Can You Still Get Pregnant With Low AMH: REI Explains
Many patients wonder “Can you still get pregnant with low AMH?”
In this article, Dr. Kimberly Thornton, MD, a Reproductive Endocrinologist and Infertility Specialist helps you to understand low AMH and how it affects getting pregnant.
Can You Still Get Pregnant With Low AMH? Yes, but..
Low AMH levels do not necessarily prevent pregnancy. While AMH indicates ovarian reserve, women with low levels can still conceive naturally or through fertility treatments.
AMH levels, however, are strong predictors of how well an individual will respond to fertility medications for IVF and egg freezing. Given this, patients with low AMH levels may require multiple cycles to successfully achieve pregnancy if they suffer from infertility.
What Is AMH?
AMH stands for Anti-Müllerian hormone. It is a protein produced by the ovaries. AMH plays a crucial role in female reproductive health and fertility assessment.
AMH is a hormone that gives doctors insight into a woman’s ovarian reserve. As a woman ages, AMH values go down.
What Is Ovarian Reserve?
Ovarian reserve refers to the number of eggs remaining in a woman’s ovaries. A woman’s ovarian reserve naturally declines with age, particularly after the age of 35.
How Is AMH Measured?
Doctors measure AMH levels through a simple blood test. This test can be performed at any time during the menstrual cycle, making it a convenient option for fertility evaluation.
Do AMH Levels Change In Life?
AMH levels typically decline as women age. This decrease in AMH reflects the natural decrease in egg quantity over time.
Higher AMH levels generally indicate a larger ovarian reserve. In contrast, lower levels may suggest a reduced number of eggs, or a lower ovarian reserve.
However, it is important to note that your fertility specialist will use more than just your AMH to make your treatment plan. Let’s now talk about how AMH relates to fertility.
How Does AMH Relate To Fertility?
AMH testing has become an important tool in reproductive medicine. It aids in predicting ovarian response to fertility treatments and assessing the potential for success with assisted reproductive technologies.
Predicting Ovarian Reserve
Anti-Müllerian hormone (AMH) serves as an indicator of ovarian reserve. It reflects the number of eggs remaining in a woman’s ovaries. Higher AMH levels generally suggest a greater number of viable eggs. Doctors use AMH testing to help assess a woman’s reproductive potential.
What Does Low AMH Mean To A Fertility Doctor?
Low levels of AMH usually means that a person has a low ovarian reserve. This can mean lower chances overall of getting pregnant with fertility treatment. However, AMH alone does not determine fertility outcomes. There are other factors like egg quality, uterine health, and your partner’s sperm quality that also affect your ability to become pregnant.
Medical Treatments With Low AMH Value
AMH testing helps guide fertility treatment approaches. Women with low AMH may require different protocols for ovarian stimulation during IVF. They may also need to consider options like egg donation sooner.
It’s important to note that pregnancy is still possible with low AMH. Some women conceive naturally despite low levels.
AMH provides useful information but does not definitively predict fertility success or failure.
Why Does Low AMH Make It Hard To Get Pregnant with IVF?
Usually with lower AMH levels there are quantitatively less eggs available during each menstrual cycle. This reduction in egg quantity makes it harder to extract a larger number of eggs per egg retrieval cycle with IVF. Since many eggs are often not viable, a lower number of total eggs retrieved can yield a lower chance of obtaining a healthy embryo for implantation.
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What Else Plays A Role In Getting Pregnant Besides AMH?
There are many factors aside from your anti-mullerian hormone level that can affect your ability to become pregnant. These include your overall health, your partner’s fertility, as well as the health of your reproductive organs.
Age
A woman’s age plays a significant role in fertility outcomes. As a woman ages, the quality of her eggs declines. Younger women with low AMH levels generally have better prospects than older women with similar levels of AMH since the quality of the remaining eggs tends to be better in younger women.
Structural Abnormalities
Structural abnormalities in your reproductive organs can impact fertility. For example, having blocked fallopian tubes can mean that your egg is not able to travel to meet the sperm. In this case, despite having good ovarian function your success rates of becoming pregnant will be lower.
Health Conditions
There are also certain medical conditions like polycystic ovary syndrome and endometriosis that are associated with more difficulty getting pregnant. Thyroid disorders should also be well controlled before a person tries to become pregnant.
Family History
A family history of infertility can also mean a decreased chance of getting pregnant. If you know this at a younger age, then you should consider egg freezing early in your life when the quality of your eggs is higher. This will give you a greater number of eggs for later use when you are ready to try to become pregnant.
FSH Levels
FSH stands for follicle-stimulating hormone. High FSH levels may indicate reduced ovarian reserve, even if AMH levels are within a normal range.
Male Factor Infertility
Even if you have a normal AMH level and a healthy egg, it is also important for your partner to have healthy sperm. Male factor infertility can come from a variety of different things. Some common causes include low sperm count and poor sperm motility.
Vitamin D Deficiency
There is increasing evidence that vitamin D deficiency may impact fertility. Vitamin D is crucial for various bodily functions, including reproductive health. In women, adequate vitamin D levels support ovarian function, hormone regulation, and endometrial health, all of which are essential for regular menstrual cycles, ovulation, and successful embryo implantation.
Additionally, women with polycystic ovary syndrome (PCOS), a common cause of infertility, often have low vitamin D levels, and supplementation may improve their insulin resistance and menstrual regularity.
Is Natural Conception Possible With Low AMH?
Natural conception remains possible for some women with low AMH. Here are some ways to optimize your chance of natural conception before trying IVF treatment. It is important to have fertility experts involved so that you can gain advice on when to try IVF so that you can optimize your reproductive years.
Timed Intercourse
Tracking ovulation and timing intercourse carefully may increase chances of success.
Medications Like Clomid
Clomid is a common first-line treatment for infertility. Clomid works by stimulating the ovaries to produce and release eggs. By promoting regular ovulation, Clomid increases the likelihood of conception. For women who do not ovulate regularly or at all, Clomid can induce ovulation, making it possible to conceive naturally.
Because Clomid can help regulate ovulation, it can make it easier for couples to time intercourse during the woman’s most fertile days. This increases the chances of conception.
Clomid is usually prescribed for a limited number of cycles, usually only 3-6 months. This is because the effectiveness of Clomid tends to decrease after several cycles. Also, long term use can have side effects.
IVF And Low AMH
Some patients, especially those in an older age group, will need to consider in vitro fertilization in their treatment options.
If you have a low level of AMH and a low egg reserve, IVF can help you to become pregnant.
What Can You Do When You Have Low AMH To Improve Your Chances Of Getting Pregnant?
Women with low AMH levels can take several steps to enhance their fertility.
Diet And Exercise
A healthy lifestyle is very important
\ when you are trying to get pregnant. This includes limiting unhealthy food, maintaining a balanced diet rich in antioxidants and vitamins. Regular exercise can also boost overall health and fertility. However, it’s important not to overdo it, as excessive exercise may negatively impact hormone levels..
Stop Smoking And Limit Alcohol
Quitting smoking and limiting alcohol consumption are essential. Both habits can damage egg quality and reduce fertility.
Supplements
The evidence for supplements in fertility is limited. Some doctors may recommend supplements to support egg health, which can include CoQ10, DHEA, and Vitamin D. Remember to only use these with the involvement of a fertility specialist (REI doctor).
Fertility Treatments
Early intervention is key and involving REI doctors can help to increase pregnancy rates. Women concerned about their AMH levels should seek the proper medical advice as soon as they can.
Fertility treatments can be effective for women with low AMH. In addition to medications like Clomid that induce ovulation, IUI (intrauterine insemination) and IVF are also options. Some patients may need to consider using donor eggs as well.
Pregnancy And Low AMH Levels: Summary
While low AMH levels can present challenges to becoming pregnant, they do not eliminate the possibility of conception. Women with low AMH can still conceive naturally or through fertility treatments, especially with the guidance of a reproductive endocrinologist. It’s important to remember that AMH is just one piece of the fertility puzzle, and other factors like egg quality, overall health, and partner’s fertility also play significant roles. With early intervention, personalized treatment plans, and a healthy lifestyle, many women with low AMH can achieve successful pregnancies.A reproductive endocrinologist can develop a personalized treatment plan. This may involve hormone therapy or other targeted approaches.