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AMH Update

I had my AMH retested to see if it was really <.03 ng/mL, and also had my vitamin D levels tested for the first time to see if a low vitamin D level was making my AMH appear lower than it really was.

I’ve also read numerous studies on DHEA raising AMH levels. Now I know a lot of women online who say AMH cannot be changed because it is a measure of your ovarian reserve, but I also read these research studies and I know many women who have seen DHEA raise their AMH levels.

AMH levels are put out by primary follicles. So if you can increase the number of primordial follicles becoming primary follicles, why couldn’t you increase AMH? But I am not a research endocrinologist, clearly.

Anyway, I’ve been on 75 mg of micronized DHEA for a solid 6 months now, as well as 2000-4000 iu of vitamin D, so I thought surely my AMH could be higher. Maybe as high as .1 ng/mL

My AMH is now .05. That is not a significant enough change to even consider it to be a change, obviously; it can be attributed to a normal variation in lab results. At least now I know that my AMH level is a true AMH level. My ovarian response is certainly reflecting that, also.

So we know that there are many causes of DOR and many women don’t know the cause of theirs, but I know the cause of mine because of a genetic test my doctor gave me in February.

I have a single nucleotide polymorphism on the gene GDF9 (growth differentiation factor-9). The polymorphism is c.447>T (C/T). This means nothing to anyone who doesn’t know genetics and in my own reading I have come to feel as though I am trying to crack the da Vinci code. I need to mention right now that my own RE also has a PhD in genetics and runs a genetics research lab at the Ivy League university where we both work, so I feel silly playing amateur researcher. It’s not like I’m going to gain some understanding that she doesn’t already have.

But I can’t help myself. I’m an info person.

Effect of growth differentiation factor‑9 C447T and G546A polymorphisms on the outcomes of in vitro fertilization

This study shows, for my specific genetic variation:

  • “a significant association with poor ovarian stimulation responders”
  • “a significant association was observed with a poor fertilization rate”

This is one of the only (and latest) studies to show a risk for DOR with this gene polymorphism, and there are other older studies showing it has no risk. I read in one of the studies that GDF9 caused DOR is rare anyway.

Growth differentiation factor-9 is required during early ovarian folliculogenesis

  • “Here we analyse ovaries from GDF-9-deficient female mice and demonstrate that primordial and primary one-layer follicles can be formed, but there is a block in follicular development beyond the primary one-layer follicle stage which leads to complete infertility. Oocyte growth and zona pellucida formation proceed normally, but other aspects of oocyte differentiation are compromised. Thus, GDF-9 is the first oocyte-derived growth factor required for somatic cell function in vivo.”

This second study is on mice and it is not drilled down to specific polymorphisms of this gene (I think) but this is the study that showed what the function of GDF9 is in oocytes.

I don’t know what to make of any of this. People who know way more than I do don’t know what to make of it either, perhaps. Maybe in 30 years they will have perfected a method of in vitro maturation where they are able to alter the oocyte’s GDF9.

Not everyone has the same cause of diminished ovarian reserve, and I’m getting the idea that I have a rarer one that isn’t a case of finding the golden egg among aging ovaries, or taking enough antioxidants to correct the mRNA. I think maybe I am injecting FSH into myself and my eggs don’t even have the capability of responding. How did I get pregnant before? Maybe 100% of my eggs grow improperly or don’t grow at all.

 

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8 thoughts on “AMH Update”

    1. I’ve read of so many sister pairs with DOR! I don’t know about my own sister. If she does have DOR she didn’t have it in her twenties. She had her three kids by the age of 26.

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  1. Hmmm. Interesting. I also saw lots by women saying AMH can’t be changed. So this generation issue combined with the virtually unchanged AMH, what does it tell you for the future? Does it impact where your mind was going? And having been on DHEA for so long will you continue till you’re done with treatments? Or is there a point where you’ll decide it’s time for a rest?

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    1. I think I will continue with the DHEA and continue trying because I need to know that I did everything that I possibly could. And when we think there’s nothing else we can do, we may move on to donor eggs.

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  2. My AMH at the very beginning of our journey was at .1 and then when I retested It 2 years later it was I think at .03, and my FSH was all over the map both times. Now I haven’t had my period for almost 3 months but of course it’s not like it means anything positive 😦

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    1. All of the low AMH success stories are about AMH of .2, and I’m like okay that’s low but it’s not reeeeaalllly low like mine. I have scoured the internet for low AMH success stories and have found literally three or four that involve AMH below .1. This should be a wake up call but instead I’m going to be over here meditating and sniffing essential oils and taking supplements until I perform a magic trick on my eggs.

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      1. My favorite urban myth is the one about eating eggs to improve your eggs… I think the worst thing for me is wondering if I had measured this when I was in my early twenties if the numbers were different or if I’ve always had DOR. Should be part of annual GYN exams as far as I’m concerned! When I turned 30 my doctor asked me if I wanted to freeze my eggs and of course I could never afford anything like that so I left it off

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