You can have them repeat the AMH test, but it is pretty reliable (doesn't even matter what day of your cycle you test on).  I'm 30 and mine is 0.6, so 0.28 at 38 is certainly low, it is not exactly unheard of or likely inaccurate.  However, from my understanding, a high FSH and a low antral follicle count are important as well in a DOR diagnosis, so I might ask for those tests.

My RE didn't have any reason, it is just the way things worked out with your body.  

My history is similar to yours, I have normal, very regular cycles, ovulate naturally, had one natural BFP in fall 2011.  But, the RE still gave us a 3-4% chance of conceiving naturally.   

Either way, I know that initial low AMH can feel pretty devastating.  AMH is only something they have even been testing for about a decade (if that), so there is still a lot of unknown.  If you need IVF, you may want to seek out an RE with a fair amount of DOR experience.  Good luck and feel free to let me know if you have other questions!  

baker916:

You can have them repeat the AMH test, but it is pretty reliable (doesn't even matter what day of your cycle you test on).  I'm 30 and mine is 0.6, so 0.28 at 38 is certainly low, it is not exactly unheard of or likely inaccurate.  However, from my understanding, a high FSH and a low antral follicle count are important as well in a DOR diagnosis, so I might ask for those tests.

My RE didn't have any reason, it is just the way things worked out with your body.  

My history is similar to yours, I have normal, very regular cycles, ovulate naturally, had one natural BFP in fall 2011.  But, the RE still gave us a 3-4% chance of conceiving naturally.   

Either way, I know that initial low AMH can feel pretty devastating.  AMH is only something they have even been testing for about a decade (if that), so there is still a lot of unknown.  If you need IVF, you may want to seek out an RE with a fair amount of DOR experience.  Good luck and feel free to let me know if you have other questions!  

Thank you, that is helpful! And you just got a good fert report for your current IVF cycle right? Yes we are just starting the planning for IVF, my RE is on vacation until Monday so we won't have a formal plan until then. The nurse said there are several different protocols they use for DOR patients. We live in a fairly small city so there's really only the one major fertility clinic here, but from what we've seen they have good IVF success rates.

It seems like all the data on low AMH relates to IVF success, I haven't seen any data that shows low natural fertility, but maybe I'm missing something. It would make sense that IVF would be more challenging because it requires a large number of eggs to start with and we don't HAVE a large number of eggs we can produce each month, but the data on whether or not eggs are low AMH means lower quality eggs seems to be conflicting, so does it really mean natural fertility is lower?

It's all very confusing :-/

The last time my AMH was tested was last December and it was 0.3 at age 38.  Yes, that is low. My FSH is also sky high. I think it is strange that your doc won't test your day 3 FSH and said it is unreliable??  It can fluctuate but you are only as good as your highest FSH. I never stimmed well- 3 was the most amount of eggs I ever got and that was only 1 cycle. My egg quality was also terrible and I never got a good embryo. Others with numbers a bit better than me still got pregnant as their egg quality was just better. That is just dependent on the person and you won't know until you try. It may take a few try's though. 

BootsOrHearts:

baker916:

You can have them repeat the AMH test, but it is pretty reliable (doesn't even matter what day of your cycle you test on).  I'm 30 and mine is 0.6, so 0.28 at 38 is certainly low, it is not exactly unheard of or likely inaccurate.  However, from my understanding, a high FSH and a low antral follicle count are important as well in a DOR diagnosis, so I might ask for those tests.

My RE didn't have any reason, it is just the way things worked out with your body.  

My history is similar to yours, I have normal, very regular cycles, ovulate naturally, had one natural BFP in fall 2011.  But, the RE still gave us a 3-4% chance of conceiving naturally.   

Either way, I know that initial low AMH can feel pretty devastating.  AMH is only something they have even been testing for about a decade (if that), so there is still a lot of unknown.  If you need IVF, you may want to seek out an RE with a fair amount of DOR experience.  Good luck and feel free to let me know if you have other questions!  

Thank you, that is helpful! And you just got a good fert report for your current IVF cycle right? Yes we are just starting the planning for IVF, my RE is on vacation until Monday so we won't have a formal plan until then. The nurse said there are several different protocols they use for DOR patients. We live in a fairly small city so there's really only the one major fertility clinic here, but from what we've seen they have good IVF success rates.

It seems like all the data on low AMH relates to IVF success, I haven't seen any data that shows low natural fertility, but maybe I'm missing something. It would make sense that IVF would be more challenging because it requires a large number of eggs to start with and we don't HAVE a large number of eggs we can produce each month, but the data on whether or not eggs are low AMH means lower quality eggs seems to be conflicting, so does it really mean natural fertility is lower?

It's all very confusing :-/

 I agree, the low AMH by itself does not always correlate with low egg #s or low quality.  The research on it yet isn't perfect.  Based on the feedback from my RE, it seemed like generally low AMH is correlated with lower fertility or lower conception rates.  But I never asked that directly.  For instance, for IVF, he said (initially) he'd normally give a 30 yr old couple with unexplained infertility a 65% success rate at that clinic, but for us, with my low AMH, he'd give us a 55% chance of success.

We were lucky, my first IVF cycle (so far) has gone very well. We did an estrogen priming protocol.  13 eggs, 10 mature, 9 fertilized naturally.  The quality was good as well, as 6 of 9 made it to blast (transferred 1, froze 5).  My RE thought our quality was likely ok before IVF because I'm on the younger side.  

I'm also lucky that I live in Colorado, so I am with CC.RM, and they have lots of experience with DOR patients. 

I am 31 now, but when I was 30 I had CD3 bloodwork done by my OB/Gyn and my FSH was a decent 7. But when I finally started going to an RE, she ran my AMH and it was <0.16 (undetectable) but I had a decent AFC at 11-14 and FSH around 6.5. My RE was a little confused why my AMH, FSH, and AFC didn't all tell the same story. I ovulate naturally according to Basal Body temps and I am very regular with my cycles.

We went ahead and attempted IVF using max stim meds, but unfortuantely I didn't respond whatsoever. So in hindsight, it appears that the AMH was indeed a true indication for the severity of my DOR.

As far as retesting goes, prior to IVF, I had my AMH retested a few times and it generally stayed the same at <0.16, but one time went up to .24 so it can fluctuate a bit. I'd agree that it is a reliable test. I hope you have good results with your cycle, but I wanted to share my history with you. Now my AFC is starting to match up because it has has dropped significantly in the past few months. It went from 11-14 to now more like 6-7.

DOR is a really hard diagnosis and it has really taken me some time to accept it. It's been so helpful to have other women on here to talk to. Big hugs to you, and again - good luck.

baker916:

BootsOrHearts:

baker916:

You can have them repeat the AMH test, but it is pretty reliable (doesn't even matter what day of your cycle you test on).  I'm 30 and mine is 0.6, so 0.28 at 38 is certainly low, it is not exactly unheard of or likely inaccurate.  However, from my understanding, a high FSH and a low antral follicle count are important as well in a DOR diagnosis, so I might ask for those tests.

My RE didn't have any reason, it is just the way things worked out with your body.  

My history is similar to yours, I have normal, very regular cycles, ovulate naturally, had one natural BFP in fall 2011.  But, the RE still gave us a 3-4% chance of conceiving naturally.   

Either way, I know that initial low AMH can feel pretty devastating.  AMH is only something they have even been testing for about a decade (if that), so there is still a lot of unknown.  If you need IVF, you may want to seek out an RE with a fair amount of DOR experience.  Good luck and feel free to let me know if you have other questions!  

Thank you, that is helpful! And you just got a good fert report for your current IVF cycle right? Yes we are just starting the planning for IVF, my RE is on vacation until Monday so we won't have a formal plan until then. The nurse said there are several different protocols they use for DOR patients. We live in a fairly small city so there's really only the one major fertility clinic here, but from what we've seen they have good IVF success rates.

It seems like all the data on low AMH relates to IVF success, I haven't seen any data that shows low natural fertility, but maybe I'm missing something. It would make sense that IVF would be more challenging because it requires a large number of eggs to start with and we don't HAVE a large number of eggs we can produce each month, but the data on whether or not eggs are low AMH means lower quality eggs seems to be conflicting, so does it really mean natural fertility is lower?

It's all very confusing :-/

 I agree, the low AMH by itself does not always correlate with low egg #s or low quality.  The research on it yet isn't perfect.  Based on the feedback from my RE, it seemed like generally low AMH is correlated with lower fertility or lower conception rates.  But I never asked that directly.  For instance, for IVF, he said (initially) he'd normally give a 30 yr old couple with unexplained infertility a 65% success rate at that clinic, but for us, with my low AMH, he'd give us a 55% chance of success.

We were lucky, my first IVF cycle (so far) has gone very well. We did an estrogen priming protocol.  13 eggs, 10 mature, 9 fertilized naturally.  The quality was good as well, as 6 of 9 made it to blast (transferred 1, froze 5).  My RE thought our quality was likely ok before IVF because I'm on the younger side.  

I'm also lucky that I live in Colorado, so I am with CC.RM, and they have lots of experience with DOR patients. 

 Well good luck this cycle!!!

I have been on femara and the first month the response wasn't good (just 1 follie) but then she upped the dosage and the next month I got 3 on one side, the month after that 2 on one side and 1 on the other, but this last month, just 1 sad little follie so maybe you can build up tolerance to that stuff. Anyway, I'm hoping that means that I'll have decent response to the IVF meds? I guess I'll see what happens.

Hope I'm not out of line posting here, but I was lurking...

I have DOR (AMH was 0.54 in 2011) and got pregnant through IUI/Clomid.  I wanted to say that I lurked around a bunch of different forums after I got my diagnosis (and still continue to do so because I plan to TTC again in the future) and I also really got into reading medical journal articles on DOR/POF, etc.  I'm a Fragile X premutation carrier so I know what caused my DOR. I was told I had less than a ten percent chance of conceiving even with ART and told to go straight to IVF.  After I got pregnant, my RE told me my pregnancy through just Clomid/IUI was pretty much a miracle. 

However, on many of the boards I have lurked/posted on, I have seen women with very low AMH levels (or high FSH levels) get pregnant.  When I was pregnant there was a woman on fertility friend dot com who had an undetectable level of AMH who was pregnant.  I think she got pregnant through an IUI, too.  I also have read medical articles where women with FSH levels at post-menopausal levels (I'm talking over 100) have gotten pregnant through IVF. 

At any rate, just wanted to give you a few links that I found helpful:

http://www.fertilethoughts.com/forums/high-fsh-premature-ovarian-failure/

The above forum has a thread of many, many amazing success stories of women who have gotten pregnant with DOR or POF...some of them naturally or just with using supps or chinese medicine, etc.

www.fertilityfriend.com also has some great forums, but you have to pay to see the boards. 

This clinic has a bunch of research articles that are very interesting and does a ton of research on incorporating DHEA into DOR/POF protocals:

http://www.centerforhumanreprod.com/news_genetic_test_predicts_better_ivf_success_for_older_women.html

Here is another good forum :

http://www.network54.com/Forum/209394/

And this is the pregnant despite high fsh/dor/pof:

http://www.network54.com/Forum/264844/  

So be encouraged that there are alot of women out there who have had success even with bad numbers.  Sometimes I think doctors give us "worst case scenarios."  WHen I was pregnant, my baby had IUGR (I had severe pre-e) and was told all of these horrible things about how my babies long bones were going to be shortened (i.e. he would have short little arms and legs) and an oversized head and would only weigh 4 lbs and could be all sorts of negatively affected...but he came out pretty healthy-just a little skinny.   My point is that I think sometimes docs just want to prepare us for the worst in case it happens, but be comforted in knowing that there are alot success stories out there. :)

IBackBevo:

Hope I'm not out of line posting here, but I was lurking...

I have DOR (AMH was 0.54 in 2011) and got pregnant through IUI/Clomid.  I wanted to say that I lurked around a bunch of different forums after I got my diagnosis (and still continue to do so because I plan to TTC again in the future) and I also really got into reading medical journal articles on DOR/POF, etc.  I'm a Fragile X premutation carrier so I know what caused my DOR. I was told I had less than a ten percent chance of conceiving even with ART and told to go straight to IVF.  After I got pregnant, my RE told me my pregnancy through just Clomid/IUI was pretty much a miracle. 

However, on many of the boards I have lurked/posted on, I have seen women with very low AMH levels (or high FSH levels) get pregnant.  When I was pregnant there was a woman on fertility friend dot com who had an undetectable level of AMH who was pregnant.  I think she got pregnant through an IUI, too.  I also have read medical articles where women with FSH levels at post-menopausal levels (I'm talking over 100) have gotten pregnant through IVF. 

At any rate, just wanted to give you a few links that I found helpful:

http://www.fertilethoughts.com/forums/high-fsh-premature-ovarian-failure/

The above forum has a thread of many, many amazing success stories of women who have gotten pregnant with DOR or POF...some of them naturally or just with using supps or chinese medicine, etc.

www.fertilityfriend.com also has some great forums, but you have to pay to see the boards. 

This clinic has a bunch of research articles that are very interesting and does a ton of research on incorporating DHEA into DOR/POF protocals:

http://www.centerforhumanreprod.com/news_genetic_test_predicts_better_ivf_success_for_older_women.html

Here is another good forum :

http://www.network54.com/Forum/209394/

And this is the pregnant despite high fsh/dor/pof:

http://www.network54.com/Forum/264844/  

So be encouraged that there are alot of women out there who have had success even with bad numbers.  Sometimes I think doctors give us "worst case scenarios."  WHen I was pregnant, my baby had IUGR (I had severe pre-e) and was told all of these horrible things about how my babies long bones were going to be shortened (i.e. he would have short little arms and legs) and an oversized head and would only weigh 4 lbs and could be all sorts of negatively affected...but he came out pretty healthy-just a little skinny.   My point is that I think sometimes docs just want to prepare us for the worst in case it happens, but be comforted in knowing that there are alot success stories out there. :)

Thank you so much. This is exactly what I needed to hear today.

It's funny because I was diagnosed DOR in January of this year, exactly 1 week before I got my first BFP which was all natural, other than timing using OPKs. So my doctor, after saying my chances of conceiving on my own were about nil, had to eat crow. :-) Sadly we lost our little guy due to a hyperspiraled cord (we are mostly certain), but nothign to do with the DOR.

Thank you so much for the links - I will check them out. I do use FF, but I've never checked out the forums there, I need to do that.

HUGS!

Hello there...I am new to posting and I too have a very low AMH.  I found out by accident that my AMH was 0.28 in June of 2012.  Because of this, my husband and I decided to start TTC.  I got off BC and we began the process.  I had several procedures done before hand to rule out any other issues, all ok.  We tried "naturally" for 4 cycles, unsuccessful.  We planned on starting IUI come January, but I wanted to check my AMH to see if any changes had taken place.  December 04.2012 my values are 0.16. 

I am waiting for my RE to get back to me as her fertility nurse is the one that broke the news to me.  i don't know if we should/could pursue IUI or IVF OR just look towards adoption. 

I am 35, my husband 38.  He is perfectly healthy, I have hypothyroidism and celiac.  Uterine fibroids and history of ovarian cysts.  Was on BC for approx 17 years. 

Lots of prayers for you and your husband.