Low AMH. What now?

[mattfoltz]

Hi,

My mom had early menopause (38 y.o) and so did my aunt (43). So I decided to get my amh tested. I'm 28 y.o and my AMH level is 9.9 pmol/l or 1.4n/ml.
Iiuc this is the range of a 35 y.o woman.
I wanted to assess my fertility to see if we have time to wait to try when I'm 33-ish.

Anyone went through something similar? What did you do? Tell it to me straight.

 

[soldireofjudah]

@mattfoltz In 2022 my AMH was .68 (at 33) and a year later is was double at 1.2 (at 34), which is lower end for my age. In that year I started a regimen of CO-Q10 (600 mg daily) and Vitamin D. I also started focusing on improving my diet and mostly eating greens and non-meat protein (beans, legumes etc), low impact and low stress exercise (minimal cardio and more focus on slow weight lifting and functional movement like pilates). I’m going to be 35 in two weeks and going to start trying again this summer after a few months off. I did have to have a talk with my husband that now is the time and we didn’t really have the luxury of being the “if it happens, it happens” kind of people. My sister is currently in perimenopause at 37 (not sure when my mom went into menopause as we don’t speak to each other, but I assume it was in her 40’s), but my other sister had an oops baby at 36, ten years after her “one and done” kid, so WHO KNOWS! I wasn’t in a position to start trying for kids early (I had brain surgery at 28, married at 30, COVID happened, and have been caregiving for my in laws who had strokes 6 months apart the last 2 years), so I am mostly okay with having waited until now, even if I had known that there’s a possibility to struggle. I think it’s up to you to figure out where you are right now and if moving up your timeline is feasible. It’s a blow to get those low numbers for sure and I felt the gut punch, but there are things you can do. And because most people are not testing AMH this early, plenty of people probably are in your same boat and conceive just fine! There’s a lot of money to make on our anxieties so I just have to remember that when I let myself spiral. Best of luck to you!

 

[dandyandy]

@mattfoltz I have not been through this, but I did see there is a section on this in the book Real Food for Fertility. I didn’t read it as I don’t know my levels or anything so I don’t need the info right now, but It might be worth looking into. From what I understand by what little I read, some of these things can be adjusted with lifestyle factors.

Wishing you luck!

 

[sisi]

@mattfoltz According to this, your AMH would fall in the normal range for women ages 26-30, though the lower end of normal. In general, it tells you what you likely already knew from your family history, which is that you are likely to go through menopause on the earlier side. However, it doesn't really tell you how much time you have to conceive - women who go through menopause earlier are also fertile leading right up to menopause, because fertility has more to do with egg quality than quantity and egg quality correlates with age, not with egg quantity. And your number isn't so low as to indicate menopause is imminent. This study found that women with about your AMH (1.5ng/ml) who were 35-39 had an average of 13 years to menopause, and women with that level at 45-48 had 9 years - likely since you are younger you'd have even more. So that would predict menopause at early/mid-40s for you.

I think how many children you want is most relevant to this question - regardless of your AMH, it makes sense to plan to have the last before late 30s if you have the luxury. Your AMH might reinforce that, mostly because if you do have trouble conceiving you might have less time to address it and are less likely to be a good responder for things like IVF, but it doesn't actually increase the chance of that being the case and so I don't think fundamentally changes much.

 

[orvillejparker]

@mattfoltz I have a similar AMH of 10pmol at 29. From what I understand it’s at the low end of normal.

We decided to move our timeline forward and start trying this year (we were originally thinking 33ish like you) BUT I also have severe stage 4 endo so that played a huge part in us moving it forward.

AMH doesn’t affect your chances of getting pregnant each month, can effect things like ivf though

I wouldn’t base any decision solely on amh, I’d consider things like if you have any other conditions that might affect fertility, how many children do you want etc p

 

[mattfoltz]

@orvillejparker Yeah makes sense! Good luck!
Out of curiosity, how did you figure out you had endo? What were your symptoms? What tests did you do? I also suspect having endo, would appreciate your response

 

[orvillejparker]

@mattfoltz Some of my symptoms were bad cramps, really bad fatigue, pain during sex, bloating and digestive issues.

I suspected I had it for ages and finally got an ultrasound which confirmed I had it and that’s when my specialist sent me to get my amh tested (endo can lower your ovarian reserve)

Then I got a lap a few months later where they removed all the endo and diagnosed me with stage 4!

 

[lilkis86]

@mattfoltz I’m 28 and when I was 26 my amh tested at only 1.3, and naturally I panicked a little. Also that’s when I found out I have hypothyroid when my tsh came back abnormally high, and I started getting that treated right after. I brought this to my doctor and she told me not to worry about it at all and try not to focus on it cause it does not tell us much other than how we might respond to ivf, and she’s seen it not impact women’s likelihood of getting pregnant. I want to trust my doc so I’m trying to let it go. I also came across some research that women with untreated hypothyroid had lower amh’s and treating it raised their numbers, so that made me feel better.

I have yet to test it since and although I’m super curious, our timeline is our timeline, and if I test and it’s way lower it would just be bad for my mental health. Also we’re close to wanting to start trying by the end of this year, so even if it was way lower, what is a few months going to change ya know? If I struggle to get pregnant, then I’m sure I will be testing all of that again. But for now I’m trying to tell myself it’s just not relevant!

 

[mattfoltz]

@lilkis86 That's a very good way to handle it. I had a bit of a mental breakdown when I saw my numbers but you also brought something to my attention. I haven't had my fsh tested, and my mom has hypothyroidism. I wonder if I could possibly have that too. Good luck with your journey. Hope it's all bright and easy

 

[lilkis86]

@mattfoltz My mom also has hypothyroidism too and it’s genetic so definitely check!! If left untreated it causes fertility issues and miscarriages. So if you have they even increase your meds while you’re pregnant cause it’s so important. Thank you and good luck to you too!!

 

[lilkis86]

@mattfoltz FSH is another marker for fertility which doesn’t hurt to test but make sure you test TSH for thyroid (thyroid-stimulating hormone)