I thought I would write a blog on what is becoming so common in this day and age: your Doctor tells you, “I’m sorry, your AMH (anti-müllerian hormone) is low, you’ll need IVF to have a baby.” You look in the mirror and think f* well I look young but here you are telling me my downstairs has effectively shut up shop.
Let me begin with a quote from a very awesome book I read “A woman is born with all the eggs she has in her life.” ….. “ok but I was born with only the two arms I will have for my entire life and they work fine thank you.”
So what is AMH testing? AMH is a blood test completed to essentially tell you how many eggs you have ‘in the bank.’ There is some trouble with this, let’s make up a figure and say you have low egg reserve, say 5,000 eggs, while another woman your age has 10,000 according to her AMH results.
Basic reproductive anatomy tells us as a woman ages that yes her egg reserve declines. This is by FAR from the problem. While you may have 5,000 and the next woman 10,000, this does NOT tell you the quality of those eggs. As we decline with age, so too does our egg quality. Going back to our two women, Miss 5k and Miss 10k, each will only produce one, mayyyyybe two eggs per month no matter if you’re banking 5k or 10k, that stays the same. Do you get where I am going here… If Miss 10k has all these delightful eggs but they are chromosomally abnormal, we could actually say Miss 5k is more likely to get pregnant with her one egg each month that is chromosomally normal.
Feel better? don’t let blood work and Doctors scare you before you do research for yourself. I have had very young friends in their mid 20’s being told they have to do IVF IMMEDIATELY as they have less than 5% of conceiving naturally because their AMH is so low. One was told she literally did not have time to wait three months until her wedding to begin IVF. Theoretically, a woman in her 20’s should have very high-quality eggs, even if not all that much of them. Being told this is not only disheartening and scary for some women, but also could lead them to jump into very expensive treatments, such as egg freezing, when it may not be necessary.
Let’s look at the below image. Take a 25-year-old woman, if her AMH was 15pmol there would be cause for concern and definite investigation. However, the next woman, who is 38 with an AMH of 15, we would say she has a relatively “good” egg supply left in the bank. Once again, this doesn’t speak for the quality of those eggs she does have.
The take away, don’t let your AMH levels scare you without further investigation. If you are being told you need IVF, question first if you are able to have 5-7 day follicle counts, make sure your AMH is tested on days 3-4, and your progesterone on day 21 (if you have a regular 28 day cycle). Take maybe 3 months to get familiar with your cycle (some of it is kinda gross but it’ll become the norm for your tracking). Get a hormone and blood panel done to assess levels, including FHS, LH, TSH, and Prolactin. Find an app, I like to recommend “flo,” to track your period and a ROUGH (I say rough as in PLEASE for the love of God don’t rely on its accuracy for your ovulation, I’ll go into this more in another blog) guide to your ovulation. There are plenty of tests that need to be done to get an overall picture of what’s ‘goin on’ with your “business” end so please, take a breath and try to relax.
PLEASE, however, take this reading as general in nature and do your own research for your own age and medical circumstances. All I am trying to say is, do not fret and think life and fertility is over because you have low AMH
