AMH: Are you running out of eggs?
On my last video about AMH I asked all of you to comment “AMH” if you wanted more information on this topic to learn more. Guess what? We’re back again this week talking about AMH because you all wanted more of this, so that’s what we’re talking about today. I said it last week and I’m going to repeat it again, AMH is not always the main hormone that is going to determine your ability to conceive. I’m happy to say and see that one of the members of my HOPE Coaching program does finally get it. I want to read to you what she said.
She says, “What I found most useful from this video is the comfort in knowing that AMH is not the be-all, end-all number that our OB-GYNs would have us believe that it is. My AMH had a precipitous decline across the span of a year, and this was so demoralizing after four-plus years of trying to conceive. Thank you, Dr. Sklar, for the simplicity and clarity of your explanations. As a member of your HOPE Coaching program, I’m especially grateful for yours and the wisdom of the women with whom I traverse this journey because we all support each other in that program together.” I thought her comment was really pertinent based on what we’re seeing here.
In this video, I’m going to talk a little bit more about AMH and I’m answering the questions that you all posted last week on last week’s videos about AMH and your specific AMH questions. I’m going to answer those on this video, so let’s get into it now.
Hi, my name is Dr. Marc Sklar, also known as the Fertility Expert, and welcome to FertilityTV. If this is your first time here, welcome. If you’re a frequent and avid watcher, thank you so much. I’ve been working with couples for over 19 years through my online coaching programs and right here in San Diego at my clinic. Again, as I’ve mentioned repeatedly, AMH is a topic that we are constantly talking about it. This week especially, I talked about it a lot, both in the clinic and with my coaching members and online with all of you because that’s the topic we covered. You all asked some amazing questions that I want to dive deeper into in this episode of FertilityTV, so I’m going to expand a little bit more on your questions, and I’m going to dive deeper into the topic of AMH.
All right, so let’s jump into it right now and dive more into this important and really interesting and what I think is fascinating topic of AMH. One of you commented and says, “Hello, Dr. Marc. I was told my AMH, 47 as per the UK metric system, was good for my age and the hormone tests were normal. Had the tubes flushed.” Awesome. “Still not conceived at 39. I have secondary infertility. My child is almost 10 now. Improved by eating a lot, lost weight, and cut down on caffeine. Have been offered Clomid.”
This is an interesting question. First and foremost, I want to congratulate you at 39 of having a really good AMH. I think that’s the first most important thing and so that you can ease your mind about that. The second thing, congratulations on already having a child, and you’re trying for a second. Sometimes that can be hard, not always because of AMH, but because of other hormones, or other issues that have arisen since your previous pregnancy, or as a result of that, and it’s been 10, 11 years since your first pregnancy, so a lot may have changed, and your body might be different. That’s where I would encourage you to dig deeper and find out more information about where your health is right now. I don’t necessarily think that Clomid is the answer to the question if you’re having a regular cycle and you’re ovulating regularly, but it could be something that you want to try if you want to. But I want to encourage you again to dive deeper to find out where your health and reproductive function is today versus where it was 10, 11 years ago.
Question two: “My AMH is 0.5 and planning to do ovarian PRP to see if my AMH improves for an IVF. Do you think an ovarian PRP will help get my numbers up?”
The answer is potentially. I hope so. PRP can be beneficial for things like this, but I can’t say it always increases every person’s number who uses it. That is something to be mindful of. Hard for me to comment on your AMH when I don’t know your age either because it might be very appropriate for your age and so there’s not much to say there. But I would say with an AMH of 0.5, you’re producing eggs, you have plenty of eggs to use, and I want to encourage you to keep trying whatever method or means you decide to use for that.
All right, question number three: “I live in Northern Virginia.” Great to know she’s here in the United States. “I’m 45 years old. My AMH is 0.41 and FSH is 12, but after two months of eating healthy food and far-off stress,” or I think she meant fight off stress, or reduce it, “and having Coq10, my prenatals, vitamin D, E, and C, I checked my FSH on six days of my cycle and it was seven. Do you think that is a good sign that the quality of my eggs has gotten better?”
I do think that that shows that your quality of your eggs has improved because your FSH has come down. It is a little bit of an incomplete number because I don’t have your LH and estradiol to also compare that to and see everything across the board and just make sure everything looks good, but all in all, I would always rather see an FSH of six versus 12, so I think you are moving in the right direction. I will also say to you that at 45, to have an AMH of 0.41 is great. You’re slightly above average in terms of where your AMH is compared to others of your age bracket, and I think that’s a great thing, so I think you’ve got a lot of positive things on your side, and I want you to keep moving forward. Stay positive and keep trying.
All right, the next question is, or statement here, and I think it’s a combination of both, it says, “AMH. My AMH is 0.32, and I’m age 32,” so obviously, for someone who’s 32, we don’t want to see that number be that low, okay? “I retested it after three months and it was even lower at 0.28. I don’t know why this has happened to me. What it translated for me is that I only had three eggs retrieved during egg retrieval. Only one made it to blast. I’m a poor responder for IVF medication. Natural IVF might be better for me since I only have one egg with classic IVF. Let’s see how implantation will go. I do stress a lot in my real life, went to a hard university where I had a lot of unslept nights, then worked. I’m also afraid I might…” The comment trails off.
Couple of things. Obviously, we want to see that number be different for her at her age. But the positive thing I’d say is she went into an IVF cycle, she had three eggs retrieved, and of the three, she had one blast. I want to correct something she said. She says, “I only get one egg during a classic IVF stimulation.” That’s inaccurate. She actually gets three, but one of those was what made it to blast as an embryo. It doesn’t mean that that’s going to be the same every month. It means that right now that’s what happened. Next month it might be different. A lot of that depends on fertilization rates and the quality of the eggs that she’s producing, and also, by the way, the quality of the sperm that it’s being used to fertilize.
I wouldn’t necessarily classify her as a poor responder to IVF. I don’t know all the numbers, but I would say that based on what we’re seeing here in her numbers, I do think a natural IVF or mini IVF cycle may be appropriate for her, and it’s worth trying for her. But more importantly, I want her to focus on recovering her health, focusing on her sleep, and getting good quality of sleep, focusing on reducing stress, and managing all of those things. I think that’s going to be way more fruitful for her in the long run, both for her health and her fertility, and that’s what I’d like to see happen. We do have one of my other members who did comment about mini IVF as well, and she thought that it might be something that is helpful for her, which I always like to see, that support back and forth from others who are going through the same journey as she is.
Before I continue on with more questions, and I’ve got a few case studies, actually, that I want to share with you all as well, I do want to ask all of you, are you interested in learning more about AMH and mini IVF or low-stim IVF? Are you interested to know what that is good for, how that works with AMH, and if it could be good for you? If that is something that you’re interested in and you want me to do a video on, then I want to hear from you, so comment below and comment “mini IVF” so that I know that this is a topic you want me to cover in the future.
Okay, so the first case study that I want to discuss with all of you is about a member of my HOPE Coaching program who just joined, and she was looking for support specifically about her upcoming IVF cycle to freeze eggs so that she had those to use in the future. I should mention that she’s 40, okay, and she was really worried when she joined about her egg quality, and she was concerned about that as she was going through all of this. Her last email to me says, “I’m really worried about the effects on my egg reserve and egg quality the longer I let time pass.”
I do understand the rush and the concern and this feeling that you have for multiple reasons. One is because you just have that urgency inside you that you want to move forward and get results and see results. But two, because that’s also what you’ve been preconditioned to believe, that the older you get, the more time you spend, that the longer you wait that the more you are compromising your egg quality and ovarian reserve, and it’s not going to be beneficial for your fertility.
I don’t want to say that that’s inaccurate, but I want to give you a different perspective on this, okay? If you’re over 40 and you’ve waited some time to start this journey and you get results back that your FSH might be high, or your AMH might be too low, and you’re concerned because the IVF clinics are really pushing you and pressing you about time, then I think we first and foremost need to understand, yeah, obviously, time is a variable that needs to be considered in the bigger picture. But if you are not going to do anything, if you are not going to be proactive on your journey, you’re not going to make any changes right now, you’re not going to change your lifestyle, diet, we could go through that whole list of things that I always talk about, if you’re not going to be proactive in that place, then absolutely, time is a concern, and using the time, or so to speak, wasting that time, and letting it go by should absolutely be a concern for you.
But I want to pose a different option for you. What if you used that time proactively? What if we took a step back, we relaxed a little bit, we de-stressed, we let go of more things, and not added more things to our plate, we got a proper plan to support you on your journey, you took the right supplements, ate the right meal, slept better, all the things that we talk about and things that I incorporate in my plans that I write for the couples that I support in the coaching program, then my feeling is that you would only get better results, not worse results. If you use that time proactively to support your health and your fertility and reproductive function, I think, actually, in the long run, and my next case study is going to be a point on that, is going to prove my point, is only going to benefit you, and you’re going to only see improved results on an upcoming egg cycle, egg retrieval, freeze cycle, or an IVF cycle the traditional way. You’re only going to see better results.
It all for me is perspective, and how you’re going to use that time, if you’re going to use it wisely and proactively, then I think there’s a lot of potential to actually not see worse results in the future and see decline like you’re worried about, but I think there’s the potential to see a lot more positive things happen in the future with your fertility, your ovarian reserve, and your egg quality.
Case study number two, and I’m going to start off by saying in the last two weeks, we’ve had several positive pregnancy tests come in from the couples that we support, and all three of them, I said “several,” it was three positive results, and all three of them had low AMH levels. But the one I really want to talk about is the one whose AMH level was 0.02 when she started to see us. That’s right, and this is a concern for anybody, but she’s 40, 0.02. She was getting ready to move forward with an IVF retrieval cycle the next cycle when she came in and said she was pregnant.
I want to share this story because first, I want you to know what’s possible, but two, I want you to understand that what I’m saying is not just made-up story and conjecture. This is real-life stuff that we see on a regular basis. She came in with a 0.02 AMH. We said, “Let’s prepare you for your upcoming IVF cycle. Let’s take some time before you jump into it,” which she agreed to, and we did our evaluation, created a personalized plan for her, and shortly thereafter, in about two months, I want to say somewhere between two and three months when we retested her AMH in preparation for her upcoming cycle, those numbers had gone up to, not crazy high, but higher, excuse me, 0.07. Okay, so she went from 0.02 to 0.07. Obviously, we’d like to see it much higher, but in the end, she was still menstruating, she was still ovulating regularly, and with that change and the lifestyle changes that we were able to accomplish for her, she conceived.
Now, obviously, is it early in her pregnancy right now? Absolutely. But I’m telling you this because it’s possible. She didn’t think she would get pregnant naturally on her own again, which is why she was about to go forward with IVF, and that cycle for IVF is now canceled because she’s pregnant. If we give it time, if we use our time appropriately, I do believe that many of you can have the exact same results that she just was able to achieve. That is what is possible for everyone with the proper plan and support if we have our ducks in a row and if we put in the proper time and effort to make those things happen. I love that story. I loved all the stories that we got these last two weeks with successful pregnancy tests and low AMH, but that one really stuck out to me, so I had to share it with all of you today in this video.
Because so many of you really wanted more information on AMH, I’m going to share with you right here a playlist that I created with all my videos on AMH right here to make it easier for you. This is like binge-watching your favorite Netflix show, but you get to see me as the TV star, and this is much more educational and beneficial for you in the long run, so make sure you grab your pen and paper, sit down, click that link so that you can watch all of these videos and learn a ton. Additionally, I created a playlist also about a miniseries that I did having to do with AMH and egg quality that can also be beneficial for all of you if you haven’t checked them out, so you’ve got those two resources for all of you in addition to all these recent videos that I created on AMH to help you get the results that you want and you deserve on your fertility journey.
All right, if you know that you are ready to see progress and change in 2023 and you’re ready to take the leap to have me and my team coach you on your fertility journey and help you through your AMH struggles or any of your fertility struggles, then we’re here to support you through my HOPE Coaching program. If you want to join, and I’d love to have you there, all you have to do is use this link in the description below to apply. We would love to support you and get you the results that you deserve in 2023.
All right, if you like this video, give me a thumbs up. If you’re not already a subscriber to my YouTube channel, you should be, so hit that bell to subscribe and get notified. If you’ve got questions or comments about this video or your fertility journey, please comment below and leave them below for me and I will get back to you soon. All right, everybody, until the next video, stay fertile.