1. Q: My doctor says I have very low ovarian reserve, with AMH test results at 0.1ng/ml. Is there any hope for me to conceive naturally with my own eggs? Please help me, I am 43 years old, soon to be 44.
A: I certainly want every woman to have hope! What we know is that science has proven that fertility and egg health begins to decline rapidly around the age of 40 and after. AMH (Anti-Mullerian Hormone) levels also naturally decline with age. It is universally believed that an AMH level of less than 1ng/ml is indicative of decreased ovarian reserve, meaning the number of eggs present may be low. This, however, does not mean that the quality of the eggs that remain is also low. It is still possible for some women in their early 40s to conceive naturally with their own eggs, but no one has the ability to estimate the chances of achieving or sustaining a healthy pregnancy at any age.
Since we know the chances of conceiving naturally with our own eggs after the age of 40 (this increases with each year we age) are lower, we find it is always a good idea to have a time frame in which you are willing to try to conceive with your own eggs. During the time you are trying on your own, you may also want to create a “plan B”, where you consider and make a plan for alternatives such as IVF with your own eggs, or with donor eggs which may increase your chance of achieving pregnancy.
2. Q: I have been trying for a baby for the past 3 years. I am 36 years old and I just went to see my Obgyn to see what may be the problem. She did hormone testing and the only thing that came back of concern to her was my FSH which was 17 and AMH was 0.7. What does this mean? Am I in menopause? She said my egg health is low. Is there anyway I can improve my egg health? I really want to have a baby. Any help is appreciated.
A: Many doctors believe that FSH levels higher than 10-15 mIU/mL when the test is done on the third day of a menstrual period may indicate diminished fertility, poor egg health or low ovarian reserve (indicated by low AMH levels). These hormone levels do not indicate menopause.
It is important to know that follicle stimulating hormone (FSH) levels fluctuate throughout a woman’s menstrual cycle. According to the National Institutes of Health, normal FSH levels for menstruating women range should range from 4.7 to 21.5 mIU/ml (keeping in mind that normal ranges may vary among laboratories) during the follicular and luteal phases of the menstrual cycle. FSH levels should be between 30 and 50 IU/L mid-cycle right before ovulation and will naturally be higher in postmenopausal women, in general at 60 IU/L or more.
It may help to reach back out to your OB/GYN and ask why these test results concern her. High or low levels of FSH, in relation to the time of your cycle when they were run, can indicate an imbalance, or fertility health concern.
We feel that the health and current state of the endocrine system needs to be looked at first when egg health is a concern due to low or high FSH levels and decreased AMH levels.
A natural fertility program for low or high FSH and a 90-day egg health program both include:
- creating a foundation for hormonal balance and a healthy uterus for implantation through Fertility Cleansing
- supporting the pituitary gland and hypothalamus through nutrition with essential fatty acids (EFAs), dark green plant foods, bee pollen and following a Fertility Diet
- using herbs like Vitex (Chaste Tree berry) and Maca (Lepidium meyenii)
- utilizing natural therapies like fertility massage and acupuncture
Herbs, nutritional supplements and natural therapies are best able to support the body when stress is managed and a healthy weight is being maintained through a healthy, whole food diet and moderate daily exercise. If you’d like help in creating a well-rounded, holistic, fertility health program made specifically for you, consider a Fertility Consultation.
3. Q: I am 35 years old and my doctor wants to run an AMH test to see what my ovarian reserve is. Is this necessary at my age?
A: It may be helpful to know your AMH levels if you have been trying to conceive for a year without success and suspect infertility, anovulation, you are dealing with a fertility health issue that could impact ovarian health or function (like ovarian cysts or PCOS), or have had recurrent miscarriages.
Each woman has a dormant pool of eggs (follicles) in her ovaries, from which one is chosen to mature each menstrual cycle in preparation for ovulation. These eggs are surrounded by cells that produce the AMH hormone. AMH testing is, as you know, used to determine ovarian reserve, or remaining egg supply. A higher AMH level indicates a larger egg supply and hence good ovarian reserve and poor ovarian reserve means there is a smaller egg supply.
“The most important modifying factor of ovarian reserve is age. Decreased ovarian reserve in a younger patient (<35 years of age) is not necessarily the same as decreased ovarian reserve in an older patient. A younger woman may have decreased ovarian reserve and though the number of eggs present may be decreased, because of her age, the egg quality may still be high. Age in combination with an assessment of ovarian reserve and the other elements of your fertility evaluation will determine your treatment path." – Shady Grove Fertility