Maybe an answer?

So I got one of my test results back. My AMH test result.

AMH or Anti-Müllerian hormone is used as a benchmark for your remaining ovarian reserve. Normally a person’s AMH peaks when they are in their 20s and falls in your late-30s and 40s until it’s very low and you hit menopause.

Ideally your AMH is above 0.9 and below either 3 or 4 or so.

Too low of AMH means your egg reserves are depleted and doing something like trying to stimulate for an egg retrieval will be challenging.

My score is 16.

The doctor said that she normally likes to see below 9 and that my high level may impact ovulation. I didn’t understand why until I consulted Dr. Google, and then Dr. Google Scholar (who is mildly more informed).

If you read through the first article, you’d notice that too high of AMH heavily correlates with PCOS. Another study confirms it.

This is kind of surprising to me. I have signs of ovulation every month, including temperature shifts, I don’t have excess weight and have a very normal BMI (21-22), but it’s been hard for me to understand why so many cycles in a row have completely failed. None of them were timed too poorly (it appeared as though some may have been early, but BBT is only accurate within a 3 day range).

Maybe this is the reason?

Should I ask my doctor? Should I take metformin or something? Most research I’ve found tends to be geared towards to obese women. Losing 5% of my body weight is possible, but I’ve heard it’s not very useful for lean PCOS.

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About DeCaf

Just a code monkey.
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33 Responses to Maybe an answer?

  1. AndiePants says:

    I’d get your other hormone and glucose levels checked. There’s still a lot unknown about PCOS but it definitely happens in thin women. Also, i have pcos and ovulated monthly, but my doctor explained that i may have been ovulating immature eggs or not ovulating “strongly” (but don’t ask me what that means! ) basically, PCOS is a syndrome not a disease so it’s possible to have some symptoms and not others. Metformin could help but I’d ask about clomid or femara and a trigger. Those are more likely to help you ovulate mature eggs.

  2. Lemon Drop says:

    DO you ovulate every month? I feel like my wife shows signs every month but her cycle lasts anywhere from 60-180 days. Took her YEARS to get a doctor to diagnose PCOS even with prompting (hormone levels were always borderline). She is tall and large, but (I think?) not obese, and took metformin before attempting pregnancy (with meds and triggered ovulation–femara and ovidrel). Still does, actually. It’s been a good move.

    • DeCaf says:

      My cycles are between 27-36 days, most 30-31 days.
      I had asked about PCOS at my initial meeting with an obgyn and he dismissed it. It was only now that we switched to an RE.
      Did the meds end up working for your wife? Or did you carry Clem? (I’m sorry I’m no good at remembering some of these things)

      • Lemon Drop says:

        Hm. Yeah, it was the RE who actually prescribed the metformin (like yours, her regular doctor at the time was dismissive) and now she sees a regular endocrinologist (or she did once her period came back). She carried Clem. So yes, I’d say the meds worked. Two cycles to conceive, one jumpstarted with Provera (EVIL) the other, I think, with birth control pills. Or maybe that was just the cycle we skipped due to travel. In any case, we love Femara and want to have its babies. Oh wait, we did. Or she did. I’m disturbingly regular. And rambly, apparently. Maybe it’s bedtime.

  3. butchjax says:

    My friend had a low supply and they kept her from ovulating for a month before using meds to control the cycle. She got pregnant the first time with that method. I’ll see if she can swing by.

    • DeCaf says:

      Thanks, but my numbers aren’t low, they’re too high which indicates a possible other problem.

      • butchjax says:

        I am the friend mentioned above. Hi!
        For reference, I’m 34.
        I tried to get pregnant for 6 mo using ovulation predictor kids, donor sperm, and IUI. Very regular cycles and ovulation. Precise timelines. No dice. Ran some tests. My anti-mullerian was quite low – 0.23. Found out (via ultrasound) that I had a huge ovarian cyst. Had surgery to remove my right ovary and fallopian tube. Tried again 1-2 mo later.
        Was on birth control to supress my cycle and time it right with the doctor’s schedule (multiple patients).
        I got pregnant on my first try with follistim and ovidrel – with lots of hormone level (blood draw) monitoring and many frequent ultrasounds to measure egg production / size. Also used progesterone suppositories from two days after IUI (insemination) until the 10th or so week. I highly recommend it. Usually called “gonadotropin therapy.”
        Hope this helps. 🙂

      • butchjax says:

        I look forward to seeing how they solve this for you.

  4. mamaetmaman says:

    Interesting new information. I think the clomid and femara will help you ovulate more fully. I would have a glucose tolerance test, androgens, and testosterone done for sure. PCOS can be different in different people- it’s a diagnosis based on a triad of signs. And really, other than the metformin, I don’t think a diagnosis will help you much with TTC, as fertility docs don’t directly address the PCOS beyond giving you other meds to control your cycle. It’s a frustrating diagnosis that way.

    • DeCaf says:

      I’ve had one and it was normal. I’ll call the doctor today. PCOS treatment seems really geared towards obese women, and how they can cure themselves with lifestyle changes. Lean PCOSers seems to be out of luck. :-/ Not that lifestyle changes are easy, but it’s something that’s not just taking medication forever.

      • mamaetmaman says:

        Yes, you are right. Lean PCOS ladies have really no clear direction for improving their condition- except maybe limiting insulin-spiking foods from the diet in general.

  5. The LadyKing says:

    I’m useless when it comes to all the technical stuff, but I can tell you The Queen had confirmed ovulation each cycle but her follicles were immature. I think they diagnosed her with PCOS but only due to her having had previous ovarian cysts when younger and, honestly, to help us bill under the fertility coverage for our IUIs.

    Her hormone levels/etc were always within appropriate range. The clomid helped the follicles mature to size and within two (Thatcher), three (Scarlett), and one (Cordelia & Lucille) cycle she was pregnant.

    • DeCaf says:

      Interesting. I only had one known cyst when I was younger. It was a doozy though (plum sized).
      I love your twins’ names. 🙂

      • The LadyKing says:

        Hers went away with BC pills.

        I’ve never had them but that sounds extremely painful! Yikes!

        And thanks! Girls names are always a lot easier for us than boys. 🙂

        • DeCaf says:

          True. My wife and I have wonderful names picked out that I really can’t wait to share. Not naming our child is something I will mourn if we end up going the foster adopt route.

          • The LadyKing says:

            I hear you. The naming process feels like such a parent rite of passage. I hope you’re able to use those names one day. It sounds like your RE is getting a little closer to making that happen. We were very pleased with clomid but I’m starting to see we’re maybe in the minority on that. We’re keeping you guys in our thoughts and sending our best wishes your way. 🙂

  6. 2ladiesmakingbabies says:

    mine is 8.3. I remember being freaked out about it but not getting any answers. We’ll connect offline. Hope you’re doing well!

  7. Elizabeth says:

    Mine is 4.4. At 38 this is quite high. Sounds like we have a lot of similarities. I have always been at my ideal weight and have a 28-30 day cycle. Never had ovulation problems. It wasn’t until I did IVF that I realized I seem to produce a lot of low quality eggs. It’s frustrating to have to guess but I assume I have PCOS to some degree.

    Have you tried myo inositol? Or d chiro ibositol? Some solid studies indicting they’re both helpful.

  8. julieann081 says:

    I’m sorry to hear this news. I don’t have many suggestions, but it sounds like others do. I’m wishing you all the best. ❤

  9. I hope this helps point you towards more answers.

  10. K.M.H says:

    You need your insulin levels checked, not the glucose levels. My glucose levels are normal and within range, but my insulin is what is high (which is the PCOS bit). I’d get your hormone levels checked, especially the testosterone and insulin levels. That’s how they diagnosed me.

    And my doctor said that weight doesn’t have as much to do with it as people originally thought. All types of people end up with it and all types of people don’t. He said that he’s seen it in thinner people and not seen it in bigger people… it just depends.

  11. This (& the comments) is incredibly informative and I hope it’s also your answer.

  12. Molly says:

    Definitely talk to the doctor. For me, my hormone levels and insulin were all within normal ranges. The PCOS diagnosis was based on symptoms rather than lab work. I met the criteria based on: 1) irregular and often anovulatory cycles, 2) hair in undesirable places, and 3) polycystic ovaries. After about a year, the doctor checked my insulin (for a third time) and we got a different result, so that’s when she put me on metformin. It’s good that you’re on track for a clomid/trigger cycle. That will likely help, but it may take a few cycles to determine what dose of clomid is best. Will they be doing ultrasound monitoring?

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