Rapid AMH Decline

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Joined: Wed Jan 27, 2016 7:44 am

Rapid AMH Decline

Post by prakes » Wed Jan 27, 2016 8:07 am

I am 37 years old and did one round of IVF 16 months ago at age 36 (my husband has low morphology but all else appears normal). My AMH was 3.5 and FSH between 4 and 5. I was put on 150 follistim and produced 19 eggs, 16 mature, 10 fertilized with ICSI. On day 5 we had 3 good blasts, of which one resulted in a baby born 5 months ago.

Now at age 37, I had my AMH re-tested in anticipation of doing a freeze-all cycle, and the result came back as 0.4. My AMH had been 3.5 at ages 35 and 36, and my prior scans always showed very high AFCs leading up to my IVF 16 months ago.

I have not done Day 3 testing yet so I do not have additional data points, but how common is it for the ovarian reserve to decline so dramatically (90%) in just 16 months? During most of that time I was not ovulating due to pregnancy and breastfeeding (although I stopped breastfeeding completely 6 weeks before the test). Does this rate of decline suggest that it will essentially be 0 in a matter of months?

Do you have any thoughts on how to proceed from here-- ivf with PGS, mini-ivf with PGS and banking, or other options?

Many thanks.

Dr. Wisot
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Re: Rapid AMH Decline

Post by Dr. Wisot » Wed Jan 27, 2016 9:06 am

Based on one AMH there is no way to determine exactly which approach would be best. One thing I can say is that in this situation, some form of fertility preservation in one of the options you mentioned would be a good idea.

When your doctor has more complete information, he/she can guide you to the best option.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

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