AMH plummets in 7 months


#1

Well, my wife and I are back to understand inexplicable bad news. Two years ago when we started our first cycle, her AMH was 1.4. It wasn’t good for someone that was 28 years old, but neither was it really bad. Either way, it was enough to put her in the “diminished ovarian reserve category.” After a failed cycle, we got in shape, got on a variety of helpful meds, and after testing her AMH again this previous December, it was 2.3

We were thrilled by the news, but sadly, we didn’t have the money to strike “while the iron was hot.” And besides, we thought, “How bad could it get in 7 months?”

So now that we’re ready for the next cycle, we tested again and her AMH was 0.9. Basically, it dropped by more than double and came out worse than before our first cycle.

Has anyone ever had such a dramatic decrease in such a short period of time?


#2

You can’t beat yourself up about not cycling when her AMH was higher. It could be that the test was run at a different lab, or even lab error. A woman is born with all the eggs she will ever have, and the supply starts diminishing before she is even born. Although the 2nd test was a higher value, your wife did not have more eggs.
It would be best to go to a RE that treats women with DOR. I have an AMH of 0.2, and my cycles have worked (I have miscarriages due to immune issues, but that is unrelated). I had an aggressive protocol with femara, and high dose stims, all taken together at the same time; it is in my signature. Also, I took DHEA (ask your RE about this) and I increased my antral count from 2 to 8 in a few months. I did not have more eggs, but I had more available, if that makes sense. Try not to worry…you can be successful with a low AMH.


#3

I don’t have personal experience with low AMH, but I have heard there’s a correlation between vitamin D and AMH. Maybe she should have her vitamin D checked. If there’s a deficiency, it could cause the lowered number. Ultimately though,it won’t change what’s going on in her ovaries, but it may help with your stress level and regret.

Low AMH and Vitamin D Link :


#4

Thanks guys. She’s on vitamin D, DHEA, and myoinsatol, and a littany of other meds, which was why it made sense that her AMH had gone up. She also had a really bad UTI/Kidney infection at the time of testing (we had to go straight to the hospital after we got the bad news to discern why she was in so much pain) but I doubt that had anything to do with it. We actually thought it might be kidney stones at first from all of the vitamin D and calcium.

And Rachela, I had a suspicion that our “good numbers” in December (the 2.3) might have been an aberation, and instead of going from 1.4 to 2.3 to 0.9, it may have simply gone from 1.4 to 0.9 over a 2 year period. But even then, it seems like a rather brutal dip in a short period of time. That’s a pretty steep downward trend from 28 to 30.

So on a separate but related note, what kind of variation in protocol (other the more meds) have you tried? Have you tried embryo banking or anything of that nature?


#5

Vitamin D deficiency can cause AMH to go down. Think about getting tested and starting some vitamin D3 in liquid capsule form to improve levels. Some people are supplementing with the wrong kinds of vitamin D.

Also I would definitely consider taking Fertinatal DHEA 25 mg three times a day. I buy that brand because it is affiliated with the clinic who did all the research with DHEA so I feel like I am getting what I think I am getting.

Both of those helped me significantly. My AMH went from 0.6 to 1.2 in six months.

Also keep in mind that there are variations between labs so if levels were drawn at different labs, you can have variations in results.

I am embryo banking now, with plans for PGD and FET once I get the number of normals to give me peace of mind. I am in the middle of my second cycle now.


#6

Vitamin D deficiency can cause AMH to go down. Think about getting tested and starting some vitamin D3 in liquid capsule form to improve levels.

Also I would definitely consider taking Fertinatal DHEA 25 mg three times a day for 2-3 months.

Both of those helped me significantly. My AMH went from 0.6 to 1.2 in six months and AFC went from 7 to 10.

Also keep in mind that there are variations between labs so if levels were drawn at different labs, you can have variations in results.


#7

Wow, this is fascinating!!! Thanks so much for the information, everyone, I am really interested by the Vitamin D/AMH correlation.

I have a rare disorder that does not allow me to spend any time in the sunshine. My vitamin D is always super low, and I honestly haven’t spent the time that I should getting it checked. My AMH in 2009 was 6.7 and this year was 1.3. I was freaking out by the huge dip, but had no clue that vitamin D could be a factor!!

Anyway, to the OP, it’s extremely scary to see your number plummet like that. As I mentioned, I FREAKED OUT when I saw how much mine had dropped. My RE suggested we move on to IVF sooner because of it (even though my number is still “normal” according to my clinic), but said that anything over a 2 is pretty unmeasurable. Ie. the test becomes much more accurate the lower the number gets. So, he told me that there’s a large margin of error with the higher numbers…a 6.7 and 2.0 aren’t all that different.

We responded beautifully to IVF in April and my AMH is only slightly higher than your wife’s. Not adding stress to the situation can only help. She still has a high possibility of a good outcome, but you are wise to make a move now. Best wishes to you both!


#8

Pharm and Francesca, thank you both for the advice and encouragement. I think we’re already starting to feel better. And good luck to both of you!


#9

As I mentioned, my AMH is 0.2. I have one ovary because I lost one with a ruptured ectopic pregnancy in 2001. I’ve tried every protocol under the sun. I think it’s important to “know when to hold em, and know when to fold em.” As upsetting as it was, I self cancelled several times when it was apparent I was going to end up with 1-2 eggs at ER. I knew I could do better. Finally, I had a meeting with my RE, and we came up with this protocol. It is a femara/ antagonist cycle.
5mg femara starting CD1 to CD5
350 follistim starting CD1 to CD9
150 menopur starting CD1 to CD9
cetrotide (antagonist) started CD8
trigger day 9

I ended up with 8 EGGS!! OFF OF 1 OVARY!! In theory, if I had 2 ovaries, I could have had 16! It just goes to show how a difference in meds/ protocol can take a person from having 1 follie to 8 follies.
With all of the supps I took in preparation, all 8 eggs fertilized, and I ended up with 1 frostie for an FET.


#10

[QUOTE=luv4rachela]As I mentioned, my AMH is 0.2. I have one ovary because I lost one with a ruptured ectopic pregnancy in 2001. I’ve tried every protocol under the sun. I think it’s important to “know when to hold em, and know when to fold em.” As upsetting as it was, I self cancelled several times when it was apparent I was going to end up with 1-2 eggs at ER. I knew I could do better. Finally, I had a meeting with my RE, and we came up with this protocol. It is a femara/ antagonist cycle.
5mg femara starting CD1 to CD5
350 follistim starting CD1 to CD9
150 menopur starting CD1 to CD9
cetrotide (antagonist) started CD8
trigger day 9

I ended up with 8 EGGS!! OFF OF 1 OVARY!! In theory, if I had 2 ovaries, I could have had 16! It just goes to show how a difference in meds/ protocol can take a person from having 1 follie to 8 follies.
With all of the supps I took in preparation, all 8 eggs fertilized, and I ended up with 1 frostie for an FET.[/QUOTE]

That is a fairly impressive number given where you started. I suppose its important, too, to come away from each attempt with a new piece of data. By the way, how much did you end up spending on medication? I know for us, on our first cycle, it was almost as much as the cycle itself!