AMH and AFC? Are they correlated? + hysteroscopy Q

J

judd04

New member
Hi all! I got the result from my bloodwork for AMH, and I am meant to go in after my period starts to have an antral follicle count (AFC) and a hysteroscopy. I am just wondering/curious if anyone knows from their own treatment — are AMH and AFC correlated? Would a “good” AMH for one’s age be indicative of a “good” number of follicles, and vice versa? I understand that AMH is a sometimes misunderstood measure / does not measure “fertility” per se, but I am wondering!

Additionally, have people done hysteroscopies with just Advil/ibuprofen and had a fine experience? My provider does not offer any further sedation except if one cannot tolerate it otherwise (and I assume also if you really insist). I have a pretty high pain tolerance but again, just wondering.

Thanks in advance!
 
@judd04 AFC is the number of follicles measuring 2-10 mm in size from both ovaries. AMH is detected in the primordial follicle and achieves peak level in the small antral follicle. The AMH level indicates the number of growing follicles, and this level can be used to determine the prognosis of fertility.

Higher AMH is observed in patients with PCOS for example (me), does not mean that the quality is amazing, for example. Which you can help a bit by taking CoQ10 and having a low carb diet to help insulin (which when too high is not good for the eggs).

I took 800mg of ibuprofen 1h before HSG and it was okay. I felt pain for 10 seconds as a cramp when the dye was injected. My tubes were not blocked, so I assume that helped me not feel a lot of pain. Some doctors give Valium for the day.
 
@stevieblunder Thank you for the explanation! My AMH is on the high end of what my IVF clinic wants to see (between 1-4), but I was wondering if one could take the AMH levels and infer that the AFC would also be “good”, although I had also seen — like you say here — that higher AMH is not ALWAYS better or an indication of AFC or other findings. I’ll find out about AFC soon enough anyways! :)

Helpful to know about the HSG, although I think a hysteroscopy is different?
 
@judd04 Correct, my mistake! I read fast and made a mistake. To my knowledge the HSG is more complete? Hysteroscopy would evaluate the cavity and HSG would tell about the tubes, the cavity… I also read that for some reason the perception of pain is lower in HSG than hysteroscopy. Again, only did HSG! Hope all goes well and sorry I could not be much helpful
 
@judd04 My experience was fine with one paracetamol and ibuprofen (so same thing). It was a high dose though. And started taking it the evening before and then an hour before the procedure.
More detailed experience is on the hysteroscopy post on the wiki of r/infertility
 
@judd04 I recently went in for a hysterocopy to remove a polyp because my dr said it “wouldn’t be that bad” and I regret it 1000% way too painful and it ended up failing bc they didn’t remove all of the polyp
 
@judd04 I have never had a hysteroscopy, but do assist with them (OR nurse). The ones I see are done under full general anesthesia.

Could you be mixing it up with a HSG (hysterosalpingogram) ?
 
@protectmysteps Definitely not, although I actually asked my nurse the same thing! It is a hysteroscopy, and she said most patients tend to tolerate it well with just Ibuprofen but on request the doctor can give conscious sedation. I broke my leg quite badly last year so I know I can tolerate a good amount of pain but I think I may ask for sedation. Not sure I want to suffer if I don’t have to!
 
@judd04 Unless I am a rare exception, you AMH levels and AFC aren’t correlated. My AFC was on the low end (not alarmingly low, just not what it should be), but my AMH is “beautiful” (my drs words, not mine lol) and at the level of a 25 year old. As for your hysteroscopy question, I really do not understand why you wouldn’t be out under general anesthesia. They have to dilate your cervix in order to get the camera up there, which is painful when done “manually” like that. I had a hysteroscopy in December to remove several polyps, and the surgery itself really didn’t take that much time, but it was definitely very uncomfortable coming out of the anesthesia and having the nurses make you walk around. I cannot imagine being awake for the surgery itself, no thank you lol. Could it be possible your nurse/doctor mixed up hysteroscopy and HSG? Because I was told to take Tylenol/advil an hour before my HSG, and that was a few days after my AFC appointment. You have to be done bleeding to get either HSG or a hysteroscopy, and you’re supposed to get your AFC checked on day 3 of your period.

I mean, your doctor’s office could operate differently than mine, but it does seem strange to schedule you for a hysteroscopy without a reason? Like if they knew you had polyps, that would be one thing. But to do this before any imaging? That’s just odd. For your sake, I hope someone made an honest mistake and it’s really an HSG you’ll be having done. That makes a lot more sense to have done around the same time as getting your AFC checked!
 
@judd04 I have a high AMH (especially for my age) and my AFC was 13 on each side. The RE said both were normal.

I am supposed to see RE to discuss my recent horrible HSG results (blocked tube, uterine adhesions) and so I've gone down the Reddit rabbit hole (I've read possibly every single post on hysteroscopy experience). It seems like people are on anything from Tylenol to general anesthesia. I have huge aversion to any sedation so I hope my RE offers the option of no sedation. It looked like in my research though that it is entirely provider-dependent

Edit: This was the source of a lot of the anecdotes I read, mentioned by another poster here: https://www.reddit.com/r/infertility/s/jjBVeGZsGS
 
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