Low AMH with PCOS?: Hello, I have just had... - PCOS UK (Verity)

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Low AMH with PCOS?

CoralCats profile image
29 Replies

Hello,

I have just had my AMH blood test results back and it's 15.2 pmol - low fertility.

I'm 28 and the NHS says this is the 10th percentile for my age range and median for a 35-39 year old.

The nurse has said it could be early menopause, but not to worry as 5 pmol is the minimum for IVF if I've considered this and they'll just double my dose of Clomid/Letrozole. My gynecologist is on holiday so I feel overwhelmed and upset about this and what it means.

I thought people with PCOS had high AMH levels and I don't know what low AMH levels mean - does it mean I'll struggle falling pregnant or won't have as many years to fall pregnant? & should I jump straight to IVF rather than Clomid/Letrozole?

Any help would be appreciated!

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29 Replies
Bluelady-sing profile image
Bluelady-sing

We can be prone to hyperstimulation

CoralCats profile image
CoralCats in reply to Bluelady-sing

Hello,I discussed OHSS with the gynecologist a while back and he said they'd start me on the lowest dose, monitor me and increase the dose if needed. But now that my AMH result is back and it's low, the nurse has said they'll start me on a higher dose so I'm feeling anxious and waiting for the gynecologist to get back from hols to understand more!

Thanks

Bluelady-sing profile image
Bluelady-sing in reply to CoralCats

What meds are they giving you

CoralCats profile image
CoralCats in reply to Bluelady-sing

They were planning to give me Clomid or Letrozole and maybe with Metformin but that was before this test result came back and now I'm not sure what's best going forward!

AVN1 profile image
AVN1 in reply to CoralCats

Hello! Sorry I don’t know much about the AMH results as not sure whether I had this checked or not but just wanted to say if you are offered clomid and it doesn’t work, definitely push to try Metformin...this was and still is my miracle drug and allowed me to get pregnant twice and have normal periods even though the doctors can’t really explain why I should need it! Good luck with everything 😊

Bluelady-sing profile image
Bluelady-sing

I see, it depends what is the actual problem is it lack of eggs or poor quality, presumably these meds are to help boost eggs supply

I wander if IVF would be quicker, for your age what is the percentage success?

CoralCats profile image
CoralCats in reply to Bluelady-sing

I'm not too sure on my egg quality - do you know if there's a way to test this?

I'm in my late 20s so I think the IVF success rates would be higher but I understand with low AMH this lowers the quantity and quality of eggs.

Bluelady-sing profile image
Bluelady-sing in reply to CoralCats

The AMH tells them this, what was your AMH?

Bluelady-sing profile image
Bluelady-sing in reply to Bluelady-sing

The meds might boost the number of eggs not quality

CoralCats profile image
CoralCats in reply to Bluelady-sing

My AMH was 15.2 pmol which is low fertility apparently. The gynaecologist I usually deal with is on holiday so I'm not sure what this means for the best next steps

Bluelady-sing profile image
Bluelady-sing

Usually people have false- positives a high AMH . How many follicles did you have on the scan on either day 9 or day 14 of your cycle? Pre post treatment?

Bluelady-sing profile image
Bluelady-sing

What is your bmi?

CoralCats profile image
CoralCats in reply to Bluelady-sing

My BMI is around 22

Bluelady-sing profile image
Bluelady-sing

As your 28 I am not sure, you have up 44 with own eggs 50 with a Donor I am 44 just finding all this out, my day 21 has increased since the last check at 42. ( from 21mmnols to 55mmols)

I currently have no partner I found two clinic willing to treat with own eggs.

I just need the money I have pcos, with midcycle bleeding, my Pap smear is fine, the Gp wants to check my fsh LH, this is a feature of pcos

CoralCats profile image
CoralCats in reply to Bluelady-sing

Best of luck to you! Everything's new to me too so I don't really understand what the results mean. My FSH & LH were in the normal range but had these done November last year so they could have changed I guess. It's hard to know the impact PCOS has on all of this, it's overwhelming and I feel there's a lack of information to understand the results and best course of action x

Bluelady-sing profile image
Bluelady-sing

Day 21 of your menstrual cycle E 1 progesterone tell you have ovulated.Over 30mmnols tells me you have ovulated. The higher the number also egg quality.

As I am having midcycle bleeding from day 9- 15 I suspect the lutienising hormone is problem.

That is after the egg is released to maintain the lining

Harder to treat.

What did scan show about the lining?

Any polips fibroid?

What was your AMH before the current treatment?

And now?

Did the treatment change the numbers at all?

CoralCats profile image
CoralCats in reply to Bluelady-sing

Thanks for this - it's good to know progesterone levels show egg quality.

The day 21 progesterone test showed that I didn't ovulate. I don't believe I was given the number. Do you think this would still show the egg quality if I didn't ovulate?

Sorry to hear about your mid-cycle bleeding - finger's crossed it can be treated.

They said I had polycystic ovaries although everything else was ok. I've only had the 1 AMH test which shows low - so I'm not sure how this has changed during this time.

Bluelady-sing profile image
Bluelady-sing

If the numbers have increased the AMH post treatment then maybe this Nurse is right.You mentioned the Gynae being on holiday, presumably once they are back.

Are you being treated by the NHS?

CoralCats profile image
CoralCats in reply to Bluelady-sing

Yes, I'm being treated by the NHS although it's been a very long process where I've been forgotten about, struggled booking tests in, and and I'm not very happy with the service. There's a mailbox that I contact for queries but then I get a call back from receptionists/nurses having a go at me for raising anything, as though the gynecologist is too busy and I'm wasting his time. They're very patronizing and expect me to understand what this all means, to not ask questions and to not be upset about the results.

Are you being treated by the NHS? I considered going private and contacted Create Fertility a while ago but they said I'd need to have all of the tests done again and some were really awful i.e. HyCoSy and seems like a waste of the past 9 months of tests!

Bluelady-sing profile image
Bluelady-sing in reply to CoralCats

It sounds awful.. to be kept in the dark about something so important

Where in the world are you? Are you being treated by a gynae in an clinic ie fertility clinic

As I am 44 I will have to go private, the private sector used to precarious- but now it is the reverse.

I can DM my whole NHS story, started 2003 and ended in formal complaints in 2011.

Not cheap though

CoralCats profile image
CoralCats in reply to Bluelady-sing

I'm based in Kent and being treated by a gynecologist in a NHS hospital.

Oh no, so sorry to hear that you've had a bad experience with the NHS and especially going back to 2003!

I do feel like a lot of time has been wasted with the NHS, it's taken 9 months just to have the tests needed before starting ovulation induction. I will try these meds for the next 6 months and then we might need to go private for any further treatments!

Bluelady-sing profile image
Bluelady-sing

A repeat of tests might give you a different opinion, you could do this anyway get a second opinion.

CoralCats profile image
CoralCats in reply to Bluelady-sing

Yes, I was thinking this as I've read on this forum that results can change month to month.

I found out that I have a benefit at work that gives me a second opinion for medical conditions so I'm going to try that and see what they make of all these results.

I'd ideally like to repeat the test but I'll maybe do that if these meds don't work for the next 6 cycles and perhaps go private!

Bluelady-sing profile image
Bluelady-sing

In my case I am going private for an opinion scans and tests, the official success rate is 2% of natural.

Less than 1% they will push for donor eggs at my age if I do not insist

CoralCats profile image
CoralCats in reply to Bluelady-sing

Best of luck to you xx

I've been told we have 'not zero but a very low' chance of success conceiving naturally :( they wouldn't give me a percentage but were basically saying no chance but miracles happen

JoyfulStar profile image
JoyfulStar

Hi Coralcats, I have been reading your posts above and I am sorry for what you are going through. I did not respond sooner as I have no experience of low AMH or PCOS so could not give you specific advice.

I can understand your frustration about the NHS clinic not providing you with enough information and I have used NHS clinics although I paid for my IVF. They tend to give minimal information so I had to do my own research elsewhere. It certainly helped me feel more in control.

Have you tried researching books, podcasts or even YouTube videos? There is a useful fertility expert on YouTube called the Egg Whisperer who covers all sorts of IVF topics in a very easy to understand way. She is American so her treatment options may not be available here but she does go through the basics in a very engaging way. You can google Egg Whisperer and PCOS or any other topic you want to explore.,

I also found these podcasts

play.acast.com/s/bigfatnega...

I hope you find the answers you are looking for and all the best with your journey 🙏🏾

CoralCats profile image
CoralCats in reply to JoyfulStar

Hello,

Thank you for this.

I've been doing lots of research and watched a few Egg Whisperer videos but I haven't been able to find information about low AMH results and PCOS. Everywhere seems to say people with PCOS will have high AMH. The gynecologist is adamant I have PCOS based on other symptoms but it does make me question the diagnosis...

JoyfulStar profile image
JoyfulStar in reply to CoralCats

Perhaps get a second opinion? It may put your mind at ease…

Bluelady-sing profile image
Bluelady-sing

Presumably a egg donor would increase such chances, I have been told 2% based on my age

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