wanted to have another child) and I am currently pregnant with my third child after my AMH went down to .68, which was another unassisted pregnancy after a few months of doing infertility acupuncture and taking a bunch of herbs/supplements given to me by my acupuncturist.   

I know it's hard not to spaz about a low number (Lord knows I have in the past) but with my first they never even tested my AMH and that was only just over 3 years ago.  It's a fairly new test and definitely not the only factor to consider.  

  

Don't give up!