Hi Doctor,
I recently got my test results back. My appointment with RE is still a month away (did testing in advance) and I am anxious.
Day 3 results are as follows
FSH - 3.9
Estradiol - 35
Prolactin - 10.1
TSH - 2.0
AMH - 9.3
Clear HSG
I also had AFC count done and the ultrasound tech stopped counting after 20 follicles, so I am not sure what the exact count was.
I am 30. Trying for over a year now, had one chemical pregnancy. At first I was really excited over my numbers, but now I am growing concerned.
Is there such thing as too high AMH? Too much of a "good" thing?
Everywhere I read indicates that high AMH, low FSH and high AFC can be indicative of PCOS. The thing is, I have no symptoms of PCOS whatsoever, am thin, no body hair, no acnes, and my cycles are very regular, ovulating (confirming by opks and temps) every months. Could I still have PCOS given the test results? Could it be that I have too many follicles that do not mature? Is it possible that RE would be hesitant to help us given risk for OHSS? I know I should stop reading Dr. Google, but a month seems like an eternity to discuss the results.
Thank you.
Very High AMH.
Re: Very High AMH.
I would not worry about your results. It is true that women with PCOS have high AMH but from what you write it does not sound like you have any features of PCOS.
Your doctor will just have to take into account that you will be very sensitive to fertility drugs and plan accordingly.
Believe me, too low an AMH is a much bigger problem.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Your doctor will just have to take into account that you will be very sensitive to fertility drugs and plan accordingly.
Believe me, too low an AMH is a much bigger problem.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Re: Very High AMH.
Thank you so much for the reply. I feel much better now 
Are there protocols doctors can utilize to minimize the risk for OHSS? I would still be allowed to proceed with treatments, IUIs and IVF if needed, right?
Are there protocols doctors can utilize to minimize the risk for OHSS? I would still be allowed to proceed with treatments, IUIs and IVF if needed, right?
Re: Very High AMH.
Triggering with Lupron almost eliminates the chance of OHSS especially if it is combined with a very conservative amount of gonadotropins.
So the high AMH would not be a reason to not do IVF. IUI by itself would not be a concern. They would just need to be more cautious using injectable drugs for ovulation induction combined with IUI because of a high chance of multiple m=pregnancy and hyperstimulation.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
So the high AMH would not be a reason to not do IVF. IUI by itself would not be a concern. They would just need to be more cautious using injectable drugs for ovulation induction combined with IUI because of a high chance of multiple m=pregnancy and hyperstimulation.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Re: Very High AMH.
Thank you. Could you please advise if AMH/AFC are indicative of egg quality or just the quantity. Is there anything to test the quality.? Could high count cause follicles not to mature/no dominant one to form, or as long as I am ovulating every month it is a non-issue?
Would metformin be worth trying?
Would metformin be worth trying?
Re: Very High AMH.
It's an indicator of quantity. A day 2-3 FSH/E2 level is the indicator of quality.
It would not create any of those issues. Metformin would not be helpful unless they find you have PCOS.
What is not helpful is all the stress this is causing you. I suggest you try to reduce the stress and forget about it and wait for your appointment to get more answers.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
It would not create any of those issues. Metformin would not be helpful unless they find you have PCOS.
What is not helpful is all the stress this is causing you. I suggest you try to reduce the stress and forget about it and wait for your appointment to get more answers.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Re: Very High AMH.
Thank you doctor. I do agree with you that worrying about it does not help anything. I am stepping away from Google. 
Its just that we have been actively trying for over a year, and with everything being "great on paper", it is frustrating that nothing is happening. I promise I did not start off this stressed out, we were pretty laid back for good first 6-9 months, but after 12 months mark, growing very anxious. 
Thank you so much for your feedback. I think it is absolutely amazing that you provide this online forum and help people tremendously.
Its just that we have been actively trying for over a year, and with everything being "great on paper", it is frustrating that nothing is happening. I promise I did not start off this stressed out, we were pretty laid back for good first 6-9 months, but after 12 months mark, growing very anxious. Thank you so much for your feedback. I think it is absolutely amazing that you provide this online forum and help people tremendously.