# Understanding AMH Results



## Mrs Thomas (Jan 19, 2009)

Hi all,

I was advised to have an AMH blood test after a poor response on long protocol on my first IVF (after 3 unsuccessful IUI's). I received the results this afternoon as 8.31 when the clinic said that anything below 15 is poor fertility, I am 36 years old. I am currently on a break from treatment and was hoping to start IVF again in July/August.

Can anyone please advise on this because I have read that anything under 15 is low fertility but also read in other articles that between 5 and 15 is normal. I am now really worried that I will be unable to get a good chance of IVF success. I wasn't expecting the result so didnt really ask many questions. What does this mean ? Is there anything I can do other than have a higher dose of drugs to help ?

Thanks,

Mrs T


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## popsi (Oct 11, 2007)

Mrs Thomas

I am sorry about your results, i dont know what it means, but i know there are two scales which they measure AMH on.. i would suggest you pop on over to the link below as the ladies there are so knowledgeble on this subject its amazing the advice they can give you xx 

http://www.fertilityfriends.co.uk/forum/index.php?topic=194954.720


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## kara76 (Dec 14, 2004)

Mrs T 

I am so sorry you have had a poor results

There is different scales out there and it really depends what scale your clinic use. poor fertility doesn't mean no fertility and amh can rise....mine did

i would imagine your clinic will put you on a maxium dose of drugs , what did they put you on before?

if anything amh gives them a guide on stimmulation yet doesn't tell them egg quaility, fsh is better for that , so ive read

im begining to think AMH is purely a fashionable test that isn't worth anything, i have a good amh yet responsed worst than someone with alot lower amh.

you could also talk to your clinic about DHEA as this is thought to help poor responders

do you have appointment booked with your clinic?


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## Mrs Thomas (Jan 19, 2009)

Hey Kara, was hoping you would come along..

They said that normal results would be at least 15 if that helps with the scale. On my IVF attempt I was on long protocol at 200 of Puregon. I'm not sure what the maximum dosage is.

I am due to have my FSH test next cycle.

What is DHEA ?


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## kara76 (Dec 14, 2004)

did you get any follicles?

that is a lowest dose, short protocol with high dose drugs sounds the way forward depending on how you response last time


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## kara76 (Dec 14, 2004)

http://www.tdlpathology.com/index.php?option=com_content&task=view&id=201&Itemid=73

this could be the scale your clinic use

*PLEASE NOTE IVF WALES DOES NOT USE THIS SCALE*

/links


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## Mrs Thomas (Jan 19, 2009)

I converted to IUI after getting only 2 follicles. It was already the plan to change to short protocol. Do you think there is still hope ?


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## kara76 (Dec 14, 2004)

there is always hope hunni

do you know what dose of drugs they are using?


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## kara76 (Dec 14, 2004)

http://www.fertilityfriends.co.uk/forum/index.php?topic=169391.0

here is our thread on DHEA

i have seen lots of ladies with lower amh levels go on and have healthy babies. Hopefully your clinic will get your protocol right now

is it true LWC only use puregon?


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## Mrs Thomas (Jan 19, 2009)

Thanks again Kara, best of luck for tomorrow. 

I'm not sure about the Puregon, they did say they might be switching to Menopur ?


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## kara76 (Dec 14, 2004)

when is your next clinic appointment?

you said your having your fsh done, have you had it tested before?


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## Mrs Thomas (Jan 19, 2009)

Havent booked my next appt until I have sorted out my pain so still on hold. I'm sure I had FSH tested when I first joined the clinic and it was OK but the doctor at my follow up asked that I have FSH and AMH tests. I just missed the right point in the cycle for the FSH test this time


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## annacameron (Dec 16, 2008)

best thing to do is to look up little jen's posting on this test. 

she has done ahuge amount of analysis, much more than any cons i have ever met and she knows it inside out. 

try poor respodners thread to get her name...


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## kara76 (Dec 14, 2004)

amh is thought to be better because it doesn't go up and down, or shouldn't

my fsh is ok but i have had one bad result. it can change from month to month. 

mention to jackie about your amh level to as acunpucture can help so im told


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## Mrs Thomas (Jan 19, 2009)

Yes, I'll ask Jackie next week. 

Did you ask at the clinic why your AMH increased ?


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## kara76 (Dec 14, 2004)

i did and they could answer why and how lol


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## PixTrix (Aug 20, 2008)

just wanted to add that my AMH is 30 and so they put me on a low dose of stims as with an AMH of 30 I should have responded very well. Well on low dose didn't respond at all good and got converted to IUI. I was told that the AMH hasn't proved reliable. On normal dose of stims next cycle so will see what happens then.


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## kara76 (Dec 14, 2004)

my amh is 11.4 and my cycle has just been abandoned due to poor response , 2 follicles

i spoke to debs today and she said it is usually a very good indicator yet sometimes there is someone like me or pix , most of the time its a good guide


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## Mrs Thomas (Jan 19, 2009)

Thanks for all your responses girls, I have managed to get a follow up with the Dr next Friday to discuss my AMH & poor response. I have been thinking about some questions for the appt and have these so far :

Does my low AMH explain why I have not conceived naturally or with IUI or is it just an indicator of my poor response to the first IVF

Should I have my FSH checked again, it was normal before, if so on what day of cycle

What egg count do you think I can achieve by increasing the stimms dosage (started on 200 last attempt), what are the chances of success now ? Is switching from long protocol to short going to be enough ?

Can I / Should I take the following which have been recommended by various people in the hope of a better response :
- Omega 3 supplements
- Agnus castus
- Baby aspirin
- L'Arginine
- DHEA

I am planning to use acupuncture on my next cycle, will this help ?

Are there any other tests I should have ?

When do I need to consider immune testing ?

I would be grateful if any of you can suggest adding to my questions

Thanks, Mrs T


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## Laura36 (Jun 27, 2007)

Hi Mrs T,
My AMH is 2.3 which is terrible (almost in the undetectable range) yet on the IVF cycle when I got it tested I had 5 follies, 2 embies and a BFP.  However since then I've been converted to IUI as only 1 follie. 
I started DHEA in April but my next tx isnt til July/Aug so will wait and see if it works.
I took baby aspirin on my last cylce and did reflexology but don't think it made any difference - was worse than previous cycle by a long stretch.

My successful cycle was Long Prot on max dose of menopur (450). My last cycle was on same dose and also LP.  I'll be doing SP this time but still taking menopur (450).

As for acupuncture, agnus castus this is personal choice.  I had 2 years of these before starting proper tx and spent loads of money and nothing improved.  For me I feel it wasted time but loads find acu helps.  At least it's very relaxing.  I did reflexology last time for that and it was lovely.  Although I'm not convinved it made any difference.

I don't know about immune testing. Have you only had 1 IVF so far?

Hope this helps.  I think clinics vary in what they suggest though.
Good luck.


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## Mrs Thomas (Jan 19, 2009)

Thanks Cardifflaura, you give me hope. Not succeeded in any IVF's, after 3 IUIs my first IVF was converted to IUI after only getting 2 follies.


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## kara76 (Dec 14, 2004)

hun i think these are good questions and can you ask your con?

Does my low AMH explain why I have not conceived naturally or with IUI or is it just an indicator of my poor response to the first IVF
possible, amh tends to indicate ovarian reserved not quaility though

Should I have my FSH checked again, it was normal before, if so on what day of cycle
yes on day 1 to 3, your gp should do this for free

What egg count do you think I can achieve by increasing the stimms dosage (started on 200 last attempt), what are the chances of success now ? Is switching from long protocol to short going to be enough ?
i don't think anyone can answer this, ivf is trial and error hun

Can I / Should I take the following which have been recommended by various people in the hope of a better response :
- Omega 3 supplements
- Agnus castus
- Baby aspirin
- L'Arginine
- DHEA
i take omega 3, dhea would probably help you and again you need your con to know your taking this and also you need to take it 3 months prior to ec.

I am planning to use acupuncture on my next cycle, will this help ?
it helps some people

Are there any other tests I should have ?
you could have a antral follicle count!

When do I need to consider immune testing 
i personally wouldnt consider this til after a few failed cycle and then it depends on how you personally feel about the test and treatment that are involved

Do the LWC back you up on any other tests and DHEA?


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## Mrs Thomas (Jan 19, 2009)

Wow Kara, I dont need to go for my appointment after all, lol ! It's much cheaper getting advice from you !

I'm not sure what their view is on DHEA etc, I dont expect that they will encourage it but if they have no objection I will take it anyway, wort a go and I seem to have seen loads of poor responders get BFP on IVF or even naturally.


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## kara76 (Dec 14, 2004)

your as mad as the rest of us mrs T lol

there are so many success stories out there for poor responsders and low amh levels, keep reading the postive and ignore the negative


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## Laura36 (Jun 27, 2007)

I might get my AMH retested girls.  What do you think? I know they say it can't change but Kara yours did and I've read that others increased after taking DHEA too.
Do you think the clinic will charge?


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## kara76 (Dec 14, 2004)

hiya hun

JE told me the AMH can fluctuate a little!

im pretty sure you wouldn't get charged yet it takes around 6 weeks to get the results (i think)


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## Mrs Thomas (Jan 19, 2009)

Here are my answers to the follow up :

Does my low AMH explain why I have not conceived naturally or with IUI or is it just an indicator of my poor response to the first IVF. Just an indicator of reserves and with poor response reiterates the need to change the protocol.

Should I have my FSH checked again, it was normal before, if so on what day of cycle. Previously was 5.4, dont need to retest as now know enough to change the protocol

What egg count do you think I can achieve by increasing the stimms dosage (started on 200 last attempt), what are the chances of success now ? Is switching from long protocol to short going to be enough ? Expect that changing to short protocol on 450 dose of menpur should be enough to give enough eggs. Would be happy with say 6 eggs but delighted if we can get any more

Can I / Should I take the following which have been recommended by various people in the hope of a better response :
- Omega 3 supplements. Not necessary ? Why have others been recommended it then, i forgot to ask !

- DHEA. Because it is under trial the clinic dont recommend it but are happy for mr to take it if I want

I am planning to use acupuncture on my next cycle, will this help ? Happy for me to do it

Are there any other tests I should have ? Antral follicle count will be done as part of scans

When do I need to consider immune testing ? Forgot to ask this one !

So I feel a lot more hopeful with all the support from you girls and the follow up response, following my need to have an operation due to my dodgy leg I will probably now have to wait until September for the next attempt

Thanks, Mrs T
[/quote]


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## kara76 (Dec 14, 2004)

im glad your happy with how things have gone hun and good luck with your op


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## miriam7 (Aug 8, 2007)

glad your questionse were answered and hope the diffrent protocol will do the trick ..sept will be here soon


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## kara76 (Dec 14, 2004)

who has had more than one AMH level done

i thought this doesn't fluctuate? well mine does

march 2008 - 9.2
december 2008 - 11.4
june 2009 - 7.5


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## Laura36 (Jun 27, 2007)

Kara, if I ask at the clinic will they let me have mine tested again?  It's a year since my last AMH test.  Just not sure they would do it for free if there was no real purpose to testing - i.e. I am on max dose.


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## buster24 (Jul 11, 2005)

hi and sorry to but in, and maybe you dont want to here my story so sorry before i start    
I went through nearly 16 years of tx, it was always my fsh levels that were checked, as in the beginning they never really did amh, anyway i always had a good fsh around 5 to 7ish, and always managed to get a few eggs that appeared to be OK grades, on my 4th attempt i got pg but MC and was devastated, i then went to Istanbul for tx discovered i had 2 large hydros and was cancelled on day we arrived, came home had bilateral salphingectomy and returned, was on huge doses of stims and got 2 rubbish eggs, so failed again, i came home went to the hospital that had been treating me and taking my money for years and asked for a amh to be carried out, it was 1.1       i was devastated, i felt i had wasted so much time and caused so much heartache, if i had know this years earlier i would have gone with donor, so that is what i did, my sister donated her eggs her amh was 17.5 which they said was excellent and we got 14 wee eggies, 1st attempt failed, on the second i moved my frosties to a new clinic as had lost heart in the clinic i had been with and got a BFP this was my 8th attempt in all and i got my adorable wee twinkles who are now 7 months old. I know there are girls who have gone on to get bfp with low amh, but for me personally i wish i Had had the test years before and had had the choice to choose whether i went down the donor route, before i spent 30k, and spent so much of my life unhappy due to fails etc. I am only telling you this as it madens me when i think of what we went through and i am sure that clinic new it was fruitless, but continued to take my money. But it was worth it in the end. wishing you all the very very best 
but dont give up there is always hope


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## kara76 (Dec 14, 2004)

laura its pointless really as it takes 4 weeks for the results

buster hiya i remember you from the hydro boards. i see your at the GRCM, this is where my amh test is done!!!! i am hoping that i can maybe find out if the rise and fall has happened to anyone else, just seems strange

love your story and i have to say that if i had to go for donor i would (probably)


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## buster24 (Jul 11, 2005)

i did have wee tiny thoughts in my mind that when the babies arrived i would think they are my sisters, although i never told anyone these thoughts, but they were rubbish and i am sure no matter where the eggs came from i would have felt the same they are mine all mine, i carried them grew them inside me, and i love them to bits, and would do it all again tomorrow.
ps GCRM are the best, is it marco you are with, he is a wee angel. my hero    
all the very best.
love kim xxx


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## kara76 (Dec 14, 2004)

no im not with the GRCM but i believe my AMH test is done in glasgow and i think it could be here

fair play buster you have been through alot of treatment and well done for getting the dream


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## buster24 (Jul 11, 2005)

all the very best kara i am sure you will get your dreamt to      
kim xx


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## Laura36 (Jun 27, 2007)

Buster, what a great story. I am at the point of having to make a decision to go with donor.  One last IVF with my own eggs coming up first though.  Then perhaps a difficult conversation with DH who thinks this is our last tx. Don't think he'll want to do anymore or do donor but that's what I would want to go for.
So lovely that you have your twins!


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## buster24 (Jul 11, 2005)

cardf my husband was the same, he didnt say yes straight away needed a wee bit convincing, but i explained the way my sister and i felt, she felt it was only a few wee cells she was giving to me, that she flushed away most months, dh and i would be the ones that would make them a baby, also she said if i had needed blood she would give it or a kidney bit extreme but you know what i mean. and do you know as soon as sister had had her et, he never felt like they werent ours from that moment on, as it was then just us going to the hospital etc. wish you all the best and hope it works with your own wee eggs this time and you dont even need to think about the next option       
love kim xx


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