IVF Protocols For Low AMH: Maximize Your Fertility Potential
Jan 2025 None
IVF

IVF Protocols For Low AMH: Maximize Your Fertility Potential

Fertility is a complex aspect of human life with many things affecting it. While some of the things affecting fertility can be easily seen, such as lifestyle and body weight, others are not. The things that cannot be easily seen include chemicals, nutrients, and hormones. Now, if you have read or heard a bit about fertility, you should know that there are many hormones that affect fertility, and one such hormone is an Anti-Mullerian Hormone or AMH for short. But even is an AMH? How does low AMH affect fertility? And why is it important in IVF? Well, in this blog, we discuss these very things. 

Here, we shall talk about what an AMH is, the symptoms of low AMH levels, and the causes of low AMH levels. But, before we go into the deep, let's first discuss what an ovarian reserve is, as the effect of AMH can be seen in the ovarian reserve of the user. 

What Is An Ovarian Reserve?

Ovarian Reserve

So before we discuss anything else, let’s first discuss what an ovarian reserve is. In simplest terms, ovarian reserve is essentially the quality and quantity of a woman's remaining eggs in the ovaries. Needless to say, ovarian reserve is an important factor in determining your fertility as a woman. 

Now, there are many factors which can affect the ovarian reserve. Some of these include age, genetics, overall reproductive health, and, of course, levels of AMH. That said, it should be noted that AMH also acts as an indicator of ovarian reserve. 

The relationship between levels of AMH and ovarian health is rather simple and direct. High levels of AMH indicate a healthier ovarian reserve, i.e. an ovary with a higher number and quality of ovaries. Likewise, lower levels of AMH indicate that your ovaries have lower numbers of ovum or that they are of low quality. 

All in all, ovarian reserve refers to the reflection of the quality and quantity of eggs in the ovaries of a woman, which in this case is you. Levels of AMH, while affecting the reserve, also act as a form of indicator of ovarian reserve. 

What Is The Anti-Mullerian Hormone (AMH)?

So, AMH affects and reflects ovarian health. But what even is an AMH? Well, AMH is essentially a hormone produced by the granulosa cells of small and developing follicles in the ovaries. Needless to say, this hormone is an essential hormone in reproductive health. It regulates the growth of ovarian follicles by preventing the recruitment of too many follicles during each menstrual cycle. It also aids in maintaining a steady pool of eggs over your lifespan. This hormone is sacred by early-stage, also known as antral and preantral, follicles in the ovaries. The production of AMH decreases as the follicles mature. 

Since the AMH levels do not fluctuate significantly during the menstrual cycle which makes it a reliable test at any time. Do note although AMH levels do not fluctuate during the menstrual cycle, they do vary by age to some extent. There are many uses of AMH.

Some of the key uses include

  • Aids in examining a woman's fertility potential
  • Lower AMH levels can indicate approaching menopause
  • Elevated AMH levels are associated with PCOS due to access to small follicles
  • AMH can be used to predict ovarian response to fertility treatments such as In Vitro Fertilization(IVF)

What Are The Symptoms Of Low AMH levels?

At this point, you should be aware that the levels of AMH indicate low ovarian reserve. But the question here is how can you detect them? There are many ways to detect low AMH levels. One of the easiest and simplest ways to do so is by looking at the symptoms. So, what exactly are the symptoms of low AMH levels? Well, some of the key symptoms to look out for when checking low AMH levels include: 

  • Menstrual cycles may become irregular or stop altogether.
  • Difficulty getting pregnant due to a smaller pool of viable eggs.
  • Shorter menstrual cycles, often less than 24 days.
  • Symptoms like hot flashes, night sweats, mood changes, or vaginal dryness.
  • Reduced response to fertility treatments like IVF, with fewer eggs produced.
  • Fatigue or low energy levels due to hormonal imbalances.
  • Lower libido or changes in sexual function.
  • Increased risk of early menopause if levels are very low.
  • Poor egg quality, which may affect embryo development.
  • Emotional distress or anxiety related to fertility challenges.
  • No noticeable symptoms in some cases, especially in the early stages of declining ovarian reserve.

This is by far not an exhaustive list of the symptoms you should look out for. But we do hope you got the general gist of the signs and symptoms to look out for. 

Causes Of Low AMH Levels

When discussing low AMH levels, it is not enough to just know the signs; you should also know about some of its causes. Now, there are many aspects which cause AMH. Some of the key causes of AMH levels include:

  • Natural decline in ovarian reserve due to aging, especially after 35.
  • Family history of early menopause or low ovarian reserve.
  • Autoimmune disorders characterized by the immune attack on ovarian tissue.
  • Ovarian surgery, either to remove cysts or to treat endometriosis, eliminates healthy follicles.
  • Ovarian follicles damaged due to radiation or chemotherapy treatment.
  • Cigarette toxins negatively impact ovarian function.
  • Polycystic Ovary Syndrome (PCOS) may eventually lead to low AMH due to ovarian exhaustion.
  • Hormonal imbalances affecting normal ovarian function, such as hypothalamic or pituitary dysfunction.
  • Exposure to harmful environmental chemicals like pesticides or industrial toxins.
  • Unknown causes (idiopathic) in some cases.
  • Severe stress or chronic illness impacting ovarian function.
  • Obesity or being underweight affects hormone levels and ovarian health.
  • Poor blood flow to the ovaries, reducing their function.
  • Infections or inflammation in the pelvic region damage ovarian tissue.
  • Genetic conditions like Turner syndrome or Fragile X premutation.
  • Early ovarian failure where the decline of ovarian functions takes place prematurely.
  • Prolonged use of some medications, including hormone replacement therapy and certain chemotherapeutic agents.
  • Nutritional deficiencies: severe deficiency in vitamin D levels or deficiencies in other vital nutrients.
  • Scarring or destruction of ovarian tissue occurs with endometriosis.
  • History of pelvic surgeries or trauma to the ovaries.

Do note that these are just a few of the key causes relating to AMH. Other than what we mentioned, there can be a lot many causes. But either way, we are sure you enjoyed it.

Why Is The Anti-Mullerian hormone (AMH) Level Important In IVF?

Why is AMH Level Important In IVF

After looking at some of the key causes and signs of AMH, let’s talk about its importance in IVF. So, why exactly is AMH important in the IVF process? Well, there are many reasons why. Some of the key ones include:

  1. Products Ovarian Response: The levels of AMH present in the body help in assessing how many eggs you may produce during an ovarian stimulation. The higher the AMH levels, the better the response during the stimulation. On the other hand, low levels of AMH mean a low level of response during the stimulation phase in iVF.
  2. Guides Fertility Treatment: Another important role of AMH in IVF is that this hormone can guide the IVF process. Doctors can tailor stimulation protocols based on the AMH response in order to maximize the chances of egg retrieval. This further helps to avoid overstimulation or under-stimulation.
  3. Estimates Egg Quality: Depending on the AMH levels, you can also gain the overall snapshot of the ovarian reserves. You can then use these snapshots to predict how many eggs are left, which can impact the overall success rate. Staying active can improve egg quality for IVF and pregnancy by boosting blood flow to the ovaries.
  4. Helps Avoid Ovarian Hyperstimulation Syndrome (OHSS): If, upon checking, the levels of AMH are very low, then that enables the doctors to make the necessary treatment changes to reduce the risk of OHSS-a complication with IVF. Overstimulation, due to excessive stimulation, causes OHSS.
  5. Refines IVF Planning: The last aspect concerning the importance of AMH IVF is that the knowledge about the levels of AMH would help the reproductive experts to come to a conclusion on whether or not you should go for IVF. It also allows them to consider if you need other forms of treatment, or manage your expectations for egg retrieval and quality of the embryos.

In short, AMH levels guide the IVF process, providing important insights for fertility specialists to maximize treatment effectiveness and minimize risks.

IVF Protocol For People With Low AMH

Now that we have covered the basics of what an AMH is, its signs, and how to check for one, along with its importance in IVF, let's take a quick look at IVF protocols for low AMH. So, keeping up with the theme and heading straight to the topic, what are some of the IVF protocols for low AMH? Well, among many protocols out there, three of the key ones include:

  1. High-dose Stimulation: One of the most popular IVF protocols for low AMH is simply administering high doses of stimulation medications to overstimulate ovaries for retrieval of more eggs. This serves to maximize your egg retrieval because your ovarian reserve is limited.
  2. Natural Cycle IVF: The other common IVF protocol for low AMF is the following of regular natural cycle IVF. This is concluded when you want or require fewer medications to avoid overstimulation.
  3. Pre-treatment with Supplements: The last IVF protocol for low AMH levels includes the use of supplements like DHEA, CoQ10, and melatonin for improving egg quality and supporting ovarian function.

As mentioned above, though not an exhaustive list, some of the best IVF protocols for low AMH are listed herein.

Additional Treatments for IVF with Low AMH?

Alongside implementing IVF protocols, you can also implement additional IVF treatment if you have low AMH. Now, do note that you must consult your reproductive expert before you make the decision to start this process. Nevertheless, once you have undergone a consultation and this procedure is advised, some of the additional treatments you can incorporate include:

  1. Donor Eggs: This is very much an option when the ovarian reserve is extremely poor. The problem of both the quality and quantity of the eggs will be dispelled, and the chance of pregnancy will be enhanced.
  2. Embryo Freezing: Freezing embryos for future use can be a strategy if there is a risk of declining egg quality or ovarian reserve over time. This allows for later IVF cycles using previously retrieved embryos.
  3. Exercise: Regular moderate exercise can improve blood flow and overall reproductive health, but intense or excessive exercise can negatively impact AMH levels. It’s important to find a balanced routine.

Pre-IVF Preparation and Stimulation Protocols

As we get to the end, let's finally talk about some of the key protocols for pre-IVF preparation and stimulation. Now, the exact protocols used shall depend on your circumstances. That said, some of the key pre-IVF preparation and stimulation protocols include the following:

  • Blood tests (AMH, FSH, estradiol) and ultrasound to check ovarian reserve.
  • DHEA, CoQ10, and Vitamin D improve ovarian function, egg quality, and fertility in general. Good nutrition, adequate exercise, and stress-relaxation techniques are crucially important regarding infertility. Avoid smoking and excessive intake of alcohol. Higher doses of FSH/LH are used for the stimulation of ovaries to develop more eggs; it should be closely monitored in order not to overstimulate.
  • In some instances, mild or natural IVF-where less medication is administered to develop just one or two eggs to minimize the risk of overstimulation-may be adopted. GnRH agonists and antagonists are usually applied to avoid the possibility of early ovulation for appropriate maturation of eggs. Further medication that could include growth hormone or testosterone can be added to enhance the quality of eggs.
  • Close follow-up through ultrasounds and blood work is very necessary to monitor response and to adjust medications accordingly.

Seek Expert Advice From Hardik IVF Center

Seek Expert Advice From Hardik IVF Center

Now, after knowing all these, let's talk about the best place that follows IVF protocols for low AMH. If you are wondering about where it is, then naturally it is Hardik IVF and Fertility Center. But why Hardik?

Some of the major reasons you should consult with Hardik are given below:

1. Experienced and Caring Team

Hardik IVF has a team of highly qualified gynaecologists, embryologists, and genetic counselors with years of experience in the field and a sensitive attitude toward care. They make sure that each step in the IVF process, particularly for patients with low AMH, is tailored and well-managed.

2. Advanced Reproductive Technology

Besides the inclusion of several updated procedures with the help of reproductive technologies such as IVF and ICSI and other customizations for a low AMH rate, the following clinic boasts of advanced instrumentation which best accommodates the highest rate of desired conception and guarantees fertility care and completeness.

3. Comprehensive Fertility Care

Hardik IVF strongly believes that fertility treatment is a physical and emotional journey. Integrated mental health counseling at the center offers emotional support to the patients during and after the IVF process in order to make the infertility treatment holistic.

4. Transparent and Supportive Environment

Transparency in every aspect of the IVF cycle at the clinic forms a supportive and caring atmosphere for the patients. The open atmosphere will instill trust in patients, ensuring confidence and care in treatment.

5. Value-for-Money and Accessible Services

Hardik IVF provides top-notch quality in IVF services at an affordable cost for treatments to be within the reach of many people. This makes sure that those patients who present low AMH can receive specialized care with no financial burden. But this is not where the function of AMH ends. Depending on the specifics of your circumstances, it can also be integrated into the IVF procedure as well; that said, the protocol for IVF depends on the levels of AMH hormone. If you have low AMH, there are separate IVF protocols for low AMH.

Conclusion 

Anti-Müllerian Hormone (AMH) is essentially a hormone produced by the cells in the ovarian follicles. This hormone is widely used for knowing ovarian health. But this is not where the function of AMH ends. Depending on the specifics of your circumstances, it can also be integrated into the IVF procedure as well; that said, the protocol for IVF depends on the levels of AMH hormone. If you have low AMH, there are separate IVF protocols for low AMH. 

In this blog, we discussed various aspects of IVF protocols for low AMH. We hope you found this helpful. If you seek further insights into the various aspects of IVF, do check out some of our other blogs, do check out some of our other blogs. And if you want the best IVF service in Nepal, look no further than Hardik IVF and Fertility Center.

Thank you for reading till the end!!!

FAQ For IVF Protocols for Low AMH: Maximize Your Fertility Potential

1. Which IVF protocol is best for low AMH?

Low AMH women are very often being treated with high-dose stimulation protocols in order to develop more eggs. Such protocols may include higher dosages of the fertility medications, FSH and LH, associated with closer monitoring for appropriate medication adjustments. Sometimes this may be a mild or natural cycle IVF, using fewer medicines to stimulate one or two eggs. It really depends on the response of the ovaries and the given situation.

2. Is IVF possible with 0.01 AMH?

Yes, IVF is still possible with 0.01 AMH, but it can be more challenging due to the extremely low ovarian reserve. With such low AMH, there may be fewer eggs to retrieve, and the chances of success can be lower. High doses of fertility medications and intensive monitoring will be necessary to maximize egg production. While the process may be more difficult, many women have still achieved successful pregnancies with careful planning and support.

3. Which IVF protocol is best for poor egg quality?

Poor egg quality: IVF protocols may include the administration of growth hormone, CoQ10, and other supplements that help improve the health of the eggs and encourage better quality. Besides this, your doctor may advise strategies such as egg freezing or even donor eggs if the quality is badly compromised. This is done in hope of retrieving the best possible eggs that can get successfully fertilized and develop well as embryos. Your fertility specialist will determine the right combination of treatments based on your individual needs.

4. Can I get pregnant with a low AMH or low egg count?

While it is possible to conceive with low AMH or a low count of eggs, it may be quite difficult. Women with low AMH usually have fewer eggs available, which decreases the chances of success with natural conception. On the other hand, IVF can increase this chance because fertility medication can stimulate egg production even with low ovarian reserve. Success rates may vary, and one needs to be specific with one's fertility doctor regarding the work-up.

5. What causes low AMH at a young age?

Low levels of AMH at a young age could be due to genetic conditions whereby some women are naturally predisposed to having low ovarian reserve, or it can be an end result of medical conditions such as PCOS, endometriosis, or even autoimmune disorders that affect ovarian reserve. Also, lifestyle aspects like smoking or excessive alcohol consumption, and previous treatments including chemotherapy or radiation, may contribute to lower AMH levels at a relatively younger age. In some cases, the cause may not be clear, but it's important to seek medical advice for a thorough evaluation.

6. What is the best IVF protocol for diminished ovarian reserve?

Generally, the most suitable IVF protocol for diminished ovarian reserve is with high-dose stimulation in an effort to retrieve the maximum number of eggs since not too many are likely available. Supplements of DHEA, growth hormone, or medications to improve egg quality can be added to the stimulation protocol by your doctor. This could include using fewer medications at other times-for instance, doing a natural or mild IVF cycle. Really, this will depend on the given situation. This will ensure the best quality eggs are retrieved to increase the chance of successful fertilization and embryo transfer.