Challenges In Conception Due To Low Ovarian Reserve.

What is Low Ovarian Reserve? What does a low AMH blood test result mean? how do you find out your ovarian reserve? ETV Bharat Sukhibhava was in conversation with Dr.S. Vyjayanthi, MD, Sub Specialist in Reproductive Medicine and Surgery (RCOG, UK), Director, Mother to be Fertility”, Head of Department and Consultant Fertility Specialist, KIMS Fertility Centre.

What is AMH and what Does Low AMH Blood Test Result Mean?

AMH or the Anti-Mullerian Hormone is a protein hormone that is secreted by the developing egg sacs or ovarian follicles. This test helps in assessing the ovarian reserve – or the number of eggs left in the ovaries – of a woman. Low AMH count indicates a declining level of fertility.

Reduced reserve means that with fewer eggs in the ovaries, the chances of a healthy egg being released for fertilization decreases, and women find it difficult to conceive with subsequent physiological, psychological, and social implications.

However, this can be addressed with a combination of options.

Reading the Test Results

Low AMH level indicates a lesser number of eggs in the ovaries. As woman’s age increases, this number keeps reducing, indicating reduced fertility. Typically, an AMH level of 2.0 – 3.0 ng/ml is considered “normal” for a fertile woman. A count of less than 1.0 ng/ml indicates a reduced ovarian reserve. A very low AMH count is common in women approaching menopause.

Fertility Level

While age is the primary factor that impacts AMH level, improper nutrition, vitamin deficiency and cancer treatments such as chemotherapy and radiation could also play a role in decreasing one’s AMH level. The test does not assess the quality of the eggs and cannot predict the chances of a natural conception or success of any form of fertility treatment.

When Do You Take the Test?

This test is recommended for a woman as part of a fertility workup particularly if the age of the woman is more than 30 years or before the start of any fertility treatment. Women intending to delay getting pregnant due to various reasons or not yet found their ideal life partner yet can also consider checking their levels so that if their levels are on the low side can consider egg freezing.

Treatment Options for Low AMH

Mostly a low AMH level is not reversible, so for those who wish to conceive, doctors suggest using assisted reproductive technologies.

For women who do not wish to conceive immediately, fertility (egg) cryopreservation, where they can freeze their eggs for the future is recommended. Former Miss World Diana Hayden was among the first celebrities to set an example for young, ambitious women by having her eggs frozen in her mid-30s. Thawing them eight years later, Diana was able to become a mother at the age of 42.

If AMH level is sufficient for an IVF cycle, then IVF (In Vitro Fertilization) is recommended. Here the egg is retrieved (after hormone stimulation) via the egg retrieval procedure, and fertilized in the lab, and implanted into the woman’s uterus.

Following an IVF cycle, if the quality of eggs is poor or the AMH level is very low and not considered suitable to offer IVF using one’s own eggs then the next suitable option would be an egg donation. Here, the egg is donated by another donor, and embryos formed in the lab using IVF and then implanted back into the woman’s uterus.

Improving the Health of Your Ovarian Reserve

While the ovarian reserve itself may not improve naturally, a healthy lifestyle will impact the quality of the eggs.

Finally, if you have shown a low AMH level in your test seek professional help by consulting a fertility specialist to discuss further options.

For more queries on Infertility and conception, contact, Dr. Vyjayanthi atsvyjayanthi99@gmail.com