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Apr24
Low Amh- What to Do?
What is meant by less number of eggs?
A woman is born with finite number of eggs in her ovaries. This is called “Ovarian Reserve”. In every month, number of eggs are destroyed and this is unavoidable. However, in some women, this process of destruction is accelerated and this is called “Poor ovarian reserve (POR)” or “Less number of eggs”.

How can I know that I have less number of eggs?
Blood results can show low AMH and high FSH. The most definitive test is checking for the eggs (AFC- Antral Follicular Count). It must be kept in mind that a single result is not confirmatory. In short, we have to look into age, AMH and AFC together.

What are the treatment options?
Only a low AMH or low AFC cannot decide what treatment you should have.

We also have to consider your age, duration of infertility, previous pregnancy (if any), condition of your tubes and partner’s sperms. If all other factors are favourable and you have only low AMH and AFC, a short period of Ovulation Induction (OI) and IUI (Intra-uterine insemination) can be tried. If these fail, you may need to consider IVF.

Is IVF done as the last resort?
Low AMH does not always mean that you need IVF. However, if your age is on the higher side or duration of infertility of long, IVF may be the better option for you.

We always encourage the women to try IVF with your own eggs first. If that fails, then ONLY consider donor eggs.

What is the chance of success?
It depends on your age, duration of infertility and your response. In general, the chance of pregnancy after each cycle of IUI is 15-20% and after IVF, 30-40%. However, the chance is slightly lower in women with POR.

Is there no chance of natural conception?
In women who have menopause before 40 years, 10% can conceive spontaneously. In women with POR, this chance of natural conception is even higher. So, POR does not always mean that you have do OI, IUI or IVF.

What medicines can be tried?
Some medicines may be tried to improve ovarian response, like DHEA, testosterone gel or antioxidants, vitamin D etc. However, whether the medicines are actually helpful, is a matter of debate and it needs further research.


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