I remember it so clearly. My husband and I were both taking a day out from work back in 2015 and were hanging out in East London at a cafe, when I got the call from the doctors to confirm and discuss my fertility blood results.
I had initially opened the results and stared unknowingly at the numbers and symbols on the paper in front of me just a few days before. Having done a bit of homework I knew roughly what I wanted to see. And ‘low’ wasn't top of the list.
On the line reading ‘AMH’ (Anti-Mullerian Hormone) it indicated the figure ’15’ which was determined as ‘low’. Now back then I didn't have much of an idea of if that was really, hopelessly low or not. Did that mean 15 eggs?! So while we sat waiting for our food to turn up, my nerves were on the rise as the doctor on the other end of the phone explained that it was at the high end of the low bracket, which made me feel marginally better. But I was 32 and healthy, why was the test that essentially indicates, albeit not precisely, your ovarian reserve of eggs coming out as low?
This low AMH diagnosis was roughly two years prior to my endometriosis diagnosis which could go some way to explain my reading, possibly due to damaged ovaries.
My mind started to spin. All I could see were two empty ovaries. Closed for business. I felt wretched and guilty that my body was possibly going to stop my husband and I from achieving biological parenthood. What became glaringly obvious to me though is how little I knew about my own body. I had taken for granted throughout my early twenties that I was fit and well and likely extremely fertile. In all my desperate searching for answers and help, it seemed that your AMH is sort of set in stone. There isn't a supplement or therapy you can have to really move the dial on it. Great, so the one thing I couldn't control was determining my fertility. It’s not like I could change my diet, or find a way to destress or in the case of a few people I know, take a simple blood thinner in order to boost my fertility.
What does low AMH really mean?
In hindsight, now that I have been on the infertility journey and so gratefully emerged the other side with a beautiful baby girl thanks to CREATE Fertility, I realise that the tests themselves for ovarian reserve are just not that accurate and while your results are plonked on a scale, I have had many a conversation with women in and outside of my circle who were triumphant in becoming mothers despite low readings, sometimes alarmingly so. One woman I know was categorically told she was a ‘lost cause’ but she decided to keep trying via IVF and her dreams came true because of one amazing egg that was retrieved.
Because that’s just it. It just takes one healthy egg.
I recently opened up my blog for others to share their fertility stories as a means of raising hope and belief in those struggling to conceive. This story alone touches on the subject of low AMH and has a beautiful happy ending.
Getting pregnant with low AMH levels
I really think more has to be done to educate both sexes as to the female reproductive system. Had I known years ago that my egg reserve was low or dwindling quicker than the norm maybe I would've looked into fertility preservation methods.
Low AMH does not mean no baby, either naturally or via assisted conception it could however mean, a longer road to motherhood.
In short, you can get pregnant with ‘low AMH’, I and countless others are proof of that.
IVF and low AMH
I asked Professor Geeta Nargund, the founder & medical Director of CREATE Fertility what exactly an IVF clinic can do to help someone with low AMH;
“If tests show that a woman has a low Anti-Mullerian Hormone (AMH) level, then this indicates that she also may have a low ovarian reserve, will need an ultrasound scan of the ovaries and may need medical assistance to conceive. This can seem daunting, but there are treatments on offer that provide a good chance of success for women with low AMH.
Natural and Natural Modified IVF cycles – which use no or fewer stimulating drugs and focus on the natural selection of eggs and a higher quality of embryos – can work especially well for many women with very low ovarian reserve, so be sure to ask your clinic if this form of treatment is on offer. These types of treatments work with a woman’s body, within their natural cycle, and are designed to enhance the natural development of follicles without the need for intensive drug protocols.
As a result, a higher quality egg is naturally selected by the body (as opposed to multiple eggs of potentially lower quality being forced into release following intensive drug treatments), which studies have shown offer a good chance of success without resulting in wastage of embryos. Ultimately, clinics should try, where possible, to work with a woman’s natural cycle as much as possible, to offer both the best chances of conception and to protect the health of the woman undergoing treatment.”
Should your blood tests return a low AMH result, it is worth speaking to professionals in the field of fertility that perhaps your GP could refer you on to. It is a very specialist area and there are people out there that can help guide you on to the right course of treatment to help your fertility outcome.
With CREATE Fertility, I knew that they took ovary and follicle stimulation very seriously, to ensure the health of their patients and to nurture healthy eggs, no matter how many. Even though my AMH was ‘low’ back in 2015 and therefore likely even lower when it came to my IVF journey a year or so later, 14 eggs were retrieved of which 10 fertilised overnight. I will never forget taking that phone call the day after egg collection. It all felt like magic, that somewhere in London, in a lab, was the embryo that would later turn in to my daughter.
If I can recommend just one thing...
It might sound ridiculous but one additional thing I started to make sure of once I was over the initial shock of having a low AMH reading, was that I started to speak more kindly to myself, internally. Instead of blaming my body or feeling resentful toward it, I decided it was so very important to start visualising a healthy reproductive system and that although low, I still had a chance.