For infertile women, AMH ( anti-Mullerian hormone, also known as MIS ( Mullerian inhibiting substance) has become the standard marker for egg quality . It provides us with a quantitative measure for checking ovarian reserve, and measures both egg quality and quality. You can read more about this at www.drmalpani.com/knowledge-center/infertility-testing/amh
In the past, we had to depend upon FSH levels. A high FSH level suggests poor ovarian reserve, but FSH levels are not very reliable, because they vary according to which day of the cycle the test is done; and can also be artificially suppressed by a high estradiol level. AMH is a much better marker for ovarian reserve. It does not vary from cycle to cycle; and remains the same throughout the cycle.
A low AMH suggests you have poor ovarian reserve. You can read more about this at http://www.drmalpani.com/knowledge-center/the-infertile-woman/oopause
Even if your level is low, this does not mean you should panic ! Remember that it's just a test - and good doctors do not treat tests - we treat patients !
Step number one is to repeat it again - preferably from another lab.
Step number two is to run an additional test to check your ovarian reserve. This is called an antral follicle count , and is done by doing a vaginal ultrasound scan on Day 3 of your cycle . You can read more this at http://www.drmalpani.com/knowledge-center/articles/afc
Even if these are poor, this does not mean you cannot improve it ! While Western medicine does not have much to offer, there are alternative medicine options you can try to improve your ovarian reserve
These include the following:
1. Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day.
4. Vit D3 ( Calcipherol), 60000 IU, once a week for 10 weeks
Women have tried other supplements, such as Royal Jelly, MACA, Wheat germ and CoQ , but there's no proof that they help - this is all empiric therapy.
If you have not been trying for too long, do remember that young women with low AMH levels do also get pregnant on their own ( though their chances are reduced). After all, levels provide information about groups of women , and there can be a lot of individual variability !
IVF with aggressive superovulation would be your best option as it would maximize your chances of getting pregnant quickly and help you make the most of the eggs you have left. It allows us to telescope time for you. The problem however is that often poor quality eggs result in poor quality embryos, which means that your chances of implantation are poor , and you need to be prepared to accept this bitter fact.
Plan B would to consider natural cycle IVF. Read more at www.drmalpani.com/knowledge-center/articles/natural-cycle-ivf
Plan C would be to use donor eggs, if you are willing to consider this option. This has a much higher success rate. Read more at http://www.donoreggs.in/
For heaven's sake, please do NOT allow your doctor to do surrogacy for you if you have a low AMH level ! Surrogacy is an expensive and complex treatment option, which is best reserved for
women without a uterus, or whose uterus has been irreparably damaged. For women with a low AMH, the problem is with poor egg quality - your uterus is usually perfectly normal . Transferring your embryos into another woman's uterus makes no sense at all , and will just waste your money !
You can read about more about how we take care of our patients at http://www.drmalpani.com/ivf-treatment-at-malpani-ivf-clinic.htm
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !
In the past, we had to depend upon FSH levels. A high FSH level suggests poor ovarian reserve, but FSH levels are not very reliable, because they vary according to which day of the cycle the test is done; and can also be artificially suppressed by a high estradiol level. AMH is a much better marker for ovarian reserve. It does not vary from cycle to cycle; and remains the same throughout the cycle.
A low AMH suggests you have poor ovarian reserve. You can read more about this at http://www.drmalpani.com/knowledge-center/the-infertile-woman/oopause
Even if your level is low, this does not mean you should panic ! Remember that it's just a test - and good doctors do not treat tests - we treat patients !
Step number one is to repeat it again - preferably from another lab.
Step number two is to run an additional test to check your ovarian reserve. This is called an antral follicle count , and is done by doing a vaginal ultrasound scan on Day 3 of your cycle . You can read more this at http://www.drmalpani.com/knowledge-center/articles/afc
Even if these are poor, this does not mean you cannot improve it ! While Western medicine does not have much to offer, there are alternative medicine options you can try to improve your ovarian reserve
These include the following:
1. Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day.
4. Vit D3 ( Calcipherol), 60000 IU, once a week for 10 weeks
Women have tried other supplements, such as Royal Jelly, MACA, Wheat germ and CoQ , but there's no proof that they help - this is all empiric therapy.
If you have not been trying for too long, do remember that young women with low AMH levels do also get pregnant on their own ( though their chances are reduced). After all, levels provide information about groups of women , and there can be a lot of individual variability !
IVF with aggressive superovulation would be your best option as it would maximize your chances of getting pregnant quickly and help you make the most of the eggs you have left. It allows us to telescope time for you. The problem however is that often poor quality eggs result in poor quality embryos, which means that your chances of implantation are poor , and you need to be prepared to accept this bitter fact.
Plan B would to consider natural cycle IVF. Read more at www.drmalpani.com/knowledge-center/articles/natural-cycle-ivf
Plan C would be to use donor eggs, if you are willing to consider this option. This has a much higher success rate. Read more at http://www.donoreggs.in/
For heaven's sake, please do NOT allow your doctor to do surrogacy for you if you have a low AMH level ! Surrogacy is an expensive and complex treatment option, which is best reserved for
women without a uterus, or whose uterus has been irreparably damaged. For women with a low AMH, the problem is with poor egg quality - your uterus is usually perfectly normal . Transferring your embryos into another woman's uterus makes no sense at all , and will just waste your money !
You can read about more about how we take care of our patients at http://www.drmalpani.com/ivf-treatment-at-malpani-ivf-clinic.htm
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !
Since AMH is produced by the antral follicles, I've always thought of it as actually a surrogate measure for the antral follicle count, which is the true measure of your ovarian reserve. Is it that straightforward?
ReplyDeleteSo then the question is, do DHEA, coenzyme Q10, wheat germ, accupuncture etc, increase the number of follicles recruited from the reserve?
Vitamin D of course is working by a different mechanism. Interestingly, I found that after increasing my vitamin D levels, my antral follicle count has actually dropped in half, going down from 30 to 15. Wonder whether that has something to do with Vitamin D- something else to study, IMO!
Unfortunately,nothing in medicine is ever simple !
ReplyDeleteFor most women, this correlation is pretty good and both AMH levels and antral follicle counts go hand in hand, which is what one would logically expect !
However, there are always exceptions, and one can learn a lot by studying them ! There is a lot of inter-individual variability between test results and real life fertility - and patients need to appreciate the imprecision of all these tests, rather than starting to panic just because their numbers do not fall in the normal range !
Hello Doctor,
DeleteI am in USA, we have been married for 3 years, however with no children yet. Hence we approached a Gynecologist who did some blood work and said all my reports are normal. They checked my husband and found no sperm count in his Semen analysis. Then we approached Urologist he did ultrasound for my husband and found absence / blockage of VAS tubes. They suggested biopsy to be done for my husband before that the urologist wanted to me contact the IVF specialist to know if I am good to proceed for IVF/ICSI/IUI.
I approached and they done their tests and asked me to take Synthroid 25 mcg as my AMH 1.4, TSH 3.8 and 2 month later changed to Synthroid 50 mcg.
Simultaneously they scheduled for biopsy for my husband and they found enough sperms with low motility, they took the tissues of my husband and frozen it.
They asked to me start my IVF Injections as below:
Bravelle 300 and Menopur 150 this combination of injection I started taking from 23/04/2014 till 02/05/2014 with blood work and ultrasound done every alternate day. They found only one follicle growing on right ovary with two other which was un-measurable. The last measurement of follicle on 10th day stimulation was 17mm.
Finally on 03/05/2014 doctor’s visit they said they can’t proceed with IUI/ICSI/IVF with 1 follicle. We were very upset on this.
Please advise me on how to increase my follicle count with quality eggs so that my treatment doesn’t fail. I am not understanding as to why I didn’t understand why I didn’t respond to Injections. The medications and treatment cost is very expensive here. Can you please also let me know if any diet to be followed? We are not interested in other options like donor egg / sperm. Please help me what to do?
I do not think your doctor did a good job with superovulating you
DeleteYour low AMH level ( www.drmalpani.com/amh.htm)
suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
You can take the following to improve your ovarian reserve.
1. Yoga. Find a yoga teacher and tell them you need to learn exercises to help you improve your uterine blood flow
2. Acupuncture. An acupuncture specialist can suggest what he can offer to help improve your fertility
3. DHEA, 25mg thrice a day. This is an anti-aging hormone
4. Wheat germ oil, 1 capsule daily. This is a nutritional supplement
Continue these until you get pregnant
5. Cholecalciferol ( Vit D) , 60000 IU, once a week for 4 weeks
Read the book, Inconceivable, at http://www.amazon.com/Inconceivable-Winning-Fertility-Julia-Indichova/dp/0966007859/ref=sr_1_2?ie=UTF8&qid=1330844751&sr=8-2
We would use the Letrozole -Antagon protocol for you which we use for poor ovarian
responders. This will help you grow more eggs of better quality.
PESA- ICSI treatment starts from Day 2 of your cycle.
Day 1 = Day of bright red bleeding. If the bleeding starts after 6 pm count
the next day as Day 1. Ignore the spotting.
On Day 2, you need to do an
ultrasound scan at our clinic to confirm there is no ovarian cyst, after which we start
your superovulation .
Tab Letrozole 5 mg daily from Day 2 - Day 6
Inj Menogon ( 75 IU), 8 amp ( 600 IU ) daily from Day 2. The dose of HMG
will depend upon your ovarian morphology and your antral follicle count.
From Day 7, you stop the Letrozole and start Inj Orgalutron/ Antagon, 0.25 mg daily .
This is a GnRH antagonist. The Menogon continues.
We do the next scan on Day 7, after which you would have to be in Bombay
for about 10 days. Your husband is needed on Day 12-Day 14 ( the day of the
egg pickup). All the treatment is performed at our clinic, which means you
never have to go elsewhere.
This is what the daily schedule would look like.
Day 1.
Day 2. Vaginal ultrasound scan to confirm there is no ovarian cyst. If
there is no cyst, we can commence superovulation.
If there is a cyst, we aspirate ( puncture) it and continue with the
treatment.
Tab Letrozole 5 mg daily . Inj Menogon ( 75 IU), 8 amp ( 600
IU ) daily
Day 3 Tab Letrozole 5 mg daily . Inj Menogon ( 75 IU), 8 amp
( 600 IU ) daily
Day 4 Tab Letrozole 5 mg daily .Inj Menogon ( 75 IU), 8 amp (
600 IU ) daily
Day 5 Tab Letrozole 5 mg daily . Inj Menogon ( 75 IU), 8 amp
( 600 IU ) daily
Day 6 Tab Letrozole 5 mg daily . Inj Menogon ( 75 IU), 8 amp
( 600 IU ) daily
Day 7. Vaginal ultrasound scan to monitor follicular growth
Day 7 . Inj Menogon ( 75 IU), 8 amp ( 600 IU ) daily. Inj Orgalutron, 0.25
mg daily
Day 8. Inj Menogon ( 75 IU), 8 amp ( 600 IU ) daily. Inj Orgalutron, 0.25 mg
daily
Day 9. Inj Menogon ( 75 IU), 8 amp ( 600 IU ) daily. Inj Orgalutron, 0.25 mg
daily
Day 10. Vaginal ultrasound scan to monitor follicular growth
The Menogon and orgalutron injections continue until the follicles are
mature ( approx Day 12). Then the HCG injection is given, and eggs retrieved
36 hours after this.
Embryo transfer is performed 3 days later.
After the transfer, luteal phase support is provided with daily Progynova
( estradiol valerate2 mg, 3 tab daily; and Uterogestan ( 200 mg), 6 vaginal
suppositories daily.
You can travel back 3 days after the embryo transfer.
14 days after the transfer, you need to do a blood test for beta HCG to
confirm a pregnancy.
You can print out an IVF calendar ( of your cycle ) at
www.ivfindia.com/ivfcalendar2.php
Hello Doctor,
DeleteI am very confused and don't understand all medical terms and levels. My doctor asking me to go for egg / sperm donor. I am really in depression please tell me in simple steps what is the diet and things to be followed to get pregnant with the frozen sperms at my hospital in USA. Please suggest me according to USA so that it will easy for me in getting tablets etc. I will be great full to you.
Hi Dr.
ReplyDeleteI am 30 yrs old with 2 failed letrozole cycles (1 chem preg) and 1 failed gonadotropin cycle. My Amh was 1.6 and FSH was 10.6--my dr is saying IVF asap. I have a 2 year old that we conceived naturally (with the help of some monitoring). I am trying to destress as i know stress is playing a huge roll in this.
Any advice would be appreciated. Thank you.
Since this website mentions the work of Julia Indichova and her book Inconceivable, I would like to say that her approach is really unique and has helped many women with bad diagnoses. I also learned from Julia that talking about
ReplyDeletestress and infertility creates a lot of confusion and often does more harm than good.
Several women with low AMH conceived with her tools, you can read the testimonials on her message board, www.fertileheart.com. She even has some special imagery on her latest CD
that are specifically created to support healthy ovulation. She works with diet and visualizations. you could also look at her video on fertility success stories on youtube. Hope this can help other women!
P.
Dear Dr,
ReplyDeleteIf you could excuse me I would like to give my views on this post. AMH is a harmone secreted by growing follicles (pre-antral and antral) and hence its decline correlates with the decline in the number growing follicles. Thus it helps in determining ovarian reserve.
Does increasing AMH production by artificial means can increase pre-antral and antral follicle count (ovarian reserve)? Actually not. Research findings till date did not find a feed-forward loop. More AMH, more antral follicles but adding AMH to ovaries does not increase AFCs. Infact addition of AMH to neonatal ovaries in vtro inhibits primordial follicle recruitment and hence can decrease AFC. Thus it can also preserve ovarian reserve for a longer period. Slower recruitment of primordial folicles = longer reproductive period. Mice which do not produce AMH deplete their ovarian reserve faster and reach menopause quicker (they are fertile!). So if we artificially increase AMH or give AMH from outside recruitment of primordial follicle is prevented. This can explain Jay's observation that after taking Vit D (for increasing AMH levels) her AFC has decreased to half.
A very recent publication 'Vitamin D Regulates Anti-Mullerian Hormone Expression in Granulosa Cells of the Hen' has found an opposite effect of what Jay has experienced although it is not a study in humans.
The message is AMH is not an indcator of egg quality. But people with poor egg quality can have low AMH ( because aged people have poor egg quality and they also have less ovarian reserve). I beleive they are two different process not mutually exclusive. So a younger woman with low AMH doesnt necessarily have to have low egg quality. Woman with PCOD have higher level of circulating AMH (bcoz of more AFC) but not necessarily good quality eggs. The second message is increasing AMH artificially can decrease your AFC count and hence eggs available to be collected via IVF.Might be for a women with PCOD Vitamin D therapy can help if it decreases their extremely high AFC!
The entire thing is interesting because PCOD woman have more AFC and hence more AMH. Might be such high AMH levels prevent ovulation (by preventing selection of follicle hence no mature follicle) and also prevents primordial follicle recruitment. This means PCOD women can be fertile for a longer period of time than their normal reproductive counterparts interms of egg production. An older PCOD woman can produce more egs because her ovarian reserve is preserved but do they have good quality eggs is again a question here!
Just my few cents on this topic.
Dear Dr,
ReplyDeleteWant to make some changes to my previous comment :)
1) More AMH, more antral follicles but adding AMH to ovaries does not increase AFCs.
This sentance should be read as: More antral follicle count = more AMH but adding AMH to ovaries does not increase AFCs.
2)I beleive they are two different process not mutually exclusive.
This should be read as : I beleive they are two different process WHICH ARE mutually exclusive.
Actually you hypothesize somethng in science and scientific community already knows it :) Well something to support the last paragraph of my previous comment :
http://www.jeanhailes.org.au/resources/international-research/1290
Hope my comment is useful!!!
Hi Doctor,
ReplyDelete'am a 35 years old with no kids. Have got a series of failed IUIs. Had 2 IVFs. first resulted in pregnancy only till 6 weeks and 2nd IVF failed.
My recent AMH is 9.98, FSH - 8.71, LH - 10.47, Estradiol - 39.89 and Progestrone - 0.38.
Pls suggest, is it difficult for me to conceive ?
Dear Dr. Malpani,
ReplyDeleteMy doutor told me that my amh decrease from .58 to .30 in last 4 months while i was ranking dhea 3 times a das. He suggest to use eggs donated. What eles can i do to increase the amh until january 2013 to do Ivf .
Best regards
Vivino
Hi Doctor,
ReplyDeleteMy wife is 40 years old, AMH is 0,2 and FSH is 6,1 and LH is 3,4, TSH 0,68, T4 16, our Doktor said there is no chans to my wife to get a good egg...
What can we do?
Mick
Dear Dr. Malpani,
ReplyDeleteI am a 40 year old lady who recently learnt that my AMH is 0.2 and my husbands sperm count is 5 million but motility 3%. Seeing this combination the Doctor here sees no hope in continuing it further. However since I was insistent she said that we could only once try (ICSI) Intracytoplasmic sperm injection. However before that we need to undergo a series of genetic test which we are currently doing. If they come normal we can go for ICSI.
My question is would be there some chance of having a normal child through this procedure or is it better to accept it as our fate and leave it for good.
I really need your answer as it would go a long way in clearing the dilemma.
Thanks...
A lady who wants to a mother....
Dear Dr.
ReplyDeleteI am 34 for years of age. I was diagnosed with grade 4 endometriosis in the year 2004 and operated on that very year. My recent amh and fsh test results show the levels at 0.03 and 14.78. I had done one cycle of ivf. Now doctors are suggesting ivf by donor egg.I am not being to come to terms with the concept. I ovulate normally and experience ovulation pain and light brown discharge during ovulation. Please help.
I am 36 yrs old and was diagnosed with an AMH of 4pmol/L - I.e. very low. I was devastated after having been given hope with my FSH & LH of 4.1 plus good estrogen and progesterone levels, plus I knew I was ovulating. We had been trying to conceive for around 18 months. Anyway, long story short, a few days after my low AMH came back and we were about to begin IVF, I discovered I was already pregnant - naturally. I'm now 15 weeks and confident things are progressing well. I hope my story gives people some hope. Number are sometimes simply numbers and miracles can and do happen.
ReplyDeleteThank you for giving some of us hope :)
DeleteRespected Dr. Malpani,My age is 31 i m married for last 4 years, but have not conceived yet, recently i got my amh done it was 1.7 ng/ml, what does this mean? can i conceive naturally? Plz answer my query
ReplyDeleteA low AMH does not necessarily mean you are infertile ! Women with low AMH levels can have babies too !
ReplyDeleteDo a complete workup before starting treatment haphazardly.
You need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility). Read more at www.drmalpani.com/sperm.htm
blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, www.drmalpani.com/hsg.htm) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
With these test results, we can determine what medical problems are causing your
infertility.
If there is a problem, then we can treat it !
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270
FAX ( India) 91-22-22150223.
Helping couples build families !
PS Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Hello doctor,
DeleteI m 29yrs old. My AMH is 0.40. both falopion tubes were blocked. Opened by laproscopy and cannulation. Then she did 2 IUI which got failed. I ovulate only one follicle in every cycle. His semen count is low. What should I do. We have all 3 major problems together. Please help me come out of this
Hi Dr. I wondered if you would give me your thoughts on my case?
ReplyDeleteI am 25, I had my AMH test done twice over a 10 day period, first it was in the reduced response category at 2.25 and then came back even lower 0.95. I had my FSH, LH and Oestradiol which came back normal, and my follicle count was 15 over the two ovaries. My womb looked fine on the scan. I know that AMH is a predictor of IVF success, which considering my score doesn't look good for me, I know that most stats will tell you that an average of 30-35% success for those under 35. But I wondered if you had any further thoughts on my chances specifically. I have been referred as a high priority case on the NHS for IVF. I am hoping that because I am young my chances are higher than a normal person because the majority of people going through IVF are older??
also, i am healthy, sporty - go to the gym, i dont smoke i very rarely drink although my BMI is 28/29
any thoughts would be appreciated.
Thank you
Dear Sacha,
ReplyDeleteThe fact that you are young and you have a good antral follicle count means you have a good prognosis, so please don't panic.
Let me know how your cycle progresses !
Best of luck !
Dr Malpani
where and in what form can I find Wheat germ? how should I take it?
ReplyDeleteHello Doc,
ReplyDeleteI have irregular menstrual cycle problem due to which my doctor advised me to test my AMH level.
Following are my details.
Age: 28 yrs
TSH:2.77
AMH: 0.5 ng/mL
My doc has told me that I have low AMH level which could cause problem in conceiving.I have not planned pregnancy yet for 6 months atleast.
Can you please tell me , whether I will be able to conceive naturally ?
Hi Dr
ReplyDeleteCould you send me the items you listed above? or tell me where i can get them?
This comment has been removed by the author.
ReplyDeleteCan you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
ReplyDeleteYou can try the following to improve your ovarian reserve.
1. Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day. This is an anti-aging hormone
4. Wheat germ oil, 1 capsule daily. This is a nutritional supplement
5. Coenzyme Q10 , 100 mg daily .This is an antioxidant
Continue these until you get pregnant
6. Cholecalciferol ( Vit D) , 60000 IU, once a week for 4 weeks
Read the book, Inconceivable, at http://www.amazon.com/Inconceivable-Winning-Fertility-Julia-Indichova/dp/0966007859/ref=sr_1_2?ie=UTF8&qid=1330844751&sr=8-2
Hello doc im a 40 year old i've had my tubs burned and i want to have a baby i have 3 kids already but i want one more i had my amh levels tested and they came back 0.1 iknow i have to go thur ivf to have a baby because of my tubs but should i tke dhea to raise my amh levels i want to use my eggs if i can.please help
ReplyDeleteHello Doctor,
ReplyDeleteMy AMH is 1.34, FSH/LH Normal, Is there any option other than IVF ? IUI is successful with Low AMH level ?
Dear Bijal,
ReplyDeleteA low AMH is worrisome. In what units was this measured ? ng/ml ?
A normal FSH and LH is not necessarily reassuring, because these tests are not as good at measuring ovarian reserve as an AMH level is.
However, do remember that we do not treat numbers - we treat patients !
What's your age ?
How long have you been trying to have a baby ?
Is your husband normal ?
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
I need more information to be able to provide you with intelligent advice.
Could you please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better?
We look forward to helping you to have a baby !
Doctor,
ReplyDeleteMy AMH was 0.5 in June 2012; 1.1 in June 2013 - how can this be?? I have had 20 cycles -7 IVFs and 13 IUIs-numerous losses-but clinging to hope. I am so confused by recent AMH levels...what does this mean?
Thanks,
Angela
Dear Angela,
ReplyDeleteYou are a remarkably determined woman !
AMH levels can fluctuate - this is quite common in any biological system !
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
Can you send me more details about your IVF cycles ? What were the meds which were used for
superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
How many embryos were transferred ?
What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
Can you please send me the printed treatment summary from your IVF clinic ?
We look forward to helping you to have a baby !
Dr.,
ReplyDeleteThanks for responding! I realize AMH levels can fluctuate - but this is a strange jump - isn't it??
Oh boy - each IVF was so different - I get scns quite often. I've usually been on max meds with each IVF cycle - 525 gonal-f with 150 repronex. Eggs retreived ranged from 10-12 over the years. I have 0 embryos that ever went to freeze - my last IVF was successful with my first ever Day 5 transfer (3 were transfered) but i had a very rare "c-section scar pregnancy" which led to me needing chemotherapy and waiting for months to resolve. Today I underwent an HSG to check tubes, but all looks good. My E2 and Prog levels were usually pretty normal-at times my prog would drop but i was also on prog injections. My thickness varied, but was never wonderful...I understand egg quality was B range last attempt; but made it to Day 5 for the first time. Yes - I have photos of my embryos...I am not sure if it is dangerous to try IVF again at this point since i need max meds...or go with clomid and try one last IUI...what are your thoughts? Thanks again!!
~Angela
ReplyDeleteYour low AMH level ( www.drmalpani.com/amh.htm)
Suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
You can try the following to improve your ovarian reserve.
1.Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day.
4. Take wheat germ daily
5. Coenzyme Q10 , 100 mg daily
6. Cholecalciferol, 60000 IU, once a week for 4 weeks
Read the book, Inconceivable, at http://www.amazon.com/Inconceivable-Winning-Fertility-Julia-Indichova/dp/0966007859/ref=sr_1_2?ie=UTF8&qid=1330844751&sr=8-2
IVF with aggressive superovulation would be your best option as it would maximize your chances of getting pregnant quickly and help you make the most of the eggs you have left
Treatment takes about 20 days. Should I send you the treatment plan ?
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
Treatment can be expensive, but a baby is priceless.
Plan B would to consider natural cycle IVF. Read more at www.drmalpani.com/naturalcycleivf.htm
Plan C would be to use donor eggs, if you are willing to consider this option
This has a much higher success rate
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270
FAX ( India) 91-22-22150223. Our US FAX is 1-775-249-6041
Helping couples build families !
PS Read our book, How to Have a Baby - A Guide for the Infertile Couple, online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://doctorandpatient.blogspot.com/
my AMH level is low 1.07 can I get pregnant advise please
ReplyDeleteHi Doctor,
ReplyDeletei married 1 year for now, not gotten pregnant. in Fertility center amh result is 0.5 and my age is 27. Can you please provide the possibility to get pregnant and any treatment to increase amh levels.
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
ReplyDeleteYour low AMH level ( www.drmalpani.com/amh.htm)
suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
Hi Dr. Malpani,
ReplyDeleteI have just found out this internet site and I was so happy.
first sorry for my English. I hope I can explain correctly my sitauation.
I'm 39 and married for two years. and I could not get pregnant during this period. and I made 4 times FSH, E2, TSH, proloactin test. my last FSH was 11,42 (befor 9 , 7, 11, )and finaly decied to make directly IVF.
when we (me and my husband) saw dr. she told me that my TSH was so high to start IVF, actually it was 6. And I was happpy becasue I thought now I know the reason of not getting pregnant and with treatment my tsh level would be good and I can get pregnant by IVF. And then I started to take medicine to make it lower then 2,5 by seeing an endocrinologist dr.
Also my IVF doctor asked me to take amh test. Here starts my very bad story. 3 days ago I learnt that my amh was 0.01! I wished to be dead. the most thing I want in this world to have a baby but now it seems to me impossible until I saw here.
my next period is 31 october and I will start to IVF. do you think I have a chance?
my cyclus are very regular, in every 28-29 day I have my period and take 6-7 days. I have never thougt that my amh will so bad.
please give me some hope and advice.
thanks.
Hi Dr Malpani,
ReplyDeleteI forgot to ask you one thing that was the one of reason to write you.
can high TSH level have a negatif effect on AMH?
I mean if my tsh level becomes to normal range, can my amh leve change?
many thanks in advance for your reply.
and loves from Turkey
No, the TSH has no effect on the AMH level.
ReplyDeleteYour low AMH level ( www.drmalpani.com/amh.htm)
suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at www.facebook.com/Dr.Malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Hi Dr Malpani
ReplyDeleteI am 28yr old female with PCOS diagnosed 4yrs ago. I am on yamini and bigomet SR 500. My amh level is 0.99 and my husband's sperm count is 0.1 million per ml as per his latest test. We are planning to go for ICSI after 4 months. Can u pls suggest some supplements we can take to improve our fertility and what are our chances of success with ICSI.
Thank you.
Your low AMH means you do NOT have PCOD. Patients with PCOD have a high AMH level ! Please stop your bigomet - this will reduce your reserve even more.
ReplyDeleteI agree ICSI would be your best treatment option
Treatment takes about 20 days. Should I send you the treatment plan ?
We look forward to helping you to have a baby !
Dr Malpani
My latest fasting blood sugar report was 122. When im on metformin it goes down to 115. Please send me the treatment plan and supplements that my husband and I can take to improve our chances. We have about 3months time.
DeleteTruly appreciate your help doctor.
Thank you so much
My latest fasting blood sugar report was 122. When im on metformin it goes down to 115. Please send me the treatment plan and supplements that my husband and I can take to improve our chances. We have about 3months time.
ReplyDeleteTruly appreciate your help doctor.
Thank you so much.
Hello Doctor,
ReplyDeleteI know I am commenting on an old post, but hope you answer my question. How often should the AMH test be repeated while undergoing fertility treatment, should it be before every IUI as well.
Thanks...
Hello doctor,
ReplyDeleteI am 30 years old.got marrued 5years back. I did my amh test after vagial ultrasound. My amh is 0.2. So what would be the next coyrse of action
Hello sir,
ReplyDeleteI am 30 years old married 5 years back. We are trying for baby. I did amh after vaginal ultrasound . My AMH is 0.2
Sowhatwould be the next course of action
ReplyDeleteYour low AMH level ( www.drmalpani.com/amh.htm)
suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
Hi! Dr, I am 41 with no children and my AMH count is 2. You recommend I've for a low count however, my GP says I can't have IVF as my AMH is too low. Does this mean I only have egg donor as an option? Or, could i try naturally with Comid or something?
ReplyDeleteIs there any treatment at all available on the NHS?
I have been pregnant in the past (2007 being the last time) but have miscarried each time. My GP is going to send me to the recurrent miscarriage centre to check all is well in there but.. I'm at my wits end worrying I'm going to be childless. C x
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
DeleteIn what units was the AMH tested ? pmol/L or ng/ml ? Read more at www.drmalpani.com/amh.htm
Time is now at a premium for you - please don't waste it ! You should never have any regrets that you left any stone unturned and didn't give yourself the best shot at fertility treatment.
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at www.facebook.com/Dr.Malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
hi, doctor. i am 30 yr old, married for 5 yrs. i had an laparoscopy followed by cystectomy in both ovaries in 2011 August.my amh level is very low 0.1 with FSH 9. Doctor found no follicle in tvs scan. plz help me.
ReplyDeleteThe cystectomy was a bad idea. It has caused you to have ovarian failure :(
DeleteI am sorry, but your high FSH level confirms you have ovarian failure.
You can read more about this at http://www.drmalpani.com/premature-ovarian-failure-pof.htm
Your best option would be donor egg IVF ( www.drmalpani.com/eggdonation.htm) or embryo adoption ( www.drmalpani.com/embryoadoption.htm)
Which would you prefer ?
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270
Helping you to build your family !
PS Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby – A Guide for the Infertile Couple,
Online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
Relationship at http://doctorandpatient.blogspot.com/
One of my known is having problem in getting pregnant., married 20 yrs back, got pregnant naturally after one year but aborted due to personal reasons, again after one year got pregnant naturally, her financial condition was poor as her husband was having no work. got aborted Gynac in her town suggested to put Cu T , kept CuT for one year. After removal she could not get pregnant.All the reports were normal including tubes patent. Done 6 IUI cycles & IVF , but no positive results. Can CuT cause permanent infertility? what is the solution for this. AMH level at present is 1.4. Can she try for another IVF ET cycle or Surrogacy is the answer. age is 41 years. Husband is 43 with all reports normal. Kindly answer and suggest further treatment options .
ReplyDeleteDear Dr. I'm 38 & Husband is 41. I want a 2nd opinion, we've been trying for 7 months & recently conducted tests. Results after my Cloud challenge indicates FSH-12 AMH-.37. My Husband sperm analysis indicates semen conc -7.0, Semen Morp-6 Motility-27 non viable- 43.5% Obgyn prescribed vitamins for Hubby & suggests IF with donor eggs. Please advise!
ReplyDeleteYour low AMH level ( www.drmalpani.com/amh.htm)
DeleteSuggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
You can try the following to improve your ovarian reserve.
1.Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day.
4. Take wheat germ daily
5. Coenzyme Q10 , 100 mg daily
6. Cholecalciferol, 60000 IU, once a week for 4 weeks
Read the book, Inconceivable, at http://www.amazon.com/Inconceivable-Winning-Fertility-Julia-Indichova/dp/0966007859/ref=sr_1_2?ie=UTF8&qid=1330844751&sr=8-2
IVF with aggressive superovulation would be your best option as it would maximize your chances of getting pregnant quickly and help you make the most of the eggs you have left
Treatment takes about 20 days. Should I send you the treatment plan ?
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
Treatment can be expensive, but a baby is priceless.
Plan B would to consider natural cycle IVF. Read more at www.drmalpani.com/natural-cycle-ivf.htm
Plan C would be to use donor eggs, if you are willing to consider this option
This has a much higher success rate
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270
Helping couples build families !
PS Read our book, How to Have a Baby - A Guide for the Infertile Couple, online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://doctorandpatient.blogspot.com/
Hello Dr. Malpani,
ReplyDeleteI have a high FSH and not getting period but i like to conceive naturally. Can you suggest me natural medication i can take? I lived in Canada so suggest me accordingly.
Thanks for your help.
I am sorry, but your high FSH level confirms you have ovarian failure.
DeleteYou can read more about this at http://www.drmalpani.com/premature-ovarian-failure-pof.htm
Your best option would be donor egg IVF ( www.drmalpani.com/eggdonation.htm) or embryo adoption ( www.drmalpani.com/embryoadoption.htm)
Which would you prefer ?
Time is now at a premium for you – please don’t waste it ! When you are 50 years old and looking back at your life, you should never have any regrets that you left any stone unturned and didn’t give yourself the best shot at fertility treatment. Treatment can be expensive, but a baby is priceless !
Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Tel: 91-22-22151065, 22151066, 2218 3270
Helping you to build your family !
PS Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby – A Guide for the Infertile Couple,
Online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
Relationship at http://doctorandpatient.blogspot.com/
Hi Dr,
ReplyDeleteI got married 1 yr back.my age is 25 . I was having a problm of irregular periods before marriage when it started after marriage also I went to adoctor she prescribed me 21 days medicine for regular cycle.after I stopped that medicine from last three four months I m having a prolonged heavy bleeding which only stops after medicine. Doctors ask me for some test in which I came to kne that my amh is very low .44 and also I have two fibroids 16×14mm and 13×13 mm plus I have pcod problem.she advised me for tb tst also.my montoux and tb gold is positive but my tb pcr test is negative.she started akurit 4 for three months.now my main concern is I want to stop this heavy bleedingand want to conceive.please tell me..which treatment should I start first.
You do NOT have PCOD. Patients with PCOD have a high AMH level !
ReplyDeleteThe two small fibroids will not affect your fertility
These TB Gold tests are very unreliable ! You can read more about this at http://www.drmalpani.com/tuberculosis-and-infertility.htm
Your low AMH level ( www.drmalpani.com/amh.htm)
suggests you have poor ovarian reserve .
You can read more about this at www.drmalpani.com/oopause.htm.
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at www.drmalpani.com/afc.htm
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
Treatment can be expensive, but a baby is priceless.
We look forward to helping you to have a baby !
Hi Dr, I conceived a beautiful boy when I was 30 without any effort. I used Mirena since then for 4 years. I haven't been able to get pregnant again and I have been trying for almost 2 years (Now IM 37). A year ago I got all my tests and everything was fine except for my AMH which was almost undetectable (0.16). I took all recommended products for a year and last month my AMH levels were up to 0.84. I have been doing ovulation tests and seems like I'm not ovulating although in my last ultrasound I had 3 follicles and 7 in each ovary. I was wonder if Clomid could help me to ovulate or what do you recommend I can do. I don't have the resources for IVF nor IUI. Thanks a lot for your help.
ReplyDeleteYes, if you cannot afford anything else then it makes sense to try the clomid ( though I wouldn't be too hopeful !)
ReplyDeleteHello Doctor..!
ReplyDeleteMy Name is Kirti, 29 yrs Old, trying to conceive from last 2 years... 2 Months before My Dr. get me test for AMH and it was 1.17, My dr. told me it is low, After that I have 2 cycles of IUI but due to follicles not ruptured it get cancelled. this month my folical count is 4. Dr. suggested me to take Ovigyn DSR 1 per day for 3 months and take IVF after that. My family is forcing me to start Ayurveda treatment. what is your suggestion on this.. I shall be grateful for your advice. Regards,
The cystectomy was a bad idea. Unnecessary surgery reduces your fertility as normal ovarian tissue is also removed along with the cyst wall, thus reducing your ovarian reserve.
ReplyDeleteHello doctor, I am 39 year old and heading for IVF cyclle ..just want advise from you - Is glonal f 450 + Lueris 150 good protocold for me? Or menopour is good protocol for me?
ReplyDeleteI got my amh levels of 1.9ng/ml on the day i started miscrrying at 5 weeks..i had got a positive hpt that day..can presence of hcg in blood affect amh values
ReplyDeleteThis suggests you have ovarian failure, sorry
ReplyDeleteYour best option would be donor egg IVF
I am 33 year old. My Amh level decreased by. 27 to. 22.
ReplyDeleteWhat to do doctor.
I really don't want to follow the option of donor egg.
Please help.
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
DeleteDear Dr.
ReplyDeleteI am 39 years old working lady in a bank and recently test AMH level 0.35. Other blood test results are on the normal range. I did test Foliculometry and TVS several times found out no follicles recently with chocolate syst on my both ovary. My husband has 20mil count with 40% motality and 65% morphology with oligogospermia with genital infection. I am taking DHEA 50mg for last 1 week and other drug like Ovacare for last 2 months, Folic acid for last 5 months. My husband took syprofoxacilin and doxicyclin for 1 week each within last 3 months. he is also taking oligocare, levocarnitine, liquid vit E for last couple of months. But still, do not get pregnant yet. Is there any chance that I can get pregnant in normal way or any other way or no chance? Please let me know. Thank you.
Your low AMH and low antral follicle count suggest you have poor ovarian reserve, sorry
DeleteHi,My Wife has AMH Level as 1.36.Doctor has prescribed her to take Lineator Capsule,Ovafem,Calshine 60K & VOFOl Plus.But after searching in google,we came to know that Lineator is used for men only.Can you please tell me whether women also can take Lineator Capsule.If not,then is there any side effect as my wife has already consumed 3 capsules.Please Help
ReplyDeleteMy FSH 46.2 and AMH 0.03. DO I HAVE ANY CHANCE to HAVE ANOTHER CHILD?
ReplyDeleteI am sorry, but your high FSH level confirms you have ovarian failure.
DeleteYou can read more about this at http://www.drmalpani.com/index.php/knowledge-center/articles/premature-ovarian-failure-pof
Your best option would be donor egg IVF ( http://www.donoreggs.in/) or embryo adoption ( http://www.donorembryos.in/)
Great post Dr. Malpani. It was very useful to all keep sharing this kind of things to us.
ReplyDeleteHi..my AMH is 1.57 and FSH 7.94 and LH 3.39 PROLACTIN 13.78 MY age is 25 before 6 months my AMH is 2.86 I am trying since 2 years..my uterus is bicournuate and right tube is faintly block..and in my FS study my egg is rapturd on 13tn day and size is 18.5 mm plz tell me wht I do..I am so worried why my Amh is falling..plz tell me how I increse my amh ....
ReplyDeleteYes, this is worrisome
DeleteCan you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
Do a complete workup before starting treatment haphazardly.
You need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility).
Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b
blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
With these test results, we can determine what medical problems are causing your
infertility.
If there is a problem, then we can treat it !
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Hello Doctor,
ReplyDeleteI am having my right tube closed, and husband with low semen count.
I am also having FSH 12.3 with low AMH level.In April we went under ICSI. I produced three eggs out of which got two embryo one with A grade and another with grade B. I had three day transfer of both embryo but unfortunately embryo growth stopped after six weeks. Had to abort baby in June 2016.
Please suggest me when i can start next cycle. Is there any way to improve my FSH level and egg quality. I am 34 with normal weight and having no other medical problem.
I agree this can be very frustrating.
DeleteCan you send me more details about your IVF cycle ?
DO YOU HAVE PHOTOS OF YOUR EMBRYOS ?
You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
What were the meds used for
superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ? What was the embryo quality ? What was the endometrial thickness ?
Can you please send me the printed treatment summary from your IVF clinic ?
Repeating the ICSI cycle with better superovulation and careful monitoring and transferring better quality embryos would be your best treatment option
as it would maximise your chances of conceiving. You can read more about our approach at www.drmalpani.com/knowledge-center/failed-ivf/failedivf
Treatment takes about 20 days. Should I send you the treatment plan ?
You can read about how we take care of our patients at http://www.drmalpani.com/knowledge-center/articles/pampered-ivf-patients
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at www.drmalpani.com/success-stories
The fact you have conceived in the past ( even though you did miscarry) means your chances
of having a healthy baby are excellent, so please don't get disheartened !
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Dear Dr Malpani
ReplyDeleteIf 5 eggs make it Blastocyst stage how many should we transfer?
1 or 2
DeleteCan Ovigyn and Clomid taken together
ReplyDeleteYes, but if you have poor ovarian reserve, clomid is not likely to help, sorry
DeleteDear Dr Malpani,
ReplyDeleteI have Light gluten intolerance and 0.01 amh. Can i use wheat germ anyway?
Sincerely.
Yes, but with such a low AMH level, it's not likely to help, sorry
DeleteAMH 0.82 Doc advised for donoregg.is it possible with own egg??
ReplyDeleteYes, you can try with your own eggs
DeleteCan you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
Dear Dr Malpani,
ReplyDeleteMy wife has AMH of .6 and AFC of total 7 (3 in left ovary and 4 in right) .She is 35. We had 1 IVF attempt where three eggs were retrieved 2 fertilized and transferred but didn't result in pregnancy. The doctor is ready to take a second attempt where he plans to put her on the highest injection dose from day 1, in the earlier attempt the highest dose was given after a few days. My question is given she has low AMH and AFC so most likely her egg quality is not that great so can there be a risk of the baby having any defect even if we succeed with her own egg..
No, the risk of the baby having a defect is not increased. However, the risk of another failure and a miscarriage are increased.
DeleteI agree IVF failure can be very frustrating.
Can you send me more details about your IVF cycle?
DO YOU HAVE PHOTOS OF YOUR EMBRYOS ?
You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
What were the meds used for
superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ? What was the embryo quality ? What was the endometrial thickness ?
Can you please send me the printed treatment summary from your IVF clinic ?
Repeating the ICSI cycle with better superovulation and careful monitoring and transferring better quality Day 5 embryos ( blastocysts) would be your best treatment option
as it would maximise your chances of conceiving. You can read more about our approach at www.drmalpani.com/knowledge-center/failed-ivf/failedivf
Treatment takes about 20 days. Should I send you the treatment plan ?
You can read about how we take care of our patients at http://www.drmalpani.com/knowledge-center/articles/pampered-ivf-patients
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at www.drmalpani.com/success-stories
We look forward to helping you to have a baby !
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Sir my age 23 trying for conceive, detected as pcod ,taken treatment of contraceptive pills and FSH inj but no success, recently Dr checked my amh value near about 2.5 ,and she given me coedhea plus 75mg daily once ,in last 3 months ago I got problems of hyper stimulation in left ovary which is continued alternative in right then left 5cm cyst still cyst are present in both ovaries, should I take coedhea plus or what u will suggest
ReplyDeleteYour AMH level is normal, which means you do NOT have PCOD
DeletePlease do a complete and systematic workup so we can make the right diagnosis
You need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility).
Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b
blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me at [email protected]
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
With these test results, we can determine what medical problems are causing your
infertility.
If there is a problem, then we can treat it !
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Hello Sir,
ReplyDeleteI badly need your advice. Kindly review my case :
AMH: 0.13
On 18/5/2016: right ovary had 1-2 follicles>5mm & left ovary had 1follicle>5mm
On 18/12/2016: 7th day- rt.ovary- NODF,Lt.Ovary- NODF, EM-6.9mm
9th day- rt.ovary- NODF, Lt.Ovary- NODF, EM- 9.3mm
Got done IVF with donor eggs on 24th December 2016 @ Padmaja Infertility clinic Hyderabad. But no success.
They said 3 blastocyst stage embryos were transferred.
Post ET:
Inj Susten - 20
Inj HUCOG Biweekly 5000IU/IM
Evafem
Ecosprin 75mg OD
astagen
Folinz OD
Kindly advice why did it fail even with Donor eggs when my endometrium lining was 7.4mm.
How can I get positive results?
What medications can I take to increase my AMH levels and will 2nd attempt of IVF work?
Please help me. am in depression and lost.
Can you send me more details about your donor egg IVF cycle ?
DeleteDO YOU HAVE PHOTOS OF YOUR EMBRYOS ?
Hi
ReplyDeleteI have low AMH level of 1.10, FSH-6.63,LH-3.99, PROLATIN-49.17,TSH-4.650 & Blood sugar fasting-114.1. Doctor says that there are less chances of getting pregnant. can you please update me what are the chances of getting pregnant. Let me know the diet to increase the AMH levels and decrease the prolactin levels.
Do a complete workup before starting treatment haphazardly.
DeleteYou need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility).
Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b
blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
With these test results, we can determine what medical problems are causing your
infertility.
If there is a problem, then we can treat it !
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
I have any 7.49 ...Pls suggest me the right treatment can I do
ReplyDeleteHi,I am 29 years old.my AMH level is 1.7ng/l.my husband's sperm count is zero as per test.still I can conceive naturally?
ReplyDeleteNo, your husband needs sperm to get you pregnant !
Deletehi doctor,
ReplyDeleteI am 30 yrs old my amh is 0.4, FSH is 7 and LH is 3.8.
can i conceive with this amh naturally?
The chances are poor, sorry
DeleteFalse hope can be cruel
Hello doctor,
ReplyDeleteIam 36 yrs old.my amh is 0.53 . In tvs sonography dr.found few antral follicals and suggested advised for IVF through egg donor. We followed the advise. I conceived but my second trimester anamoly scan was showing pregnancy at increased risk and at 5 month pregnancy doctor informed us the growth is not normal and it should be aborted. I am tired of visiting so many doctors. I want to conceive naturally. Kindly advise how can i conceive naturally. I have hypothyroidism.
Hlo..dr.
ReplyDeleteMy Name Is Preeti .i Am 32 yr ..i got My Baby Girl 2.25 yr Back..but Due To Some Reasons I Lost My Child..after That I Dont Get Pregnant Again..my AMh 7.48 ..& MY DR. Priscribed Me Hsg Test Which Shows My Both Tubes Are Open...pls Suggest Me How Can I Reduce My Amh Harmone ...i Have Done My Folliculor Study 3 times But Due To My High Amh on Mu 15 day My Eggs Increses Upto 55 mg But Not Ruptured..pls Reply ..i will Wait For Ur Reply..pls.
Your high AMH suggests you have PCOD
ReplyDeleteYou can read more about how we treat PCOD at
http://www.drmalpani.com/knowledge-center/the-infertile-woman/how-to-manage-your-pcod
Do a complete workup before starting treatment haphazardly.
You need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility).
Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b
blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, www.drmalpani.com/hsg.htm) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
The fact you have conceived in the past ( even though you did miscarry) means your chances
of having a healthy baby are excellent, so please don't get disheartened !
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Hello Doctor,
ReplyDeleteI recently had my AMH test done along with a pap smear. Both the tests came out normal. The AMH level was 0.93 (ng/mL). I am 31 yrs old, height 5.4” and weigh 176 lbs. It’s only been two months since we are trying to get pregnant. I am worried if my AMH level is between low-normal range or is it very low!? Because I was told by my doctor that it normal. Or if I work on my weight reduction, are there any chances that my ovarian reserve will increase!? Will I be able to get pregnant at this current situation!? Please advise. Thanks!
DeleteYour low AMH level ( www.drmalpani.com/knowledge-center/infertility-testing/amh)
suggests you have poor ovarian reserve .
You can read more about this at http://www.drmalpani.com/knowledge-center/the-infertile-woman/oopause
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
Dear Dr, I got my AMH blood report today it says 0.37 FSH 7.67, LH 5.21, Prolactin 10.2, Vit D 18.6, T3 3.94,T4 17.71,TSH 3.95 Endometrial thickness 3.8mm I am 39 years old, I just got married in Jan 2017. Will I be able to conceive naturally ?
ReplyDeleteYour low AMH level is worrisome, but we don't treat just numbers
DeleteDo a complete workup before starting treatment haphazardly.
You need to do ALL the following simple medical tests:
semen analysis for your husband ( to check his sperm count and motility).
Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
your fallopian tubes are open);
The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
Please send me all the results together, rather than piecemeal, so I can interpret them intelligently
If there is a problem, then we can treat it !
Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !
You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
You can add a google review for us at https://plus.google.com/102706636605134081909/about
My Facebook page is at https://www.facebook.com/aniruddha.malpani
You can follow me on twitter at https://twitter.com/drmalpani
Watch our infertility cartoon film at http://www.ivfindia.com
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Read my blog about improving the doctor-patient
relationship at http://blog.drmalpani.com
Hello Sir,
ReplyDeleteI went to a Doctor in Delhi for irregular period (last late by 6 days)of my wife having age 28 years and unsuccessful when trying together since last 1 year. He told for many tests. Among them one test AMH result is very low (0.22). Today when went again, Doctor told to retest again in another lab and give me a medicine OVIGYN DSR 75mg.Doctor told to try for a month otherwise I have to go for IVF. We are very depressed. What should I do?
I agree this is worrisome
DeleteCan you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
We look forward to helping you to have a baby !
Hello doctor,
ReplyDeleteMy AMH 1.36, FSH 7.83, LH 3.33, E2 41.56. Can I conceive naturally . I had miscarriage at 5 weeks earlier.
The fact you have conceived in the past ( even though you did miscarry) means your chances
Deleteof having a healthy baby are excellent, so please don't get disheartened !
Hello Doctor,
ReplyDeleteI’m 34, ttc last 8 months, have low AMH 1.02 ng/ml (mar’17) now 1.78 ng/ml (oct’17) after coq10 and ovares. Had 2 failed Iuis so doctors are recommending checking tubes-
option 1: HSG
Option2 : laproscopy
I’ve read studies online that Laproscopy maybe better to diagnose other conditions like endometriosis but can cause further reduction of AMH. Would you recommend I go through HSG(as painful as it is) over lapro - don’t want to drop AMH further
I would not advise you to have a laparoscopy. Read more at http://www.drmalpani.com/knowledge-center/infertility-testing/laparoscopy-and-infertility
DeleteCan you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
If 2 IUI cycles have failed, I agree that IVF (www.drmalpani.com/our-services/ivf)
would be your best treatment option
as it would maximise your chances of conceiving quickly.
Time is now at a premium for you - please don't waste it ! You should never have any regrets that you left any stone unturned and didn't give yourself the best shot at fertility treatment.
Hello doctor
ReplyDeleteI am 25 yrs old. We wanted to go for an IVF but my AMH is 1.4 is it very low for an IVF. Is there any way I could increase my AMH through diet?
Dear Priya,
DeleteBecause you are young, your chances are still good, even though your AMH is low
Can you please test your antral follicle count by doing a vaginal ultrasound scan ? Read more at http://www.drmalpani.com/knowledge-center/articles/afc
We look forward to helping you to have a baby !
Hi Dr. I have high serum DHEA (550+), low AMH (O.7) AFC - 2. Can I take the DHEA supplement?
ReplyDeleteDHEA is not a panacea and does not help all women with a low AMH, sorry
DeleteDr Aniruddha Malpani
Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
Mumbai 400 005. India
Clinic Mobile: 9867441589
Tel: 91-22-22151065, 22151066, 2218 3270, 65527073
Helping you to build your family !
Watch our infertility cartoon film at http://www.ivfindia.com
Please add a google review for us at http://bit.ly/2tN1wdb
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at www.DrMalpani.com !
Which is why I was circumspect that my fertility doctor prescribed DHEA in a cookie cutter manner. Thanks.
DeleteHii dr. I am shreya. My amh level 0.5. Dr say donor egg pregnancy. But I am pregnant. Success this pregnancy.
ReplyDeleteHello Dr. Please advise me. I'm 30 and have low amh level of .28. My husbands sperm count is 60 mn/ml and motility of 75%. What are my chances to conceive naturally or without using donor eggs?
ReplyDelete