Really low AMH - Do I get multiple opinions?

[firflet]

I am 30 years old and found out I have a very low AMH level of 0.28 - that is in the Very Low/Undetectable level. I had my first fertility appointment yesterday and had the vaginal ultrasound which confirmed the AMH findings. The doctor said that because my levels are so low I should do a few rounds of IVF as soon as possible. Obviously this is a very expensive plan but I know I want babies so I will do what I have to.

My question is - Should I get a second AMH test and/or a see a second doctor? My insurance doesn't cover any of this so each appointment is about $250 and if I go down this path, every dollar counts, so I only want to do have a second opinion if there is a chance I will get other findings/have other options.

Finally - anyone out there with an AMH level near mine that can give me any insight on what they have gone through?

Thanks in advance for any insight.

[SC-Impatient_in_VA]

If the low AMH was confirmed via u/s, then "how low" doesn't really matter much. You might get a slightly higher result from another doctor's lab, but no lab can change how many are identified each month by ultrasound. If your insurance won't cover IUIs, then it's a good idea to move straight to IVF.

EDIT: I forgot to mention that due to your age, your chances of having good eggs, even if very few of them, are pretty high. Go for it now rather than later so you can hopefully "bank" babies.

[TTCyears]

I always get a second opinion.

When AFC (antral follicle count) or AMH is super low I've heard folks consider mini-IVFs (or even IUI) rather than than by-the-book IVF.

AMH is not supposed to change much (nor AFC), but I've seen that they do. There is someone of another board that took a vitamin regime and her AMH and AFC both tripled. She did this under the care of a world-reknown clinic to optimize an IVF cycle.

GL!

[jenga12576]

i probably wouldn't pay to have your amh checked again right now... maybe after taking dhea or something, but it really isn't going to change much without doing anything.. basically it just tells you you are running out of time, much faster than a normal 30 year old. As posted above though, it doens't mean you don't have healthy eggs, it just means you don't have a lot.

WARNING pregnancy /success mentioned
At age 34 i was diagnosed with an amh level of 0.5.... at that point i was told donor egg... DON"T let that freak you... since that time i have found success with IVF and naturally AND we have severe male factor infertility, the reason for IVF in the first place.

I know a woman who was 39 with an amh level of 0.1 who had success with IVF and had a healthy daughter .

THE KEY here is that you have a very important piece of information that can help a good doctor really help you have children. YOU CAN have a baby naturally, but time will run out fast.... I would probably suggest finding a very reputable clinic that would do a bunch of ivf cycles and retrieve and freeze eggs, back to back cycles. Because those eggs will still be that age at time of retrieval. This is if you want to have more than one child. Because your amh level is low in all likely hood you will be a poor responder, you may get a few eggs, you may get 6 eggs... you won't know unless you do it. But you could always surprise everyone and get a dozen.. I DID THAT TOO

Otherwise i would still talk to a doctor, get a few more labs, consider taking DHEA if a doctor thinks you should, then chart your cycles and BD like crazy at and around LH surge. Or even IUI... b/c you are bypassing the cervix that way.

I was recently taking DHEA for an egg freezing cycle, i have done 2 previous.... i was charting and tracking my cycle so i would have a good time line for my next EPP/antagonist protocol.

WELL dh and I had sex 1 time at lh surge, and i found out 3 weeks ago i was naturally pregnant, shocked, b/c i was told this would never happen. I hope this offers you some comfort, b/c often times doctors treat a low AMH like a death sentence and IT IS NOT if you are aggressive... if i had listened to my doctors, i would have stopped in my tracks and just done donor egg, but i followed my gut and found success, i would suspect my amh level is probably around .3 by now, it has been 3 years since my last check... and i will be 37 in 2 weeks.

Jen

[firflet]

Jen - Thank you so much... you have given me hope and I need that right now.

My hope would be that I respond amazingly to treatment and we get a lot (12ish) eggs from my first round so that maybe, instead of a second round of IVF I can go the IUI route. Thoughts? Am I being a little too hopeful here?

Also - I got my FSH level back and that is a 9 which I understand is pretty good. Do you think that makes a difference at all?

[jenga12576]

Firflet- i think that an FSH of 9 is borderline, high is considered over 10, but my last one was about the same, and again i still found success. It is always nice to hope for a great response to ivf drugs. BUT this is where it is very important to go to a fertility doctor who will treat you appropriately and aggressively... your amh level says you will need max dose drugs, and most likely to stay away from lupron unless trying a microdose lupron flare protocol.. ALSO minimal suppression will be very important as well, i would probably take dhea for 3 months, and when you cycle baby aspirin, and steroids if your doctor will subscribe it for you. BUt be prepared that you will not respond well.. you want a doctor who will move forward with your ivf not cancel if you only have a few follicles. BUT I think you can get pregnant naturally... but you probably should start trying soon, tracking your cycles, using the Ovulation prediction kit, the one with the smiley face is much better at detecting. And having sex like crazy... i would have your significant other tested to make sure there is no sperm issue... you don't want to find that out too late. I am HAPPY to encourage and offer support.... when i was told my amh almost 3 years ago, and told i would NOT have a baby with my eggs i was devistated... BUT THEY WERE WRONG The thought process has changed in just a short time, yes the low amh is not good BUT having this knowledge is so important in trying now or very soon, and not finding out when it is too late.

Jen

[jenga12576]

My IVF CYCLES BELOW with severe male factor

Me age 30 -2005- long lupron - 10 eggs retreived - 2 8 cell embryos transferred day 3

Me 33- 2008- long lupron- oversuppressed- only 4-5 follicles canceled on trigger day ( right before retreival)

Me 33 1/2-2009- antagonist with birth control suppression- 6 eggs retrieved- max dose follistem 600 units 3dt of 3 embryos

me 34 1/4-2009-microdose lupron flare- max dose follistem 600 units- 6 eggs, only 3 mature- 3 embryos transferred

me 34 1/2- 2009- antagonist with NO suppression- 12 eggs retreived- max dose follistem 600 units- 3dt of 3 embryos

me 36 1/2-2011- antagonist with NO suppression- 4 eggs retreived & frozen- max dose follistem 600 units

me 36 3/4-2011- antagonist with BCP suppression- 3 eggs retrieved & frozen- max dose follistem 600 units

Me 36 about to turn 37- taking dhea for 3 months preparing for epp /antagonist protocol, natural bfp.

Jen

[lisa2103]

i have low amh .57, it has improved, i took dhea, coq forte,royal jelly, it has also lowered my fsh.trying my 4th ivf next month. good luck to all !

[BC-Medicmedic]

You might want to try wheatgrass too. I noticed a drop in my FSH after a month on it.