Massive amh drop, in total despair

[Joeysjourney]

Well my lovely friends, after my last cancelled cycle where my body didn't respond to the drugs, now we know why. My amh has dropped from 16.7 to 2.2 inside 14 months.

I'm lost for words, as was my Dr who said he's only ever seen this once before. I mean it was hard enough to get pregnant, but what does this mean for me now.

I just can't catch a break.

All advice and support welcome as I just want to curl up in bed and never get up. Is it worth trying again? Is my body trying to tell me something

[Anim88]

from what I understand, is that fluctuations happen, and it might go up. this is something no doctor seems to admit, yet blood tests from other people I know and on forums like this one, post their results and they vary month to month.

Also I heard someone saying something that put things into perspective for me. Having a low AMH does not necessarily mean you have low ovarian reserve, but that the underlying 'system' is just running on low, sending a lower amount of eggs. With lifestyle changes this can change as well!

My advice, get another blood test, and then do it again in a year.

hope this all helps! I've also struggled with amh levels

[Joeysjourney in reply to Anim88]

Thanks for your reply. I'm just devastated and very unsure what it means for me. It's definitely accurate as my recent round and how I responded to the drugs confirms it. I'm 42 in a few weeks so I'm afraid I don't have time to wait xx

[Nenad]

hi Joey, sorry to hear this. Have they done an Antral Follicle Count as well? I find these tend to be more accurate.

I’ve had a drop too and have been wondering whether it’s a side effect of IVF…

[Joeysjourney in reply to Nenad]

No they didn't do an afc but when I had my baseline scan done during my recent round, I had 7 follicles, which was the same number as I had the previous round a year earlier when my amh was a lot higher. Is that a good indication of my afc?

[Nenad in reply to Joeysjourney]

my doctor said they look at both together, she said the afc shows how many follicles are likely to produce eggs, which in your case looks like is still 7 which is good news. Perhaps check with your consultant what they make of the AMH and AFC put together because that’s how they assess ovarian reserve xxx

[Tarasunny in reply to Joeysjourney]

I agree with Nenad, don't get too hung up on AMH. I had a cycle where I got 0 eggs, when I got my AMH checked afterwards it had dropped to 2.8 (from 7.1). I was devastated however after a baseline scan I found that my AFC was 13 (only slightly less than previously). Moved clinics, used a different protocol and got 9 eggs and 2 blasts, no BFP but definitely an improvement in response. There is still a chance, don't give up.

[Joeysjourney in reply to Tarasunny]

thank you so much for the encouragment. could i ask what your change in protocol was? my consultant is only suggesting upping my stims - wants to stick with everything else. i do trust him but just interested to see what differences you made?

thanks loads

[Tarasunny in reply to Joeysjourney]

I had a natural cycle start (short protocol), no norethisterone or prostap controlling my cycle they wondered whether my body just didn't like being suppressed. Had max dose stims plus trigger 35 hrs before collection. With my previous clinic I had it 36 to 37 hrs before and had issues with empty follicles.

[Jumpppy]

Did you test AMH on day3? Although they say you can test "any day" turns our for over 35s and LORs you can't. I had this same thing happen to me. Best I could understand when explained, your dominant egg releases hormones to kill off other follicles, which can reduces your AMH. This phenomenon occurring is a good sign that your body is working right. For those with high AMH the fluctuation is negligible so often unnoticed. For perspective I was tested right around ovulation was very low (0.4 ng/ml - below 0.5 ng/ml is consideredcompletely infertile). I was DEVASTATED! Tested day3 ~2 weeks later was fine for my age (1.25 ng/ml - 39yo). Unfortunately for me only the low one was reported (was on mega stims protocol likely was a consideration for why I was being pushed to DEs) and the follow-up wasn't reported until a second opinion requested all results and we saw they tested twice and the big change. I was retested twice day 1-3 and was consistently ~1.25 ng/ml.

Agree with Anim88 and Nenad that AMH this should be looked at with AFC (mine was 15-30) and FSH (mine was below 6.5) to give an accurate picture of chance for success. AMH is just one indicator.

[Joeysjourney in reply to Jumpppy]

Thanks for the reply and sorry the same thing has happened to you.

I think my result is just about accurate as my recent stims round supports that amh level.

I've asked the clinic if I need another afc done and I'll also ask tomorrow re fsh. Thanks for the prompt.

Just very scared for the future now x

[jengi]

Hello! I’m so so sorry to hear about your AMH result. I recieved a low AMH result when I was 38 so I know how devastating it is. I cried for weeks. Please pm me if you need some support. There are options. What options have your clinic given you? Sending massive big hugs.

[Joeysjourney in reply to jengi]

thank you so much. sorry its happened to you too. i will PM you xxx

[minnesota_girl]

Hello - I'm sorry as I'm sure this feels like another crazy blow - I know it's hard to have low AMH (I do also). One thing to say is that I've known others achieve success with AMH lower than yours through embryo banking? Eg 3 egg collections in a row to then create a larger pool of embryos to take to 5 day...may be worth speaking to a clinic about this option?

[Skittles11]

Agree with the other comments that it is most useful to look at AMH in conjunction with the other measures particularly antral follicle count. I know how tough it is hearing these lower numbers, I found it very hard. Embryo banking was suggested to me to try and batch embryos over a period of time to try and get a group xx

[Joeysjourney in reply to Skittles11]

Thank you so much skittles. So would you not count my last baseline scan as an afc count? And if you would, do you think that's low?

I have asked the clinic about repeating it but I assume that my conversation with my consultant where he outlined my projects took that into account but perhaps it didn't!

[Skittles11 in reply to Joeysjourney]

I think probably the baseline count is the antral follicle count. I have had varied number of follicles show up at baseline so it is a good general indicator but even that can vary month to month a little.

I think when you have had a sudden change in prognosis it's gonna take the wind out of your sails. Despite the fact that the results are on the lower side, I have seen so many people having great outcomes with lower AMH. However you may also want to repeat the test alongside FSH perhaps. I have had two AMH results albeit at different labs, they were six months apart and the one done at a later point in time was higher than the one done at an earlier stage. So it can vary as well xx

[Joeysjourney in reply to Skittles11]

thank you lots. yes totally right, its the suddenness of it and the rareness thats thrown me completely. and i meant prospects above, rather than projects lol i asked for an assessment from him but hes basically said its still the same as before 15-20% chance of success - i assume he means that if a good egg is in there, it will come out whether ive 15 eggs or 2........not entirely sure.

Sorry just so new to all this. i know all is not lost but its a tough old journey

[Skittles11 in reply to Joeysjourney]

When you fall on the unfortunate side of statistics it can be like a punch in the face. I got no eggs in my first ever egg collection and afterwards the doctor who broke the news to me kept telling me he'd never seen this before and like you, the comment completely threw me and I didn't know what to think.

If chances are similar to before I would perhaps see what changes they would make with this new information and decide upon your path from there xx

[Catswhiskers1]

if it helps, I was devastated last year when they told me I had AMH of 0.4ng/ml and AFC of 4. Apparently my left ovary looks menopausal and doesn’t respond to stims. Only positive things were FSH 6.3 and they said age was on my side at 34. Given a 10% chance of success. Now I hesitated writing this as worried about tempting fate, but I got 3 eggs, which made two blasts on my first round, a BFP and have my 7 week scan tomorrow. I was sure I was going to need donor eggs and just viewed this try as a box ticking before probably moving on, but you just never know, despite all the numbers. As everyone kept saying- it does only take one good egg x sorry to everyone else that had the bad news and it didn’t work out, I almost feel guilty it went well for me first time (so far), although to be honest I am so worried it’s going to go wrong still as it seems to good to be true. Just wanted to let you know though even with bad numbers you can be successful.

[Joeysjourney in reply to Catswhiskers1]

Aw what a lovely turnaround for you. Don't ever feel guilty, you and all of us deserve it!! Thanks for the encouragement. I must be a glutton for punishment as I'm going again in a few weeks. Collection number 4 here we go x

[Missorla]

I have a similar story, I started with normal AMH for my age (36 at the time) and within months it had dropped to very low. My AFC was however better than the AMH would suggest and I have now done 3 collections and can tell you that AFC was always a good indicator to how many eggs I will get - for eg. my latest AFC (June 2022) was 11 and I had a collection this week and they collected 8 eggs. I've always been on maximums stim dose, so if your doctor is talking about increasing the dose it sounds like you are not, so maybe why you had less eggs? Please don't be discouraged, I cried for days because of my AMH and that is only a small part of a bigger story. Good luck XXXX

[Joeysjourney in reply to Missorla]

Thanks so much for the reply and so sorry you had this happen to you as well. Yes so my recent round protocol (when we assumed my amh was still high) was geared towards stopping me over responding (the irony) so i was on a lower dose.

This time my protocol, knowing my new amh, my Dr wants to increase the dose, but not max dose, just to 300. I did challenge him about it but he said he wants to just concentrate on a few. I am a bit worried about that.

[Missorla in reply to Joeysjourney]

Have you thought about consulting a different clinic? I've always been on max dose, even when my AMH was adequate for my age! Lots of experiments mean lots of money for the clinic no?

[TopGuntastic]

AMH can fluctuate. And, it’s only an indication of your reserve. I’m 40 turning 41 so understand the worry it brings. My consultant told me it only takes one mature egg, fertilised and to blastocyst… I’m hanging onto that, so should you x