Low AMH: possible causes, correction options, impact on the ability to get pregnant, advice from gynecologists

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Every woman dreams of becoming a mother. Particularly responsible couples undergo an examination before conceiving a child. The most important thing to do is check your hormones. To do this, you need to take a hormone test. These include anti-Mullerian hormone (AMH). But what to do when low AMH is noted in the results of the analysis? Is it possible to get pregnant in such a situation? This article will help you find answers to these questions.

AMH norm

AMH analysis helps to determine how many eggs can turn into a baby. It shows how many follicles have matured in a woman's ovaries.

Before drawing conclusions about whether you have low AMH or normal, you need to familiarize yourself with the normal indicators. This hormone begins to increase from the onset of puberty. Therefore, in women of reproductive age, this indicatorreaches its maximum mark and ranges from 1 to 2.5 ng / ml.

For a more accurate assessment of the hormone content, the analysis should be taken on the 5th day of the menstrual cycle. Deviations from the norm can be caused by various diseases. If they are eliminated, then with low AMH and independent pregnancy may be possible.

In the case when it comes to IVF, a slight increase in the hormone will only play into the hands of a woman. After all, this increases the likelihood of successful resolution of the procedure.

Reasons for a decrease in AMH

An increase in AMH levels can trigger one of the following conditions:

• normogonadotropic anovulatory infertility;
• abnormal functioning of luteinizing hormone (LH) receptors;
• tumor processes in the ovaries;
• presence of polycystic formations in the ovaries.

Low AMH observed at:

• decrease in ovarian reserve (usually associated with aging);
• menopause (not a pathology, because sooner or later comes in the life of every woman);
• overweight (obese in childbearing age, i.e. 20-30 years old);
• ovarian dysfunction.

The possibility of pregnancy with reduced AMH

The presence of a reduced concentration of the hormone in a woman's body almost always indicates the presence of some kind of pathology. Violations in the reproductive system can be of a different nature: from normal overweight to tumor formations.

Despite what causes the decrease in the level of the hormone in the body, pregnancy with low AMH becomes problematic. Since artificially the content of this hormone cannot be increased. It is possible to correct the cause of abnormalities, but an increase in the number of eggs is unlikely. It is possible to influence their quality and maturity.

Statistics indicate that for women with low AMH, only artificial insemination can be a consolation. In addition, it often requires donor biological materials.

But there are also cases when the decrease in AMH is corrected independently. This suggests that during the analysis, its content was influenced by some negative factor, which distorted the result of the study.

Therefore, in each case, it is necessary to contact a specialist and develop a specific action plan.

AMH for IVF

In today's world for couples who want to conceive a child, but for some reason unable to do it naturally, there is a procedure for artificial insemination. In medicine, it is called in vitro fertilization (IVF). This process is rather complicated and time-consuming.

Initially, you need to undergo an examination. The most revealing in this case will be an analysis of AMH. Anti-Müllerian hormone will show the reproductologist how many of a woman's eggs are suitable for fertilization. That is why there are limits, that is, a certainindicator of this hormone.

For the procedure of artificial insemination, the AMH index of a woman must be at least 0.8 ng / ml. Otherwise, the procedure will simply be impossible, because there is no required number of eggs for fertilization. Even pacing with low AMH will be difficult.

However, too high a rate can cause trouble. In preparation for IVF, hormonal stimulation of follicle maturation is carried out. Due to the increased content of AMH in the body of a woman, there is a risk of ovarian hyperstimulation.

Low AMH: is IVF possible?

Statistics indicate that IVF with low AMH is possible. But this is very difficult to implement. The hormone indicator does not affect whether the embryo will take root in the woman's body. But the very fact of fertilization can. Indeed, with a low AMH, the number of eggs is very low, and their quality can be even worse. In addition, in this case, time is not on the side of future parents.

In principle, the procedure for artificial insemination with low AMH is no different from the IVF procedure with a normal hormone level. But here the woman is forced to take more serious hormonal drugs. In addition, a longer period is needed for the maturation of eggs.

Usually, patients are prescribed hormonal drugs in a double dose. This, of course, sounds scary, but there is no reason to worry. A low hormone level will not lead to ovarian hyperstimulation or any otherdisease of the reproductive system.

Further actions of specialists depend on how the preparatory stage went. If everything went well and the number of eggs that can be fertilized has increased, then the doctors take a puncture of the follicles, fertilize the egg and implant the embryo into the mother's body. If the hormone level remains at a low level, then drug therapy is subject to revision.

IVF protocols

AMH is critical for the IVF procedure. Knowing this indicator, the reproductive specialist chooses a more appropriate plan of action and protocol.

IVF protocols for low AMH can be of two types: long and short.

Long protocols are performed a week before the onset of menstruation. Over the next three weeks, ovarian stimulation is performed to increase the number of eggs suitable for fertilization. Then a puncture of a large number of eggs (up to 20 pieces) is taken and their fertilization is performed. Artificially conceived three- or five-day-old embryos are planted in a woman. There is a possible complication in this protocol - the risk of ovarian hyperstimulation.

The short protocol is started on the 2-3rd day of menstruation. Stimulate the egg. To do this, do a puncture of the dominant follicles. However, in this case, complications are possible - the lack of high-quality eggs. In addition, the procedure is only suitable for women with good ovaries.

IVF without hormonal stimulation

With low AMHa fertilization option is possible without exposing the woman to shock doses of hormonal drugs. In this case, doctors use ultrasound to monitor the natural ovulation of a woman. In this way, no more than 2 mature eggs are obtained in one cycle, which significantly reduces the chance of pregnancy.

This method, however, is also very difficult and has its pros and cons. On the positive side, you won't get twins or triplets, and you won't suffer from the side effects of hormone therapy. In addition, the cost of such fertilization is much lower.

The disadvantages include the fact that there is a high probability of missing the moment of maturation of the egg. Moreover, its quality will not be quite what is necessary for a successful procedure.

Statistics

Low FSH, low AMH and other abnormalities are an obstacle to fertilization. As statistics show, with IVF, only 20-60% end successfully. The likelihood of success depends on the woman's age, egg quality and hormonal status.

However, medicine does not stand still, and every year the diagnosis and fertilization procedures are improved. Thus, year after year it becomes easier to give birth to a child.

High FSH and low AMH

Quite often, along with a low level of AMH, there is a high level of FSH. FSH is a follicle-stimulating hormone that is responsible for the production of follicles in the ovaries. This situation is quite serious.an obstacle to the IVF procedure.

Undoubtedly, statistics show that almost all IVF attempts end in pregnancy. But high FSH levels can prevent this from happening. In this case, it is recommended to perform the fertilization procedure using donor material.

And yet there is a chance to use your egg for this, but it is very small. This is possible only if the FSH level is slightly elevated. But with a very high FSH, you should not waste precious time. A woman may never ovulate, which indicates the use of a donor egg.

Reviews

Any woman, faced with a problem, seeks help and advice from the same not indifferent representatives of the fair sex. Reading reviews of low AMH and being pregnant at the same time, she comes across a lot of optimism.

Many women write that, despite the low level of the hormone, they still managed to get pregnant and give birth to he althy children.

However, most women still indicate that their pregnancy with low anti-Müllerian hormone was accomplished through artificial insemination.

You can also learn from the reviews this advice: never stop after taking the test in one laboratory, be sure to take the test in one or two more diagnostic laboratories. This will give you a more accurate picture of your he alth. After all, the probability of error is in any case.