Did you know that females are born with fixed number of eggs (oocytes) around 6 million when she is in her mother’s womb and it keeps reducing with increase in reproductive age. The quantity and quality of eggs in females is one of the important factors out of many factors which determines her fertility. While there are measures which can tell us the quantity of egg reserves in a female but there is no test which exists, which tells the quality of eggs.
Measure of egg count
When a female faces difficulty conceiving, fertility doctor may advice for a test known as AMH [Anti-Mullerian Hormone]. AMH is a blood test which is associated to a person’s egg count. In India it costs around 2400 to 2600 for such a test.
Normal AMH levels
AMH levels starts rising from adolescent and peak around 25 years old then it starts declining very slowly until 30 years of age. In India, after 30 years of age this value starts declining quickly. That is why it is generally stated that a female must complete reproduction before the age of 30 years to avoid facing infertility.
AMH levels is measured in nanograms per millilitre [ng/mL] and normal AMH levels are stated in given table: –
- Average: Between 1.0 ng/mL to 3.0 ng/mL.
- Low: Under 1.0 ng/mL.
- Severely low: 0.4 ng/mL.
AMH level by age: – Normal AMH level for your age can be derived from the suggestive table below: –
- 25 years old: 3.0 ng/mL.
- 30 years old: 2.5 ng/mL.
- 35 years old: 1.5 ng/ mL.
- 40 years old: 1 ng/mL.
- 45 years old: 0.5 ng/mL.
And when your AMH level does not match against your age and is low than the stated value, it is said to be Low AMH levels, meaning your ovaries are aging faster than your overall physical body. This is common for females in India, their ovaries age faster than their western counterparts. And knowing this fact they should either plan all their pregnancies before the age of 30 or plan to freeze their eggs to later get pregnant with their own eggs.
What to do when you find you have low AMH levels?
On doctors’ recommendations when you get your test done and you find that you have low AMH level as compared to your age or you are trying to get pregnant post 35 years of age, first thing that you need to do is find a fertility doctor who have got good track record to get you pregnant with low AMH. When trying to get pregnant with low AMH level chances of getting pregnant naturally or with an IUI treatment are lean. You need to make up your mind to undergo IVF, ICSI treatment.
While selecting an IVF clinic it becomes vital for you to select a clinic and a fertility doctor who has got proven track record with similar cases. This is because success with low AMH patient requires lots of experience, skill, knowledge and customized protocol both from doctors and embryologist’s end. Ask the clinic’s success rate amongst patient with more than 35 years of age. International standards are around 35 to 40% over two embryo transfer procedures with two good quality blastocyst embryos. Check that out for yourself and do your research before experimenting on low number of eggs that you are left with.
Getting pregnant with Low AMH value
PGT-A
In cases where the females age is more than 35 years of age and have got 5 or more than 5 embryos with low AMH values around 0.8 to 1 are asked to go for PGT-A.
Embryo pooling
If the doctors feel like, they may also counsel you for embryo pooling. In embryo pooling doctor attempts to gather 3-4 good quality embryos over 2 to 3 ovum pick-ups. Generally, females with very low AMH level around 0.5 to 0.7 and who prefers to get pregnant with only their own eggs are recommended for embryo pooling. After making a pool of 3 to 4 good quality embryos, two good quality embryos are transferred to get the highest chance of pregnancy.
IVF with dual stimulation/Customized protocol
Unlike traditional IVF protocols where patients undergo a single round of ovarian stimulation with fertility drugs and egg retrieval in one menstrual cycle, in the DuoStim protocol patients undergo two rounds of ovarian stimulation and two egg retrievals in the same menstrual cycle [ https://www.vcrmed.com ].
Frequently Asked Questions [FAQ’s]
Is there any medicine to improve AMH level?
No there are no medicines which can improve you AMH level as your AMH level multiplies before your birth that is in your mother’s womb. This is the only time when your egg reserves are being determined. But yes, maintain a healthy BMI level can improve your chances of success with an IVF cycle. So do have a look at it. Though there are a few studies which reveals that consuming Vitamin D as per the prescription of your fertility doctor have helped improve results on the IVF treatment, while this is still under discussions.
What food should I eat to increase my AMH level?
While there is no food which can help you increase your AMH level but you can definitely eat right to improve your egg quality to some extent. Eat plenty of leafy greens, whole grains, lean meats, nuts, fresh vegetables, and fruits. Stay away from trans fats, refined carbs, processed foods or meats, and excessive salt and sugar.
What are the other things in my control that I can do to improve my AMH level?
While there is actually nothing that you can do to increase you AMH level but you can defiantly stop worrying too much on it and follow your doctor’s advice. Secondly, you can try to keep yourself overall healthy by having good amount of sleep, rest, keeping engaged in things that help you happy and involving, keeping in company that makes you happy, and eating right. Try to exercise, walk or play sports of your choice for an hour or so. Yoga, meditation and exercises increases the amount of oxygen intake and improves blood flow in the entire body. These are small tips and have not been proven but can help boost your overall fertility and health.
