[nina9809]

My doctor just emailed me this:

"Your AMH level has returned unexpectedly low at 0.89. Normal for fertility purposes is anything above 1, so while this may be considered borderline, it's still lower than we would expect for someone who is as young as you are with healthy looking eggs on ultrasound. Keep in mind that this does NOT tell us that you are destined to unhealthy pregnancies, only that we have a reason now for your reproductive outcomes so far.
Given this, I am going to recommend that you take the DHEA. This again is DHEA 25mg three times per day. "

**** **** ****! That is pretty low!!

How can I have a low number with health looking eggs? I'm confused! Please advise. What does this low number really mean and how is it going to limit me from getting pregnant? I need you girls.

[KMH]

I am not an expert by any means, but we do have some AMH experts on our board. Specifically, "Lash" is by far the most knowledgeable, well-researched woman I know on the subject. You might PM her...she really knows her stuff.

From what I understand AMH means that you have a low ovarian reserve. The eggs that are there may or may not be in prime shape, but you just don't have as many left as would be expected. You cannot change how many eggs you have, all you can do is work to improve their quality. Some methods include acupuncture, DHEA, CoQ10, and Vitamin D.

Unfortunately, the biggest concern with low AMH is time, so a lot of low-AMH patients choose to do IVF because that is your absolute best chance of taking advantage of the eggs that you have.

I'm so sorry you got this crappy news...I wish I knew what to say to help. Sending lots of hugs your way.

_____________

Nina, here is a good thread about AMH and the women on our board who are dealing with low AMH and all the ramifications. I hope it helps.

http://www.justmommies.com/forums/f7...ults-back.html (Lab results are back... :()

[kayakr]

I am sorry Nina. The good news is that you're finding this stuff out now while you are still young. Your RE will be able to help you. If you went to him in your late 30's with and had these same issues it would be hard for them to get a plan together for you without having to use donor eggs.

Again, I am sorry and I know this news hurts. But they will be able to help you and come up with a plan so you can build your family. These feel like steps backwards, but they are really steps forward. k? Hugs.

[*JenJen*]

*hugs* That has to be a major blow. I don't know much about AMH, mostly because I haven't needed to research it yet since my levels are in the normal range. Look for posts by Lash, she is our resident low AMH expert. They did IVF last year and she did a TON of research into it before they moved into that step.

[nina9809]

Thanks everyone.....

[L-SBB]

HUGS Nina... that's unexpected & tough news to hear. I agree with the others though, knowledge is truly power in TTC and better to know the obstacles you're facing earlier than to find out years down the road when it's even tougher to address.

I hope you & your RE can develop a good plan for you...don't give up hope!

[LilHerndon]

So sorry Nina. That is horrible news to get, but try not to lose hope. You have options still, and we all know you'll get your little one, so try to keep your chin up.

[bryan and nina]

I just wanted to let you know how sorry I am that you got bad news. It's not an indicator of you never being able to have a healthy pregnancy though! At least there is an answer now and you can gather the knowledge you need to decide the next step.

[Servilia]

I'm sorry Nina.
Thing is, what they can see on ultrasound are the follicles that are actually developing at that point in time. It doesn't tell the observer how many egg-cells you have left in your reserve and AMH is a better predictor of that than an ultrasound.
I really hope the DHEA helps you.

[momof6lopez]

Nina, I frequent the PAL more than this board, but wanted to let you know that I also had diagnosed low AMH as well. Mine was a .68. I was 38 at the time. Ive since had two baby's in 1.5yrs. No MA needed. There is hope. I was told to expect alot more m/c's than the normal 38yr old, and I did.....had 3 back to back before Mia. But Selena was conceived immediately after the birth of Mia with no m/c's before her. My RE would not do IVF with this number, they wanted my number over a 1 as well. Its not a death sentence, try and hang in there.........hoping the best for you.

[nina9809]

Originally Posted by momof6lopez

Nina, I frequent the PAL more than this board, but wanted to let you know that I also had diagnosed low AMH as well. Mine was a .68. I was 38 at the time. Ive since had two baby's in 1.5yrs. No MA needed. There is hope. I was told to expect alot more m/c's than the normal 38yr old, and I did.....had 3 back to back before Mia. But Selena was conceived immediately after the birth of Mia with no m/c's before her. My RE would not do IVF with this number, they wanted my number over a 1 as well. Its not a death sentence, try and hang in there.........hoping the best for you.

THANK YOU. That definitely made me feel better. Really, thank you.

Originally Posted by momof6lopez

Nina, I frequent the PAL more than this board, but wanted to let you know that I also had diagnosed low AMH as well. Mine was a .68. I was 38 at the time. Ive since had two baby's in 1.5yrs. No MA needed. There is hope. I was told to expect alot more m/c's than the normal 38yr old, and I did.....had 3 back to back before Mia. But Selena was conceived immediately after the birth of Mia with no m/c's before her. My RE would not do IVF with this number, they wanted my number over a 1 as well. Its not a death sentence, try and hang in there.........hoping the best for you.

Did you take DHEA??

[momof6lopez]

Originally Posted by nina9809

THANK YOU. That definitely made me feel better. Really, thank you.


Did you take DHEA??

,

No, I did not get that far with my RE. After the AMH came back, he would no longer treat me (due to my age, and previous cancer history). I became pg on my own, with the basic vitamins.....b6, prenates, folic acid. Although, a good friend of mine (missy123) swears by the DHEA, she took it and now has a baby girl. I think another lady from TTCAL (in her 40's) took this as well and is now in her 2nd. trimester. Alot of the PAL ladies swear by it. I dont think it would hurt to try it........if it will give you a better chance of no experiencing so many m/c's. That really is our biggest hurdle with low AMH.

[swtneka]

I'm sorry that u r going through this. R u going to take the dhea?

[Lash]

I responded to your AMH, but I figured I'd also follow here since you'll be getting more info back soon. Given your FSH and AMH, I think it's likely the results are accurate, but you are catching it super early since you have higher follicle counts. It gives me super high levels of hope for you and that you are super lucky to catch it now. I'm 29 now, so if you were my age, you'd have my same numbers. Mine apparently started falling around your age and we didn't know soon enough.

I don't want to panic you too much, but I really would push for IVF fairly quickly, in the next few months. Even 6 months with FSH and AMH can mean big changes in a very short period of time. We found out in January, retested hormones in February, pushed for genetic testing in March, and we were suppressing in June after hunting a doctor that would work with my horrific statistics, and to get money together.

[nina9809]

Originally Posted by Lash

I responded to your AMH, but I figured I'd also follow here since you'll be getting more info back soon. Given your FSH and AMH, I think it's likely the results are accurate, but you are catching it super early since you have higher follicle counts. It gives me super high levels of hope for you and that you are super lucky to catch it now. I'm 29 now, so if you were my age, you'd have my same numbers. Mine apparently started falling around your age and we didn't know soon enough.

I don't want to panic you too much, but I really would push for IVF fairly quickly, in the next few months. Even 6 months with FSH and AMH can mean big changes in a very short period of time. We found out in January, retested hormones in February, pushed for genetic testing in March, and we were suppressing in June after hunting a doctor that would work with my horrific statistics, and to get money together.

I'm 31 Lash. My doctor hasn't suggested IVF at all.... he doesn't see it to be a problem yet I guess.... he said that while I might have lower quality eggs, it doesn't mean that they will all be lower quality - therefore I still have a very good chance of conceiving naturally. I'm not sure I'm ready to push for IVF..... hmmmm...... maybe in 6 months? I know things can change quickly and that is why I am scared..... but I really could get pregnant on my own right now and carry full term. I have a much higher risk of miscarriage, yes - but I have had three so far - so statistically.... lol.... I should get a good one in the next couple of pregnancies...

Yes, I guess I am lucky that I caught this early..... in one sense.

What do you think about the dhea? I started taking it yesterday and I'm scared of the side effects.

Oh goodness.

[nina9809]

My doctor wrote: "Generally, a low ovarian reserve indicates lower egg quality, although you are right in that it is not a direct relationship. For example, someone with a similar AMH at 42 would be expected to have much lower egg quality.

Still, given your result we do worry that you have lower egg quality than women of similar age.

Unfortunately, this gives no prediction with regard to time. I don't see a value to a repeat test as it's already come back low. If anything, a repeat to the FSH and/or antral follicle count would be helpful to see if/when they come into line with the AMH as being consistent with low egg reserve. "

If we wait to find the AMH to be consistent with low egg reserve - won't it be too late????

And he also wrote this:

"It does mean that you are at higher risk of recurrent miscarriage due to egg quality, but not guaranteed that EVERY egg will be a poor quality egg. Again though, the DHEA has been shown to be helpful in decreasing the risk of miscarriage due to diminished ovarian reserve.

We say 18 follicles between your two ovaries at the time of our visit, which is an excellent number. No need to repeat at this time (it's too soon). It's worthwhile repeating though in 6 months just to see if the numbers remain constant. "

So I had 18 follicles.....

[KMH]

Nina, how many kids do you and DH want? That is also something to think about. If you conceive naturally and carry to term now, that would be amazing...but then having a second might be really tough if things decline rapidly. With IVF you might be able to freeze some embryos and have them waiting for you.

[nina9809]

Originally Posted by KMH

Nina, how many kids do you and DH want? That is also something to think about. If you conceive naturally and carry to term now, that would be amazing...but then having a second might be really tough if things decline rapidly. With IVF you might be able to freeze some embryos and have them waiting for you.

Yeah, that's a really good point. DH says he only wants one. I want more than one.... but would be happy with whatever. But yes, I want to be able to have more than one if DH changes his mind....

[LindseyE117]

Originally Posted by momof6lopez

,

No, I did not get that far with my RE. After the AMH came back, he would no longer treat me (due to my age, and previous cancer history). I became pg on my own, with the basic vitamins.....b6, prenates, folic acid. Although, a good friend of mine (missy123) swears by the DHEA, she took it and now has a baby girl. I think another lady from TTCAL (in her 40's) took this as well and is now in her 2nd. trimester. Alot of the PAL ladies swear by it. I dont think it would hurt to try it........if it will give you a better chance of no experiencing so many m/c's. That really is our biggest hurdle with low AMH.

Ditto! I know quite a few other ladies who have taken it and it has helped them. It does not hurt to try it right now and see where it goes.

[Lash]

Originally Posted by nina9809

I'm 31 Lash. My doctor hasn't suggested IVF at all.... he doesn't see it to be a problem yet I guess.... he said that while I might have lower quality eggs, it doesn't mean that they will all be lower quality - therefore I still have a very good chance of conceiving naturally. I'm not sure I'm ready to push for IVF..... hmmmm...... maybe in 6 months? I know things can change quickly and that is why I am scared..... but I really could get pregnant on my own right now and carry full term. I have a much higher risk of miscarriage, yes - but I have had three so far - so statistically.... lol.... I should get a good one in the next couple of pregnancies...

Yes, I guess I am lucky that I caught this early..... in one sense.

What do you think about the dhea? I started taking it yesterday and I'm scared of the side effects.

Oh goodness.

Ahh ok so even better if you are at 31 and this is happening. I'm betting that means your body is starting just a tad earlier, but not super early. Egg quality and numbers start to drop at 35, and if every single woman in the world was tested starting at age 25 through their 35th birthday for FSH and AMH, you'd start to see that some have egg quality dropping earlier for some women, like at age 31. We just usually don't test everyone. I think it also means your progress towards losing eggs should be slower, since it looks like a normal aging process and not some weird anomaly