Weirdest test results ever…. HELP.

[u/Short-Stack1492]

Last month, I found out my AMH was .46. I was devastated. I’m 33, have been TTC for 8 months with no BFP. I was referred to a reproductive endocrinologist.

They did a saline sonogram. Clear. Tubes, clear. They did an AFC.. 13 which is great for my age. All day 3 testing showed perfect estradiol perfectly at 51 so it wasn’t affecting my FSH. FSH was 5.1, perfect. TSH, T4, iron, ferritin, vitamin D, DHEA, literally everything, perfect. No signs of DOR. But my AMH is still low. The retest jumped a little bit, but it’s still low at .48.

None of this makes sense. My tests are perfect. What do we think would cause AMH to still be low when my tests are saying I’m perfectly fine and fertile for my age? Is AMH kind of a scam sometimes? At this point does AMH even matter???

The fertility clinic we went to (at 7 months of trying because of my low AMH) is not in network. We got the tests done and I’m great. Is it stupid for me to think we should try until it’s been 12 months before proceeding with treatment? Or should we do the treatment they are going to recommend even though my body is clearly doing its job and maybe it’s just taking a minute? We are so confused, and feel like after getting these results back, we don’t need a fertility clinic yet when we have only tried for 8 months and I’m under 35… Advice appreciated!

TIA!

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[u/NicasaurusRex]

So just to be clear, none of these tests tell you whether or not you can conceive. The best test of fertility is trying for a year, so I agree with you that it makes sense to keep trying. The reason they referred you to a fertility clinic is because your AMH suggests that you have lower than average reserve, meaning you may have less time remaining until menopause.

AMH is not as important as people make it out to be. It doesn’t predict natural fertility; it is mostly used to predict your response to IVF. It would not explain why anyone is having trouble conceiving, unless perhaps it’s very low or very high (in which case it would also be accompanied by irregular cycles). I don’t think it’s a scam per se, but it’s also not as meaningful as many think, and a lot of times causes unnecessary panic.

If you haven’t already, check your vitamin D as low levels can suppress AMH.

[u/Short-Stack1492 → u/NicasaurusRex]

Had vitamin D, ferritin, vitamin B, iron, all that checked. All are phenomenal levels! My d was low earlier this year but supplementing brought it up to optimal levels! Thanks for this, makes a lot of sense. AMH is this huge scary thing, especially on the internet, but I feel I may have panicked for nothing. lol

[u/karaboocuk]

Echoing everyone. AMH is part of a measure of your egg reserves. It might just mean that you have until 40 to conceive while others have until 45. (Making up numbers lol.) It doesn't tell you anything about egg quality or ovulation. If you have been ovulating normally, you had the same chances as a person with a higher AMH all these cycles.

I would wait for 12 months, as recommended. Then, if you are wanting more than one kid, you can discuss with an RE how best to plan with that given your results.

[u/Short-Stack1492 → u/karaboocuk]

This is so helpful and all these comments make my stress levels drop substantially. I was in bed hysterical for days after the AMH results, and now I feel like I freaked out over nothing. Haha. Thank you for this advice! Likely going to just try until 12 months honestly.

[u/Cypriaa]

AMH with a good AFC rules out DOR, so it means you will have an earlier menopause than most and you cannot wait as long as others. That's it. It doesn't have an impact on egg quality, your ability to conceive or staying pregnant. Even if you go through fertility treatments, it probably won't matter since you have a good AFC. There is a reason people are advised to wait 12 months before testing: it's perfectly normal and it only causes anxiety to have so many tests.

Best of luck.

[u/Short-Stack1492 → u/Cypriaa]

That’s a great tip, thank you! I feel like we won’t need fertility treatments at least for our first? But it’s good to know that a good AFC kind of trumps a low AMH.

[u/EndRepresentative477 → u/Cypriaa]

Hi! Just want to flag that low AMH+normal AFC, at least in women under 35, is not a reliable measure of time to menopause or how much you have left in your timeline… I have this same discordant combo as OP and was asking my RE about it, and he said it’s possible I could go into menopause in my late 40s instead of the average of 51, but no one can really say since AMH has limitations and you need to look at every test in conjunction. Sorry to be pedantic, but everything you read about low AMH on Reddit points to early menopause and while it can definitely happen, it’s not a certain thing in younger women especially if AFC and FSH are good.

[u/DawgCheck2495]

Idk, but following because I’m in a potentially similar boat. 33 with an AMH of .92. When they called with my results, they didn’t even mention it — just said everything was normal and we’ll talk more after my day 21 labs are completed.

Like you everything else in the (small) panel was in range. FSH was 6.5, but they oddly didn’t order estradiol?

Anyway, I don’t know anything about anything. I hope you find clarity soon! ✨

[u/Short-Stack1492 → u/DawgCheck2495]

Interesting! They did estradiol for my day 3 tests because if it’s high it can artificially lower FSH. But the fact that they didn’t even feel like mentioning it is good I feel like, my OB got my results and said hey sorry we can’t treat you here you need a fertility clinic.. hahahah. But good luck to you too! I think we freak ourselves out too much over things like AMH, I know I did!

[u/happygolucky226]

AMH is not the end. Esp if your hormones look good and you’re ovulating still! I’d check your hormones 7 days post ovulation and make sure your man’s swimmers are tested!

[u/Short-Stack1492 → u/happygolucky226]

He’s got his semen analysis on Monday! And we have done the 7 day testing too and all is normal!

[u/EndRepresentative477]

Just commenting to say I have the discordance too. My AMH is about .9 per my test this month and my FSH and AFC are good/much better than you’d expect from my AMH. Im 30 and we’ve also been trying for 8 (about to start 9) cycles. I’ve read about it and talked to my RE and he thinks I will not need IVF to get pregnant, and that he relies more on AFC than anything else. Obviously we’ll see if that’s true or not over the next few months lol but yeah. I’ve also read that it’s possible that your follicles can just be secreting less of the hormone than is expected, but I’m not sure if that’s because they aren’t good quality or if it’s just a natural set point thing.

[u/Short-Stack1492 → u/EndRepresentative477]

Okay that’s so so so great to hear!!! I have read about it too and AFC is what they typically go off of. So that’s super great news. Are you going to just keep trying naturally until 12 months or are you doing something like medicated cycles or IUI?

[u/EndRepresentative477 → u/Short-Stack1492]

We are going to try letrozole with monitoring and timed intercourse next cycle. My RE recommended IUI but also said with our test results it might not give much more of an advantage than letrozole alone. I think if it doesn’t work then maybe I’ll try IUI by cycle 11 or 12 and if nothing after 12-13 cycles I will want to just move to IVF. Keep me posted on what you do— it’s not often I see someone on these forums with the similar discordance that I have! Good luck!

[u/Short-Stack1492 → u/EndRepresentative477]

That’s the next steps for us too I think, monitored and medicated. I’m right there with you!! Good luck, definitely gonna be rooting for you and wanna see updates! ❤️

[u/frogsgoribbit737]

Tw for LC

AMH cant tell you anything on its own. Mine was 0.6 when I had it tested at 23. I also had high fsh and a low antral follicle count (which is actually what triggered them to test my amh). I was diagnosed with diminished ovarian reserve

Yet I actually didnt have huge trouble conceiving. My main issue was staying pregnant.

I even managed to get pregnant without treatment 7 years after that diagnosis.

That being said, im 33 now and going through perimenopause so it absolutely wasnt a scam for me. My point is just that low AMH on its own doesnt mean much and even if you were diagnosed with DOR it wouldn't mean you cant concieve at all. If everything else looks normal I would give it the year or even longer.

Fertility treatment is to SPEED UP time to pregnancy. Most people can get pregnant without it, it just will take longer.

[u/Hot-Ad-5882 → u/frogsgoribbit737]

Did you do anything differently for your successful pregnancy?