I had a recent lap for excision of endometriosis. My dye test came back clear both tubes fine. I had a huge 13cm endometrioma on right ovary though and had to have right ovary stitched back up. Before my lap I had Amh tested and was 5.3. My gyny said this should increase after a while when endometrioma removed as it was crushing ovaries.
She said to get ivf at James Cook in Middlesbrough I’d need an amh of at least 5.4 (typical). I’m about to get re-tested at the end of this month. What I don’t understand it, ivf is there for fertility issues and surely a lower amh is an issue in itself. For my age of 36 I understand 5.3 is not bad at all and I should be able to conceive naturally but given my stage 4 endo and my age, she’d be happy to refer me for IVf but my amh needs to rise.
I just don’t understand this, surely people actually go for IVF when their amh is too low?
Hope I’m making sense.
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Emmyeve
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I’m seeing my gyny again at the end of the month and she’s lovely but I just don’t know how I can check that this info is actually correct about there being a 5.4 minimum. Sounds an odd number and coincidentally I’m just right below it. I don’t know where to turn.
I got refused ivf treatment based on a slightly raised fsh (my amh was similar to yours when I started treatment). This has nothing to do with suitability for ivf - just the ccgs way of saving money. Every area has different rules. Nice does not say anything about refusing treatment on this basis. When I tried to appeal, they essentially said they were funding best value for money - ie they only wanted to fund people with the highest chance of success! Made me so angry that due to something out of my control they can pick and choose who they treat. Sounds like you have a good chance of it increasing though, so hopefully you will be on to treatment soon x
Thank you so much for responding. I’m a little confused, so did you receive ivf treatment with a similar amh in the end? I’m worried that perhaps my gyny is Incorrect and would like to know what their criteria actually is and if I could find another nhs hospital that doesn’t have an amh minimum but I don’t know where to start!!!
I was refused nhs treatment so paid privately. It's not the hospital that decides but the ccg (clinical commissioning group) that operates in the area for your gp, so changing hospitals won't make a difference. I found my local guidelines by Google! But you can get the guidelines emailed to you if you contact your local ccg. My gynae at the hospital actually thought I was eligible, then got refused when the ivf clinic received my referral. You can read my story by clicking on my profile. I had a natural pregnancy after 3 failed ivf cycles! My consultant did think I was unlucky to not have a successful ivf cycle though as felt my age and amh weren't too bad. Hope that all makes sense?? Xx
Tbh I think your gynae is likely to be right. There is a bit in the nice guidelines around women who are harder to stimulate with ivf drugs so will need higher doses. This is the level of fsh my ccg used (higher than 8.9) and the amh on the guidelines is below or equal to 5.4. Think you should prepare yourself for that. I do remember how crushed I was when I realised my ivf wouldn't be funded and I completely feel for you. It's just such a lottery.
If you don't mind giving me a rough area you are in, I could look for you? I'm used to searching for these things! I took my complaint all the way to the ombudsmen to try to get it overturned! Otherwise you could try calling your gp who might have contact details for the ccg office. X
Thank you so much Anna, my surgeon is based in James Cook Hospital in Middlesbrough but that’s not my local area so it might be that my local clinics have diff criteria (I’m praying). I live in School Aycliffe in County Durham so my local CCG’s are Darlington, County Durham, North Durham CCG, Durham, Dales, Easington Sedgefield CCG.
This link for ccgs has links to their own websites. I've just clicked on one of the ccgs you mentioned and there is a contact details page. As you have a few, I would contact your gp to see which one you are under. If you are close to a few, and they have different criteria, it may be possible to register with another gp in another catchment. But only if you live fairly close! Xx
Hi Emmyeve, this sounds really unfair, I’m starting my NHS funded cycle of IVF with an AMH of 1.4. The AMH range for my age (38) is 5.5 to 37.4. In fact this is the range for 35-39 year olds. I’m very aware that this is a very low AMH, my antral follicle count was 5 for both ovaries and my FSH was 13. They have only given me a 10% chance of success and have told me if I use a donor egg I would have a 50% chance of success. I have my baseline scan tomorrow and hopefully all going well I will start my injections tomorrow. If I were you I would ask for a written explanation as to why you are not eligible for NHS funding. Just to see it in black & white as in my experience some of the medical professionals I’ve seen aren’t good communicators. It may very well be due to your location & clinic, I was told I was very lucky that my clinic will let me have IVF, sadly, it is a bit of a post code lottery. Wishing you lots of luck Cx
Hi my local CCG's guidelines state that in order to qualify for nhs funded ivf, AMH has to be 5.4 and above. Mine was low for my age at 3.0 when it was first tested to see whether I was eligible for nhs ivf, literally every other test they carried out came back fine and within normal range. It was tested further where it went down to 2.3 and at this point I was turned away with no help or support. Following a private round of ivf, my AMH raised to 7.5 and the last test showed it at 6.2. I am now finally eligible for nhs funding after 2 years. I agree with you that it's not fair that those who are affected by low AMH are not getting help and support. During my private cycle I managed to get 6 eggs, 5 fertilised and were top quality embryos and I had 3 of them that went to day 5 blastocysts with 1 top quality blastocyst being put back in me. Unfortunately I was left with nothing to freeze after it all and my little embryo didn't stick. But I'm going on and I hope to start a cycle within the next month or two. If you want to check the guidelines for your area you need to look on the net for your local CCG's guidelines on assisted reproductive therapies. Nice states that AMH shouldnt change on a month by month basis, but mine did change in the space of 2 months and 3 months and AMH shouldn't increase, but mine did! Good luck with your CCG xx
Lots of people have asked me what did I do but I literally did nothing! If there was something I did and could use it, I would probably be quite wealthy now, if only 😊 My nhs consultant did re run my AMH test, she said that she had had patients who were tested and got low results and when re tested their results came back fine. Unfortunately for me, when she did re test, they came back lower and that's when we got turned down, so if you go for a re test prepare yourself for results going either way (or staying the same). As your result is 0.1 below what they say they want, could you ask for them to make a special case for you? May be worth a try xx
I had a normal round of ivf with nafarline nasal spray, menopur stims, my trigger was ovitrell and i had cyclogest pessaries. My consultant at the time said that basically there is not enough evidence to determine why AMH does increase. He said that because my first 2 blood tests were done in an NHS lab it could be that their testing conditions are different to the lab at the private clinic. This whole thing is a minefield xx
The ccg's tend to hide their websites rather well. If you know the area you live in/registered with a gp in I would Google that area with ccg on the end. It took me a lot of going through pages that were nothing to do with my ccg to find my ccg's details. I have no idea why there is not a link on every gp surgery's website and every hospital trust's website to the ccg they are governed by. My theory is they don't want people to find out this information (there wasn't any information on my gp's website or local hospital). Another thing I don't understand is that when I was referred to the nhs for ivf, no one told me about the guidelines or told me where I could access them. It wasn't until they started undertaking tests that the the ivf consultant started talking about the guidelines and I located these myself. If you need any help pm me and i can always see what I can find xx
Ooooo this makes me so angry. Why can’t our country be consistant? My FSH was 18 and my AMH was less than 2! I still got ivf.... even though we knew the chance of it working were slim!
I’m really sorry our nhs system is making an already difficult journey for you even more difficult. Can you check out a hospital in a nearby other area that might fall in to a catchment area for you? Lots of ladies here drive an hour etc to be seen. x
To be honest the hospital I’m talking about isn’t my area , it’s just the hospital where I had my op and where my surgeon is based so I was just going through her as I didn’t realise different clinics had different criteria. So job one today is for me to contact all my local CCG’s and ask for their nhs funded ivf treatment criteria. Sigh! Thanks for the reply x
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