How bad is 1.3 AMH?

[dazzling1]

I just got my AMH test results after a bit of a journey. The fertility clinic I was going to hasnt been great at letting me know what was being done or explaining results and through a mix up I was on birth control when the AMH test was conducted. The nurse assured (and continues to assure) me that BC doesn’t have any impact on AMH, but many online resources say otherwise.

Anyways, I am 35 and my result was a 1.3. The nurse I spoke to didn’t tell me much about what that means other than I should start aggressively trying immediately with cycle monitoring etc. she was pressuring me hard and I’m not sure I trust this clinic due to the various mix ups/mistakes, but can’t seem to find consensus online either. How bad is 1.3 really? and how urgently should I be concerned? We are getting married in July so I really don’t want to be pregnant for that but now this lady has me freaked out.

i had all the tests sent to me so I can see the results for myself. Other details: I had 5+8 “small follicles” during my monitored cycle (no one really explained if that was good or bad?) and have an anteverted uterus apparently. They also wrote down “endometrium is hyperechoic relative to the myometrium”. I have all the hormones tests and everything too but it’s hard to tell if they are normal bc they aren’t labeled with which day of the cycle they were taken on. They haven’t been flagged though so that’s good I guess?

Anyways, is this going to be challenging for me? If anyone with better knowledge on this than me wants to chime in please do.

Thank you, sorry for the long post. So frustrated with doctors

 

[sisi]

@dazzling1 If you look at this graph, your AMH is just a little below the median for your age. As others have said, it doesn't mean anything for your (unassisted) fertility in the present or even the next few years. The nurse is not well informed - a lot of even non-specialist doctors aren't. But you do not need to start fertility treatment based on these results at all, and in fact one of the things lower AMH does mean is that you are likely to be less responsive to fertility drugs. But try not to worry about this.

 

[dazzling1]

@sisi Thank you!

 

[sgtmac81]

@dazzling1 I don’t have anything to add from the above poster, just want to say I’m 35 and I got my AMH tested a few weeks ago (not trying yet, issues with my cycle and my doc wanted to test as a possible indicator for PCOS) and my result was about the same….just want to chime in and say I hate how scary it is waiting and you are not alone, OP. I have a results appointment with my doctor today so if I get any good info I’ll come back and share

 

[dazzling1]

@sgtmac81 Aw thanks so much! This lady really freaked me out and it seems like it probably wasn’t necessary, thanks for sharing!

 

[sgtmac81]

@dazzling1 My doctor seemed unconcerned! He said obviously fertility does decline to an extent so if I want kids it’s something to think about, but that my number was in the normal range. So I’m trying to tell myself not to worry, haha!

 

[dazzling1]

@sgtmac81 Oh that’s great

 

[pilgrim8926]

@dazzling1 AMH is not a good indicator of fertility, which is why the American College of Gynecologists and Obstetricians recommends against testing it in women who are not yet experiencing fertility issues. Here’s a key quote from the position statement that might help you feel better:

“The monthly probability of pregnancy in women with low serum AMH levels (defined as less than or equal to 10 pmol/L or approximately 1.4 ng/mL) did not differ from that of women with normal AMH levels”

Waiting is so scary — I feel similarly. But don’t let the labs stress you out until you’ve started trying. The most important thing for you will be to get to know your cycle, get comfortable with tracking and make sure you’re having sex on the correct day. Because you’ll be over 35, you should see a specialist if you don’t get pregnant in 6 months from when you start rather than waiting a year. But your AMH levels do not mean you will have any trouble getting pregnant.

That nurse should not have said that to you. She’s incorrect, and it was inappropriate.

 

[alexandra91]

@pilgrim8926 AMH levels, paired with a follicle count are a measure of your remaining eggs. If you have a lower AMH your short term fertility is not significantly worse in the short term compared to women with higher AMH, as measured by percentage chance of achieving pregnancy by month. But lower AMH does indicate shorter longitudinal fertility, by virtue of having fewer remaining eggs.

 

[sisi]

@alexandra91 This is complicated, actually. AMH does correlate with when you go through menopause, but there is not evidence that it has strong correlation with when your fertility ends, at least not until the extremes. The end of fertility has to do with egg quality declining, while menopause has to do with egg quantity. Both of them correlate with age, but generally not with each other aside from the shared age association. Fertility generally ends 5-10 years before menopause, but I read a study that found that it just meant that women with low AMH were fertile for more of the years right up to menopause, e.g. a woman with lower AMH may go through menopause at 45 but her fertility ends at 42, while a woman with more average AMH may go through menopause at 52 but her fertility also ends at 42. This may be different in the case of premature ovarian failure or very diminished ovarian reserve, but that doesn't apply to OP, who according to this chart is probably somewhere around 20th percentile for her age - so lower that average, but not a diagnosis.

 

[pilgrim8926]

@alexandra91 True, but it does not mean that you will run out of eggs. Particularly not in the 6 months between now and when OP plans to TTC

 

[dazzling1]

@pilgrim8926 Thank you for sharing, I appreciate it!

 

[orvillejparker]

@dazzling1 Mines at 1.4 and I’m only 29, my specialist wasn’t overly concerned! Just said we should start trying sooner rather than later if we want a family, especially if we want multiple (I also have pretty severe endo so that plays into it)

As others have said, it doesn’t affect your chance of getting pregnant each month, I think it can affect IVF if you have to go down that route though

 

[dazzling1]

@orvillejparker Thank you!

 

[demothro]

@dazzling1 It takes ONE good egg! My cousin was told to go straight to IVF because of low AMH and PCOS at 36. She conceived naturally 2 months before the IVF appointment. I would focus on your cycle health and egg quality versus just AMH. AMH alone should not be an indicator if everything else is in the norm (like open tubes, normal TSH/Lh, etc). Good luck!

 

[dazzling1]

@demothro Thank you!

 

[lcnd]

@dazzling1 I hope this response doesn't sound too "let me google that for you" but Chat GPT says that a "Normal" AMH level for a 35 y/o woman is 1-4 ng/mL. I'd reflect on how many kids you think you might want to have. If it's 3+, it might make sense to freeze some eggs (or embryos) so you aren't limited by an ovarian reserve on the lower end of normal. BTW Chat GPT is definitely no doctor, but it's helped me to understand my lab results with a lot more depth and come prepared to follow-ups with solid questions. Oh, and my friend who had really low AMH did IVF and she recommended the book "it starts with the egg." It's about lifestyle changes that optimize the body to optimize the egg & improve chances of successful pregnancy. So sorry this is frustrating!

 

[dazzling1]

@lcnd Thank you that’s a great tip! I never thought of using chat gpt!

 

[lunamu]

@dazzling1 I’m 34 and just got mine because I’m trying to decide whether to start trying and it was 0.5. Feeling pretty bad about it tbh

 

[dazzling1]

@lunamu Aw im sorry your are feeling bad, I get it. But from this thread it sounds like AMH is such a a small piece of the puzzle and not worth stressing about!