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Is AMH Value Of 1.13 A Cause For Concern?
Question: hi i am 38. my amh is 1.13 and my eggs do not rupture on time. what do you suggest
Brief Answer:
rule out thrombophilias first.
Detailed Answer:
Hello,
Thanks for the query to hcm,
I think that your AMH levels are low but you still have an ovarian reserve, you can definitely opt for a repeat oocyte harvesting after a controlled ovarian stimulation and follow the IVF protocol of ICSI and then embryo transfer again, but prior to that i would like you to get screened for inherited and acquired thrombophilias as these are the most common reason for recurrent pregnancy losses and you should rule them out certainly before option for the cycle again.
ACLA, ANA, LAC by dRVVT method, protein c and s deficiency, antithrombin 3 deficiency, Factor 5 leiden mutation. Please follow up with reports or you can discuss with your ivf specialist.
rule out thrombophilias first.
Detailed Answer:
Hello,
Thanks for the query to hcm,
I think that your AMH levels are low but you still have an ovarian reserve, you can definitely opt for a repeat oocyte harvesting after a controlled ovarian stimulation and follow the IVF protocol of ICSI and then embryo transfer again, but prior to that i would like you to get screened for inherited and acquired thrombophilias as these are the most common reason for recurrent pregnancy losses and you should rule them out certainly before option for the cycle again.
ACLA, ANA, LAC by dRVVT method, protein c and s deficiency, antithrombin 3 deficiency, Factor 5 leiden mutation. Please follow up with reports or you can discuss with your ivf specialist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
just to tell you one more thing that the doctor did give lonopin injection for the whole period of conception and gave ecosprin drug. so i guess that was taken care off during the IVF but i still faced miscarriage. my family has no history of thrombophilias
just to tell you one more thing that the doctor did give lonopin injection for the whole period of conception and gave ecosprin drug. so i guess that was taken care off during the IVF but i still faced miscarriage. my family has no history of thrombophilias
Brief Answer:
answered
Detailed Answer:
I see, the thrombophilias have been taken care off with enoxaparin and ecosprin.
The likely reason in your case for delayed ovulation/rupture of follicle considering your weight appears to be PCOS with increased insulin resistance which would have been confirmed with usg and hormonal profile indicating increase androgen levels.
This can be treated with either reduction of weight and low dose hormonal pills ideally which should be taken for at least 3 months.
But in case pregnancy is desired early , ovulation stimulation is preferred and as in your case with borderline amh levels ivf should be considered.
You should be offered genetic counselling and CMA( chromosomal microarray test) to look for any congenital or familial diseases running in families which may not be compatible with life ( considering 3 miscarriages or missed abortions). This shall be helpful.
Thirdly, the success rate of any ivf procedure is only 30-35% across the world and hence the protocol can be repeated for 3 attempts.
regards
answered
Detailed Answer:
I see, the thrombophilias have been taken care off with enoxaparin and ecosprin.
The likely reason in your case for delayed ovulation/rupture of follicle considering your weight appears to be PCOS with increased insulin resistance which would have been confirmed with usg and hormonal profile indicating increase androgen levels.
This can be treated with either reduction of weight and low dose hormonal pills ideally which should be taken for at least 3 months.
But in case pregnancy is desired early , ovulation stimulation is preferred and as in your case with borderline amh levels ivf should be considered.
You should be offered genetic counselling and CMA( chromosomal microarray test) to look for any congenital or familial diseases running in families which may not be compatible with life ( considering 3 miscarriages or missed abortions). This shall be helpful.
Thirdly, the success rate of any ivf procedure is only 30-35% across the world and hence the protocol can be repeated for 3 attempts.
regards
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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