Low AMH Levels: What do they really mean for fertility?

Low AMH levels are generally considered to be an indicator of a low ovarian reserve. It is quite normal for a woman’s AMH levels to decline as she gets older, and in younger women this may be a sign of premature loss of fertility. Low AMH fertility treatment could consist of IVF together with hormone treatment. Alternatively, some patients may be advised that egg donation is an option worth considering. A good AMH level for IVF is anything within the range of normal for a woman under 38. However, looking at what are the AMH levels in an individual is only part of the diagnostic process.

You could be offered a test to see how well your ovaries might respond to fertility drugs. This involves a blood test to measure levels of either FSH (follicle-stimulating hormone) or AMH, which can help your clinical adviser to judge whether IVF is the best treatment.

What are AMH levels?

AMH refers to the Anti-Mullerian Hormone. This is a substance which developing egg sacs (ovarian follicles) secrete. The higher the number of eggs remaining in the ovaries, the higher the level of AMH in the bloodstream. Therefore, a low level is considered to be a sign of a low ovarian reserve, i.e. few remaining follicles. This would be normal for a woman who is approaching menopause. Conversely, a woman who has polycystic ovarian syndrome, characterised by the presence of many small ovarian follicles, would normally be expected to show high levels of AMH.

A frequent question is what are AMH levels that are considered low in this context. Very low AMH is usually thought to be an AMH below 1.05 ng/ml, and undetectably low AMH levels are calculated as below 0.16 ng/ml. A low level of FSH (follicle stimulating hormone) can be an additional indicator of a problem with the quantity of a woman’s eggs.

Low AMH fertility treatment – what are the options?

For many women, a declining level of fertility and failure to conceive is the trigger to consult IVI for advice. You will find yourself in a welcoming environment where the patient experience and needs are put at the heart of all clinical developments. We focus on turning our patients’ dreams of becoming a parent into reality and in doing so, always follow consistently high standards throughout our IVI clinics globally. This is the level of professional commitment and expertise that you can rely on.

Providing your clinical consultant at IVI considers there is a good AMH level for IVF, in vitro fertilisation could well be the treatment recommended. If on the other hand the AMH levels and thus the ovarian reserve are so low that this form of intervention is unlikely to succeed, your clinician may advise you to consider the use of egg donation. For some women with an extremely low ovarian reserve, if several rounds of IVF have not been successful, time constraints make egg donation the preferred route to a successful pregnancy. First we look at what’s involved in IVF as a low AMH fertility treatment.

The experience of IVF at an IVI clinic

The process is relatively straightforward. The treatment starts with ovarian stimulation. This consists of the administration of daily injections which cause the ovaries, instead of producing a single ovum, to create more oocytes so that a more significant number of embryos can be obtained. Depending on the stimulation protocol chosen, the treatment takes between 10 and 20 days. Our health professionals indicate the type of medication and appropriate dosages for each woman, based on each individual case. During the process follicle tracking is performed through transvaginal ultrasound scans, and serum levels in the blood are also measured to check on ovarian follicular growth and maturation.

The next step is retrieval of the eggs. This is scheduled when the follicles have reached the appropriate size. A hormone injection is administered to trigger ovulation and, approximately 36 hours afterwards, egg collection can take place. The patient attends the clinic and a light sedative is administered to prevent discomfort. The procedure takes 15 minutes and is carried out by a gynaecologist, an embryologist and the anaesthesiologist. The next stage is Oocyte fertilisation, which takes place when the sperm is mixed with the retrieved eggs to allow fertilisation to occur. This can happen by one of two methods: conventional IVF, which consists of placing the eggs in contact with sperm in a petri dish or alternatively ICSI (Intracytoplasmic sperm injection) which consists of microinjection of the sperm directly into the mature egg with the help of a pipette.

The final stage is embryo transfer into the uterus, a simple painless procedure for which no sedation is necessary. It takes just 15 minutes, after which the patient return home.

Donated eggs: another option for low AMH fertility treatment

For those women who do not have a good AMH level for IVF or where IVF treatment has not been successful, using donor eggs is an alternative approach. Egg donation is the process in which women use eggs from a donor in order to have their own child. The donor’s eggs are fertilised with sperm, usually from the woman’s partner, to produce embryos. These are then transferred into the womb in the same way as with IVF, making pregnancy possible.

IVI have a network of clinics across Spain which have for many years been working with international patients who require egg donation. There are some significant differences in the regulatory framework regarding anonymity. Egg donation is anonymous in Spain, where IVI has the largest frozen egg bank in the world. We therefore have access to egg donors with all characteristics, with no waiting list. If you decide, with the help of your clinical consultant, that this is an option you would like to explore, you can familiarise yourself by reading more about IVI clinics in Spain. This is what your patient journey would look like.

Visiting an IVI clinic in Spain

IVI clinics in Spain have become a benchmark in their field as a result of the outstanding quality of international patient assistance. Indeed, our most telling result is that 9 out of 10 couples who consult IVI for infertility problems reach their goal. This is the reason why people from over 150 countries worldwide pick IVI to help them see their dream of starting a family come true. You don’t need to have any worries about a language barrier, since we have specialist clinics which are geared up for international patients, with a team of bilingual doctors and allocated tutors who stay with you throughout your course of treatment.

Our Donor Programme operates under Spanish law which requires that in order to be accepted as a donor, a woman must be between 18 and 35 years old, their genetic history must comply with the requirements of the legislation and they must have a normal reproductive system. We also require that they undergo a full medical and psychological assessment that provides us with valuable information about their fertility and state of health, as well as a chromosomal study to rule out the possibility of any future defects.

The first step for you as the recipient woman is to receive medication to prepare your uterus for implantation with the fertilised embryo. When a suitable donor is identified, the semen, from a partner or donor, can be prepared to select the most suitable spermatozoa for fertilising the donated oocyte. The spermatozoa and oocytes are brought together through IVF or sperm microinjection. Once fertilised, they stay in the laboratory until the ideal time for them to be transferred.

At the end of the process, our aim is the same as yours: a successful pregnancy and your dream finally coming true. If you’d like to know more about treatment with IVI and in particular the options for low AMH fertility treatment, have a look at our IVI Overseas Programmes information, get in touch via our contact form or give us a call today. We’ll aim to answer all your questions.

 

Links:

ICSI https://www.ivi.uk/assisted-reproduction-treatments/icsi/

IVI Donor Programme https://youtu.be/pHT16K4YZ4s

IVI Overseas Programmes https://ivi-fertility.com/patient-journey-overseas/

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