I recently had a laparoscopy done as part of my fertility treatment. I had the op on 1st September and was discharged the same day not being told if the op had gone well no feedback. The kind nurse that was looking after me let me sneak a look at the notes from the op. Couldn’t really read the writing. Had a phone consultation 2-4 wks after. She explained that I had a adhesion that they removed and I have mild endometriosis.
Didn’t really feel like I got the answers I needed so I went back to my GP we decided to get my AMH levels retested to see if it had changed since the op.... it’s October now I get my results back and my heart sank.... my AMH level had reduced massively! Never once was I told this was a possibility. My Amh was 4.4 when last tested in June (was also declined NHS funding as its under 5.4 pmol) it is now 0.9....
Is this normal or did I test too soon after my op? Just so confused and feel deflated by it all.
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Purplelight23
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Heya unfortunately that does happen, it did to me. Mine went from 14.9 to 4.9 (after 2 laps, but I had major surgery, endo everywhere etc). They should have told you that was a possibility before lap, it’s annoying they didn’t! I did read somewhere that it may increase a bit overtime (not sure how true it is) but in any case if you were thinking of starting ivf I would suggest get on that ASAP. Wishing you all the best x
Thank you for your reply I wish they would’ve told me the implications of having lap done as it’s purpose for me was to improve fertility. I’ve read similar articles that have said that AMH levels can increase but I can only wish pray that is the case with me too. I have had a few quotes for IVF treatment but worried that I won’t be taken on by some clinics due to my low AMH score as it effects the clinics success rate. Thanks you again wishing you all the best with your journey xxx
I have heard of quite a few women who found that their AMH levels fluctuate depending on when the test was done during their cycle. So some have suddenly much lower AMH but then it seems to go higher again. I have also read of clinicians who suggest that blood tests may be processed wrongly and this is why some women get really contradicting results. It is horrible that some NHS trust reject women on the base of AMH as there is still so much discussion about how reliable and relevant this blood test is. Some fertility experts seem to avoid the discussion as it can unnecessarily worry people. Especially in terms of natural conception it turns out not as relevant as first thought. I would use the test results to have a further discussion with your fertility consultant and not get too deflated by it all. But it is really hard- I totally understand. Take care xxx
Thank you for your reply xIt’s so hard , as the whole purpose of me being referred for fertility assessments and treatments was to improve my chances now I just feel like it won’t happen for me. Especially when I have a friend who has had 2 cycles paid for on NHS and has now fallen pregnant just wish it was me too.
Just feel like getting a second opinion but stuck on where to turn as there is little support.
I spoke to one of the fertility consultants from the same hospital to discuss my decreased AMH score and his response was very much negative... he said my GP shouldn’t of let me have my AMH test done and that he was adamant that the op hasn’t effected my score and that it changes month to month. He was so blunt to the point I couldn’t get a word in and I was in tears.
My family say I should push for as they been very negligent...
I have ordered myself all the recommended supplements today to this if can help me naturally.
Thank you for your kind words wish you all the best with your journey xxx
What you need to clarify from the consultant who did the lap is whether he went into your ovaries. If the response is no, then your AMH fell for other reasons, such as years passing, time in the cycle etc. I have a lap booked but it has been pre agreed they won’t go into my ovaries as I have already almost no egg left.
Although they say you can test AMH any cycle day, mine went from normal to VERY low because I was tested right after ovulation. When I had it tested day 3 it was consistent. RE said issue was more likely to be when I than lab issue. I'd request a retest (or two).
Thank you , definitely some good advice will look into getting another re-test or two in the upcoming months when we finally get back to some sort of normality xx
I find it so horrible how people are treated in terms of fertility issues. The NHS postcode lottery is so cruel. When I first went to the doctor for investigation it took so long to finally get taken seriously and then when I was finally referred I just turned 35 and therefore for my CCG I was too old to qualify for treatment. Because I was also moving house to a different area I was lucky that I did qualify afterall- but I felt awful that this is what people have to deal with when going through one of the most horrid things possible. I've not got a medical background but have done a lot of research in the area of endometriosis. There is a lot of emerging research (this area is hugely neglected by medical science) that is saying that endo has a massive impact on successful pregnancy chances. Removing tissue can really significantly improve your chances. So even though it may have lowered your AMH it is still really good that you got it sorted. I'm hoping to also have some investigations but I have been told I may need to have to wait up to a year before being seen. I'm 38 so have no time to waste. You have to be your own advocate and fight for getting the treatment you deserve. I have seen so many women with low AMH falling pregnant. Good luck and take care xxx
Hi Purplelight, hope you’re recovering okay from your lap.
Amh most definitely does fluctuate. I know when a laparoscopy is part of fertility treatment, the surgeon will try their absolute best to not touch the ovaries too much to preserve ovarian tissue and amh. I’ve had major endo excision surgery and massive endometriomas removed from my ovaries so that wasn’t an option for my surgeon. My amh was reduced by 50% from 14.4 to 7.2. That was two years ago. I’ve since had it retested and it’s now 15.8 🤷🏽♀️
Please try not to hold too much weight on amh tho, lovely. I personally found AFC gave a better indication of how many follicles/potential eggs I had to work with before our ivf cycle.
Just to give you some hope and keep the faith, I follow a lady on Instagram who had a similar-ish amh to yours (if not lower) and she conceived naturally twice. xxx
I needed to hear that thank you! Sometimes I get my self deep in the rabbit hole when I research stuff online and get myself hurt by focusing dwelling on the negatives. Today has most certainly been one of those days!
Hey there .. hope you are recovering well .. Amh does fluctuate for me it was 0.9 and after my second lap it was 1.4 try not to focus on the levels amh only measure the quantity and not quality ... u might not have high quantity but the ones produced are good quality .. good luck in everything❤️
Thank you for taking the time to reply , overwhelmed with all your kind words of support. It’s hard talking about these issues with friends and family as they thankfully haven’t had to experience any of our issues so tend to keep it all locked it. So thank you xx Wishing you all the best with your journey ❤️ Xxx
I find it strange that a facility would discharge you without having a discussion with you on the procedure you undertook and if they didn’t perhaps you were coming off sedation so they wanted to discuss with you at your follow up when you were all there.I feel that nurse needs to be trained better on her job as letting you sneak could have gone both ways what if there was a serious issue that was been kept from you so you could heal first.Sadly Amh/ovarian reserve does go down every time we have an invasive procedure however clearing up scars/adhesion improves your ivf chances as the embryo has less to deal with.Endo grows back quite quickly so you’ld need to plan your treatment in the next few weeks.
Did you not have a preop assessment?.Usually the doctor discusses your options and let’s you do your own research and come to a decision.
I hope you heal quickly and we get good news from you soon.
Hi Purplelight, please don’t lose your hope that your lap surgery might have not improved your fertility chances. I have also gone through similar experience. We’ve struggled to conceive for over 2 years, gone through various fertility tests to finally be diagnosed with endometriosis through the lap. We were also not eligible for IVF due to post code lottery so the lap surgery was my last hope to improve our chances of natural conception before going to private IVF clinics. I wanted to say that the important thing is that the lap diagnosed you with endo and that the surgeon removed some of the endo implants and adhesions. As in your case, I also had mild endo diagnosis. I was really hopeful after the surgery as based on few research studies, the removal of endo, does improve chances of natural conception, especially within the first 6 months after the surgery. It definitely did for us. We got pregnant in the second cycle after surgery (sadly miscarried) but it was already a sign that something has changed. Then got pregnant again 3 months after and I’m now due in 4 weeks.
The removal of endo implants hopefully also changed and improved the environment in your uterus. So please don’t lose hope and keep trying for the next few months.
Just to mention, as other people said above, there is a possibility that the laparoscopy could affect the egg reserve. In my case, endo was removed from one of the ovaries and my folicle count (AFC) dropped. I haven’t tested AMH after as also read that its level can fluctuate and might have less predictive value of your egg reserve. However, this didn’t affect my conception so I wouldn’t worry too much about that in your case. Just keep trying! I will keep my fingers crossed for you 😊
thank you for your reply, and for sharing your story with me! it gives me hope hearing that it helped you so thank you! Congratulations!! I had my Lap back in September
I know the IVF postcode is an absolute joke and soo unfair.
I have ordered myself quite a few supplements to start taking , also after being made redundant its allowed more time for self care and rest so hopefully this helps too xx
Hi, i had a lap for bilateral endometriomas, one on the outside of my ovary and a 5cm one growing from the inside, I was extremely worried about the op and affect on AMH, discussed this at length with consultant as there is a lot of evidence that suggests postponing op until after fertility treatment. I went ahead with the op and my AMH levels were not affected (14). As others have said AMH needs to be tested within a specific time frame. As a backup check, I paid for a hormone profile with Thriva after the op, although this didn't check AMH, it did check FSH, oestrogen, and others which are also important. I wanted as much info as I could to know what to work on to increase my chances. Just an idea but I found it useful as well as reassuring. Definitely get the AMH retested...Hope everything works out for you 🙂
Hi, so sorry to hear that 😔....My daughter had also added Vitamin D , Coq10, which are good for AMH . Also removed any items of foods that contain caffeine and artificial sweetener.
There is a website called Foodsforfertility.com. This has lists of certain foods that are good for different points of the cycle, ie raising egg quality, increasing womb lining etc and has some good and sensible ideas. Whoever knew the core of a pineapple had such good properties!!
My daughter has low AMH and only had 2 eggs first round neither of which were mature enough so on advice of consultant began DHEA, 12 weeks ago , increased all the appropriate vitamins and we looked at the superfoods. Chia seeds, Goji berries dried, Brazil nuts, Walnuts, Blueberries, and Pomegranate seeds and juice. She is currently going in tomorrow for egg collection tomorrow with 11 follicles this time. Who knows what will happen but she feels the change in her diet has played a big part and they also said her womb lining looked amazing ( should she get that far) . As I say to her all you can do is try and throw everything you can at it.
I so desperately hope you and all the lovely girls on this group will have successes....... good luck and hope this helps in some way
thank you for sharing I just had a quick look at the website looks amazing and jam packed with useful information.
I have ordered Co10, DHA, folic from amazon should hopefully be here this week. Im also on the hunt for DHEA but quite pricey not widely available in the UK where did you purchase your daughters from?
thats amazing outcome for your daughter!! so happy for her il have my fingers and toes crossed for you wishing all the best thank you for sharing your story with me means so much!!
Hi thankyou for the kind words. Don’t forget Omega 3 too.... that has really helped too. She doesnt eat fish so was a good benefit .She got hers from the Zen clinic in London. It had to be on a prescription which her clinic faxed to them and she then paid by phone. It was micronised which is supposed to not give as many side effects. She had none. She had to phone them initially and enquire about it .
Im glad you found the website helpful....... sometimes the small things can make a big difference . Xxx
Hey I am sorry to hear that it decreased that much but it only is affected by lap if they touched your Ovaries. My surgeon talked to me before lap and we decided her not to touch ovaries and only in and around pelvic and uterus to preserve fertility.
But I can tell you the AMH is not always decreasing by age and probably that’s right that it fluctuate sometime( although not in very big amounts) because I did test after a year and almost 4/5 month after my lap and it did not change much from the year before which was surprising for me specially in Forties as they say it reduces drastically every few month!
You can work on the quality of eggs as it is more important than quantity to be honost.
I read so many research on myo inositol specially if you have higher testosterone although it reduces the AFD after longer use but in short time it increase the quality I believe.
Me and my husband both used it and in the very first ivf after a month on myo inositol and D-chiro we had only 2 eggs retrieved but both were mature and turned to top blastocysts.
But definately talk to your RE before using these type of supplements bcuz they are not for everyone and you need to all your hormones being tested includjng Testostrone, Free Tes., insulin fasting, Sex binding hormones.. etc.
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I wish they would’ve told me the implications of having lap done as it’s purpose for me was to improve fertility. I’ve read similar articles that have said that AMH levels can increase but I can only wish pray that is the case with me too. I have had a few quotes for IVF treatment but worried that I won’t be taken on by some clinics due to my low AMH score as it effects the clinics success rate. Thanks you again wishing you all the best with your journey xxx 
Anyone experienced a dramatic AMH drop?
Has anyone else experienced spotting
AMH level has risen 
Normal AMH level at 40
Has anyone had a second AMH test and seen a positive increase?
