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Jo101

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Thursday, October 8th 2009, 4:47pm

LOW AMH and IVF Success??????????

Hi all,
I know I have tried to get to the bottom of this before a bit. But I need to get some help here about AMH. My AHM is very low not sure exactly but not anywhere near normal.

What I want to know is does low AMH mean that IVF can not work? The reason I am asking is we were told we may be refused treatment because of my low AMH.

We can go private but it will mean a lot of hassle as we can not do donor tx in Sweden so we would be trotting back and forth to the UK which is far from ideal. I am just wondering should we quit if we are refused tx and just let things be.

If anyone could shed some light on this, I would appreciate it.

Thanks,

Jo x

2nd IVF :BFP:

This post has been edited 1 times, last edit by "Jo101" (Oct 8th 2009, 4:47pm)


    Germany

Posts: 2,679

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Children: Twin boys born April '10 thanks to ICSI

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Thursday, October 8th 2009, 6:16pm

Hi Jo, my AMH is low. I'm not really sure how low because in Germany they seem to use different units than in the UK so I can't really compare mine with any UK data I've found on the internet. Mine is 0.43 in the German units which according to one German website I found would make me a very poor responder, but in fact it wasn't that bad. I've had 5 fresh cycles, and got 6,5,6,6,3 eggs, the first 3 were long protocol and the last 2 were short and now I am pregnant. I know it took me a long time to get here, but still (so far) I'm proof that low AMH doesn't mean it wont work. I hope you get your funded treatment, :goodluck:!


4x IUI
Mar 08 IVF BFN
Jun 08 ICSI BFN
Sep 08 ICSI BFN
Oct 08 FET BFN
Apr 09 ICSI brief BFP
Aug 09 ICSI :BFP:

Me 40, DH 38

Our dream came true,


Lukas and Finn were born 13/04/10 at 36w6d biggrin2
My diary


Jo101

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Thursday, October 8th 2009, 7:42pm

Thanks Claire, well you are proof that sticking in there works....
I just hope I have staying power of get lucky.

Best of luck with your pregnancy.

Jo xx

2nd IVF :BFP:

bubble

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Thursday, October 8th 2009, 8:12pm

Hi Jo

I've copied some info below from another thread, along with some other threads which I think you'll find useful. Also, I've moved your thread into the IVF section where I think you might get more replies.

Best of luck hun

x

Quoted

Originally posted by Eeyore




www.reproduction-online.org

In the years preceding menopause, fertility already decreases and the menstrual cycle becomes irregular. Chronological age is a poor indicator of reproductive aging, and thus of the ovarian reserve.

To assess an individual’s ovarian reserve, FSH, inhibin B and estradiol can be measured but these factors are not independent of each other and so cannot give an accurate result in all cases. In recent years, new data indicate that anti-Müllerian hormone (AMH) may fulfill this role.

AMH expression is strongest in small antral follicles (less than 4 mm). AMH expression disappears in follicles of increasing size and is almost lost in follicles larger than 8 mm. This expression pattern suggests that AMH may play a role in initial recruitment and in the selection of the dominant follicle.

Changes in serum AMH levels are thought to occur relatively early in the sequence of events associated with ovarian aging. Substantially elevated serum levels of FSH are not found until cycles have already become irregular. Therefore, a marker that already shows a considerable change when menstrual cycles are still normal would better identify women with declining fertility.

In women undergoing treatment for infertility, ovarian aging is characterized by a decreased ability of the ovaries to respond to injected gonadotropins (such as Gonal F, Menopur, Puregon etc) and poor pregnancy outcome. Correct identification of poor responders by assessment of their ovarian reserve before starting IVF is important as it can help clinicians to determine which dose to start a cycle on.

Several studies have shown that AMH is an excellent marker to determine ovarian responsiveness in an IVF program. AMH levels are lower in patients with poor ovarian response than in women with normal response, with ovarian responsiveness being defined as the number of eggs retrieved, or as cancellation due to impaired or absent follicular growth. AMH blood levels were shown to be highly correlated with the number of antral follicles before treatment and number of eggs retrieved upon ovarian stimulation.

Blood of PCOS women contains increased AMH levels because of the increased number of small antral follicles. In PCOS women, AMH levels were correlated with antral follicle number.

AMH levels decrease with age in premenopausal women. In addition, levels of AMH correlate strongly with the number of antral follicles, suggesting that AMH levels reflect the size of the primordial follicle pool. Assessment of the ovarian reserve is particularly important in the IVF clinic, where AMH may be useful as a predictor of poor response. Since a considerable proportion of subfertility is due to postponement of childbearing, measurement of AMH levels to assess the ovarian reserve may also be of interest in women in general. Assessment of the ovarian reserve, at least of the size of the ovarian follicle pool, may provide insight into the number of fertile years a woman has left.

http://www.gcrm.co.uk/downloads/Anti-Mullerian%20Hormone.pdf

http://www.tdlpathology.com/index.php?op…d=201&Itemid=73


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ttc since July 06. 8 cycles of clomid. BFP on cycle 5 (Dec 07) ended in m/c at 9.5 weeks. Second BFP on cycle 8 (May 08)




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5

Thursday, October 8th 2009, 8:30pm

Hi Jo,
I have hideously low AMH (less than 2) but responded very well to the puregon drugs in my three IUIs (not well enough for any BFPs!) For this reason only I was very lucky that my consultant said he would allow me a go at IVF, which I'm undergoing at present. Different drug this time, Menopur, but only got one egg, maybe I should have had higher dose?

There are many low AMH success stories, just like Claires, and Bubble's given you enough reading material to become an expert!

I think that clinics should be okay about women with low AMH if they monitor the drugs appropriately? Good luck with your quest.
Sarah x

dkny26

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Thursday, October 8th 2009, 8:31pm

RE: LOW AMH and IVF Success??????????

I was told that I had a low AMH but that it is a relatively new test and therefore it isn't the be all and end all. My FSH and other hormones were normal I am 36 years old. I went on the Zita West fertility pills (vitamins) and my AMH went from low to within normal range within 6 months!!! I am not sure whether this was a coincidence but it seemed to work for me. There is always hope and you need to stay positive.

After two years of ups and downs we are about to embark on our first ivf session after having ops for endometriosis, breast lump removed, husband having a circumcism, having bowel surgery, having a failed down regulation... I have started have acupuncture and I feel much more positive and hopeful. I am starting the down reg by injection and not sniffing. Here's hoping.

So don't give up. I really don't think there is enough evidence to suggest that low AMH means low egg reserves.
x

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Reg: May 2nd 2007

Children: A boy and a girl, both living in London

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7

Thursday, October 8th 2009, 11:26pm

Hi Jo,

As you see from the above AMH is not the definitive test it is hyped as being.

Whilst it is disappointing and a shock to hear that your AMF is low, this should not be seen as the end of the line for you to conceive . AMH is a very new measure of apparent fertility, and was introduced to help and guide patients and professionals involved in IVF. There does seem to be so degree of correlation between AMH levels and the women's response to ovulation induction, but the connection is not absolutely clear, and there are constant surprises with many low AMH women responding well and conceiving.

For those trying to conceive naturally the picture is even more unclear, as most couples who ttc naturally, and conceive, do so without ever having an AMH assay done. We do not really know therefore what relevance AMH levels have for individual women. There is also still a great deal of conjecture as to what the normal range is for AMH, and how fixed this is, as many women have different levels of AMH when tested several months apart.

AMH may be an indication of how many follicles may result from ovarian stimulation, which is obviously a vitally important factor in achieving a success with IVF. However in ttc it is not so much the number of follicles but the quality of their contained eggs, and of the subsequent luteal phase that determines whether a conception happens. It is normally the case that in the natural situation, only one or two follicles reaches maturity and rupture, so the number is never that critical. IVF is a very unatural situation, hormonally and physiologically and you can never predict the response you will get. So you must continue to try and not be put off by this result.

Good luck,

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

MacMummy

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Friday, October 9th 2009, 9:45am

Hi Jo,

We have chatted before about low AMH but just wanted to say, like the others have said, that having a low AMH does NOT mean that your IVF will not work!!!
My AMH is 1.34 and I was told to consider donor TX but I insisted on trying once more with a new drug, pergoveris and you will see from my ticker that things went rather well!!!!!
OK, so having a low AMH level is not ideal as getting you to produce enough eggs for IVF can be an issue but as people often say on here, it only takes 1 to produce a baby, so hang on in there Hun :D
Everyone's circumstances & situations are different but I wouldn't lose hope yet.

Good Luck, MM xx

:girl: :girl:

twin girls

Jo101

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Saturday, October 10th 2009, 7:17am

Bubble thanks for all the additional info, good luck with your pregnancy.

DKNY you certainly sound like you have had a lot to deal with bless you.
I am on the Zita West Vitamins too and Vital DHA.

MM I got your green liquid in the post the other day and I am taking it every morning.

Paul thanks for your words of wisdom! Yes I know we must soldier on.

Sarah yes my AMH is below 2 also..... :8o: but my other hormones seemed fine too during our last round of IVF.

It certainly makes me feel better to have got some responses from you all. I know that low AMH does mean that stimulation of the ovaries is harder and I am never likely to get 10 eggs retrieved. And I know it is quality rather that quantity and during our last cycle the eggs were very good.

I will keep you all posted.

Jo xx

2nd IVF :BFP:

anemone

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Monday, October 12th 2009, 11:54pm

Great to hear of all these successes. Huge congrats to Claire and MacMummy! Atta girls!!

Jo - hope that you can convince yr clinic to treat you. It seems so unfair that they can refuse s/one treatment based on one number which may not signify that much :cross:

Quoted

I went on the Zita West fertility pills (vitamins) and my AMH went from low to within normal range within 6 months!!!


Wow, dkny, that's pretty amazing! Do you know what the vitamins were (I guess I should look up the website)? And how low was your AMH before? Good luck with your IVF!

I have low AMH too (4.5) and am really interested in whatever I can do to increase my chances while still TTC naturally for now.

Also, dkny, did you have your endo cleared away before having your AMH retested - could that be part of the reason it went up? I know that women with endo tend to have lower AMH, and there is supposed to be a higher chance of pg in the months after a lap to clear endo - but I have no idea about whether AMH actually goes up in this scenario.

Im having a lap in a week or so to check for endo - so we'll see.
xoA
Me 37, DH 45
TTC#1 since Jan 09. Low AMH. Chem preg/early m/c Sept 09. Endo removed Oct 09, tubes clear. TTC naturally until end of year then maybe IVF.

This post has been edited 1 times, last edit by "anemone" (Oct 12th 2009, 11:57pm)


dkny26

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Tuesday, October 13th 2009, 8:58pm

Hi Anemone and everyone, you know it is entirely possible that the endo was the cause of my low amh but to be honest i can't remember if i was tested before or after my operation to clear the endo. I'll check with my gyno next time i'm there. zita west vitafem (and vitamen) for your dh can't do any harm (except maybe to your wallet)




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