AMH and Ovarian Reserve: Should You Test Your Fertility?

**Learn more about my new fertility course to enhance your natural fertility and optimize your lifestyle**

You are born with all the eggs (oocytes) you will ever have, and every person runs out eventually. But how do you know how many eggs you have left? Should you test your fertility? What is AMH? What is your ovarian reserve?

Fertility Doctor, Natalie Crawford, MD talks about fertility testing and ovarian reserve. What should you know now if you want to have kids in the future? What should you know if you are trying to conceive or undergoing fertility treatments? How do you know if you are running out of eggs? How many eggs do you have left.

Questions answered:
What does it mean to test your fertility?
What is AMH (Antimullerian hormone)?
What does it mean if your AMH is low?
Does a low AMH cause infertility?
What is an Antral Follicle Count (AFC)?
What is diminished ovarian reserve?
Does birth control impact AMH?
Does endometriosis impact AMH?
Does cancer or chemotherapy impact AMH?
What does AMH mean for egg quality?
What can you do if your AMH is low?
Does AMH impact IVF?

**STARTING SOON: Fertility Q&A videos, ask in the community tab**

This is medical education, not medical advice, please ask your doctor your medical questions.

#fertility #AMH #nataliecrawfordmd

Resources:
Steiner AZ, Jukic AM. Impact of female age and nulligravidity on fecundity in an older reproductive age cohort. Fertil Steril. 2016;105(6):1584–1588.

Steiner AZ, Pritchard D, Stanczyk FZ, et al. Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age. JAMA. 2017;318(14):1367–1376.

Mesen TB, Mersereau JE, Kane JB, Steiner AZ. Optimal timing for elective egg freezing. Fertil Steril. 2015;103(6):1551–6.

Fritz and Speroff, Clinical Gynecology Endocrinology and Infertility, 8th edition, 2011

Ligon S, Lustik M, Levy G, Pier B. Low antimüllerian hormone (AMH) is associated with decreased live birth after in vitro fertilization when follicle-stimulating hormone and AMH are discordant. Fertil Steril. 2019 Jul;112(1):73-81.e1.

Seyhan A, Ata B, Uncu G. The Impact of Endometriosis and Its Treatment on Ovarian Reserve. Semin Reprod Med. 2015 Nov;33(6):422-8. doi: 10.1055/s-0035-1567820. Epub 2015 Nov 23.

Landersoe SK, Birch Petersen K, Sørensen AL, Larsen EC, Martinussen T, Lunding SA, Kroman MS, Nielsen HS, Nyboe Andersen A. Ovarian reserve markers after discontinuing long-term use of combined oral contraceptives. Reprod Biomed Online. 2020 Jan;40(1):176-186.

Porcu E, Cillo GM, Cipriani L, Sacilotto F, Notarangelo L, Damiano G, Dirodi M, Roncarati I. Impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes in young women with breast cancer. J Assist Reprod Genet. 2020 Mar;37(3):709-715. doi: 10.1007/s10815-019-01658-9. Epub 2019 Dec 24.

Bedenk J, Vrtačnik-Bokal E, Virant-Klun I. The role of anti-Müllerian hormone (AMH) in ovarian disease and infertility. J Assist Reprod Genet. 2020 Jan;37(1):89-100. doi: 10.1007/s10815-019-01622-7. Epub 2019 Nov 21. PMID: 31755000;

Berjeb KK, Debbabi L, Braham M, Zemni Z, Chtourou S, Hannachi H, Hamdoun M, Ayadi M, Kacem K, Zhioua F, Fadhlaoui A, Bahri O, Chakroun N. Evaluation of ovarian reserve before and after chemotherapy. J Gynecol Obstet Hum Reprod. 2021 May;50(5):102035---------
Dr. Natalie Crawford, MD is a double board certified OBGYN and REI, and co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas.

Welcome to the "As a Woman" community where we are all stronger together.

COME SAY HI!!!

FORA FERTILITY:
715 W 34th Street, Austin, TX 78705

Listen to the AS A WOMAN PODCAST here:

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#fertility #fertilitydoctor #nataliecrawfordmd #doctor #asawoman

Sharing fertility facts to educate women about trying to conceive, getting pregnant, ovulation, fertility treatments, IUI, IVF, becoming a doctor, life as a woman in medicine, and more.

[darcipause]

Very informative— thank you. It should be standard practice and covered by health insurance for all women to get AMH and FSH tested. I can’t believe such a simple test is not more widely available.

[tborody]

Almost 37 and I got some really disappointing, but important results from the AMH this year. It makes me mad that no one tells us anything about this when we're still young. If you're in your 30s, do it asap. It's a simple blood test. Was $100 (in Canada) and may have just changed the path of my life.

[girlwithaplaylist]

100% agree with you at 3:08 ... I was one of those who put my career ahead. But at only 24 I was diagnosed with endometriosis stage 4 and an endometrioma on my ovary. I have yet to test my ovarian reserve for IVF (takes time under the public system) but I am absolutely losing my mind. I wish I had done this earlier and that this was a topic we learned about growing up!! 20 is not too young for knowledge of our own bodies. If we can learn about sex Ed earlier we should learn about female (and male) reproductive conditions too.

[inkerikavantera]

I am 38 trying my first child. My AMH is 0.64 and follicle account was 4-6/ 6-9. I started with a medicated IUI. I was first tested 3 years ago when my follicle count was worse. My life was very stressful back then. I have lead healthy stress-free life ever since.🍃💓

[LindaMoroun]

The best video on explaining AMH so far. Thank you 😊

[chayanncarlisleking]

When we're in our 20's our mum's don't Educate us in Infertility at all much less our local family gps Thank you Doctor

[soph]

All my sisters and I have low AMH, my sisters have been able to conceive just fine in early and late 30s. I am in my first month of TTC at 31 and hoping for the best. It just takes one egg so I'm going to look at the bright side and not worry about it for now! Good information to have nonetheless.

Edit: I did get pregnant shortly after this AMH of 9, my sister was AMH 2 and got pregnant after 5 months. My other sister was 38 with AMH 9 and she conceived twins after a miscarriage. I know everyone is different, I post only because I don't want people to freak out if they have low AMH it isnt the be all and end all, like I freaked out when I saw my number towards the bottom of the big graph comparing me to ppl my age

[chelseygriffith]

Currently trying to conceive. Love your videos and all the information! You make everything so much easier to understand. Thank you ❤️

[loveslikesalt]

OMG can we PLEASE find a way to block this guy eugene from commenting on EVERY women’s post about spell casting for babies!?? i’m sick of his comments\Spam

[aboutscout]

Might be worth mentioning to people that IVF and egg/embryo freezing is SIGNIFICANTLY cheaper in other countries with comparable standards of care as the US. My husband and I are currently pursuing embryo freezing in Germany which will cost us roughly $3, 500 per cycle vs the roughly $22, 000 per cycle it would cost us to do it in our area. Even when we factor in the flights and the cost of lodging in Berlin for a few weeks, we still save a ton of money going to Europe. We were also considering clinics in Prague and a couple in Greece because they offer PGT-A which Germany does not allow.

[TheHipReview]

I am 42, and my Anti-Mullerian Hormone (AMH) 1.12 ng/mL. My antral follicle count was 12 at my baseline scan. I am going through IVF now.. We are doing an egg retrieval this round and next month we are doing a full IVF cycle. Fertilizing eggs from August along with the ones in September. I am hoping for success. Good luck everyone.

[jhonnagarcia]

You make everything detailed and easy to understand❤❤

[tj]

This was so timely! I had my AMH levels checked yesterday as I'm getting ready to start IVF and I wanted more info on this. 😊

[shelbyeaster]

First time commenting on your videos! First, I love the way you are thorough with your explanations but you don't talk down to your audience - very refreshing!

Second, any chance you could do a video on FSH and the relationship to fertility? I know there are a lot of at home blood tests that only check FSH and not AMH so knowing the differences/risks would be amazing!

[abab]

I really appreciate you. I like the hard truth- good or bad. The way you deliver complex information is outstanding. Thank you. 💜

[rachelpage]

Hi,

Thank you Dr Natalie, I LOVE your videos, so informative and helpful, gives me hope!

I'm a 33 year old single woman who is having an IUI with donor sperm in February 2024. I will have a HCG trigger only and no Femara or Clomid.

I haven't had any diagnosis of PCOS or Endometriosis, however, for a long time I suffered very badly with period pains and I once went 55 days without a period at all.

It was found that I was low on vitamin D so my GP prescribed me a 6 week course and since I finished the course (6 months ago) my periods are now regular and barely painful at all!

What I would like to know is my actual chances of this IUI working and if there is anything I can do to improve my chances?

I've been told I have 'small ovaries' and that my AMH and AFC are on the lower side, should I be worried about this?

Cycle Length: 27 / 28 Days

Usual Ovulation Cycle Day: 13 / 14

Test Reults (Cycle Day 3):

FSH: 7.2 U/L

LH: 3.6 U/L

TSH: 3.00 mU/L

AMH: 1.47 ng/mL

Endometrium Thickness: 3.4mm

Follicle Count (L): 5

Follicle Count (R): 7

Total Antral Follicle Count: 12

Ovary Volume (L): 2.8ml

Ovary Volume (R): 3.5ml

Ovary Size (L): 11 x 23.3 x 20.6mm

Ovary Size (R): 14.6 x 25 x 18.3mm

Fallopian Tube (L): No Abnormality Detected 

Fallopian Tube (R): No Abnormality Detected

I would appreciate so much if you could get back to me Dr Natalie 🙏

Sending lots of love, light and baby blessings to all those TTC 🫶

[malibooyaw]

At 34 I had to breakdown crying before my doctor would test me. When my AMH was checked it came out in the post menopausal range. Afterwards, all my provider could say was “sorry” several times.

I clearly stated over the years that I wasn’t ready to conceive but I wanted to know about how much time I had to wait. The only solution I would be met with is “try to get pregnant”. So frustrating when you just finished saying you’re not quite ready to have a child. Even up to the day I was tested, the same cold statement was made. It’s devastating that I tried to be proactive but was discouraged/ignored by providers for years. They claimed I was young and had nothing to worry about.

Then my follicle count was only 4. Btw I had removal of my left ovary and left Fallopian tube due to endometriosis at 17 y.o. So I don’t understand why I was brushed off for so long.

[carf]

You are so nice you do this for us! So helpful information! I wish you were close to where I live, I would definitely choose you for my doctor :)

[krystalavery]

Got my AMH checked today and I was so worried because I want to do a fresh embryo transfer for my IVF cycle thankful that it’s perfect high enough for IVF fresh transfer but not too high to worry about over stimulation

[sandrasolimine]

I'm 30 and my AMH is .4. I don't get it. I workout, I eat good, I do everything right. Why do I have the fertility of a 45 year old.