Guest blog by Monika Friedman, a Fertility Coach.
I remember the day when I got back my AMH and FSH test results so clearly (scroll down for what these stand for). I was well into my second year of trying to conceive without luck and had just switched to a new doctor.
To say that I was devastated would be an understatement.
I had just turned 30 years old yet was diagnosed with the egg reserve of a 44-year-old and was suspected to be pre-menopausal.
Fast-forward 4 years, 12 rounds of ovulation induction, 4 rounds of IVF, and one miscarriage later, I am now a proud mom turned to fertility coach. I’ve made it my mission to help other women navigate their own fertility journey with more knowledge and tools, less anxiety, and more joy.
Alright, let’s get back to AMH and FSH, two important ovarian reserve markers:
AMH stands for anti-Müllerian hormone, which is found in your blood and reflects the size of the remaining egg supply – or ovarian reserve. A low AMH, often in conjunction with age or genetic disposition, can indicate fewer remaining follicles. (In the US: Anything between 1 ng/ml and 3 ng/ml is considered ‘normal’. AMH levels over 4 ng/mL may be associated with Polycystic Ovary Syndrome.)
What causes low AMH?
The Center for Human Reproduction says:
- Anything that disrupts the feedback cycle of follicular development and AMH secretion, such as:
- autoimmune diseases (thyroid conditions)
- genetic factors (for example, the FMR1 gene)
- endocrine disruptors (chemicals), high cortisol release, and diet
FSH stands for follicle-stimulating hormone, which is a hormone produced by the pituitary gland in the brain that encourages follicles and eggs to grow and mature each month. An FSH level of <10 mIU/mL is great as it means your brain doesn’t have to work as hard to get your ovaries to produce eggs. The higher the FSH, the ‘louder’ your brain has to shout to get the ovaries to listen and stimulate eggs.
Dr. Marcy Maguire, the lead physician of RMA fertility clinic, says: Low AMH and high FSH often go hand-in-hand. With fewer eggs left, the ovaries are having a harder time producing. Brain needs to shout louder for ovaries to hear its signals to produce eggs.
Let’s visit some common myths that had me freaked out when I was trying to conceive; I just wish I had known the truth about AMH and FSH so much earlier.
Major Fertility Myth #1: AMH is an indicator of egg quality.
Often, when we talk about low ovarian reserve, we think that the remaining eggs are of lower quality. That is NOT necessarily the case. Some might argue that the fewer eggs we have, the lower the chances of good ones. However, a recent study has actually shown that AMH and FSH markers are not true predictors for natural fertility. This means that theoretically women with low AMH can get pregnant naturally just as well as women with higher AMH. (often the case when we don’t know about diagnosis)
Major Fertility Myth #2: If I can increase my AMH and lower my FSH, then I can get pregnant more easily.
Not necessarily true…
For starters, the scientific jury is still out on whether you can really increase your AMH and lower your FSH. Some success has been found with applying Traditional Chinese Medicine practices, including herbs and acupuncture, Ayurveda, and lifestyle changes, such as diet and practicing mind-body techniques like relaxation to balance out the hormonal messaging pathway from pituitary to ovaries.
Instead, low AMH and high FSH are more an indicator of how well you respond to stimulation during a treatment cycle. Yes, your egg count overall is lower than it should be given your age, but that just means things need a bit more of a strategic approach and it may take a little longer than you thought it would (but good things in life take time, right?).
That may also involve more heartache along the way (yup, been there) in the form of waiting, the stress of having to go through an assisted treatment cycle, or a potential miscarriage. But it does NOT mean you can’t get pregnant with your own biological child.
Major Fertility Myth #3: My biological age equals my chronological age.
You can definitely rewind or stop your biological clock. Just imagine that your egg health could be that of a 30-yr old instead of a 40-yr old if you lived your healthiest life starting today?
The likelihood of becoming pregnant after your 35th birthday is not nosediving as significantly as you think. Women get pregnant well into their 40s! It just might take a bit more effort than if you were 20.
More importantly, age is by far not the only factor impacting fertility. Genetic disposition, weight, lifestyle, and stress are important factors too.
So, the key question is: how can we improve the quality of the remaining eggs we have as much as possible?
Here’s the good news: We can definitely improve our egg quality with some simple lifestyle changes and improve our overall chances of getting pregnant by adjusting our mindset and implementing specific fertility tactics. Circle+Bloom offers two wonderful guided meditation programs to help with your mindset while trying to conceive (TTC): Positivity and Mindfulness for Getting Pregnant and their Integrated Mind-Body System for Optimal Pregnancy. They both help with reducing stress, clearing your mind of the mental clutter of TTC, and creating new healthy habits to help you have a new positive outlook on your fertility journey.
In closing, my very personal advice to you is: Don’t get hung up on your AMH/FSH numbers. There is more to your fertility journey than numbers.
I welcome you to download my Ultimate Mind-Body Fertility Guide I’ve created for more ideas how to take care of your emotions, deal with anxiety and improve fertility.
As a fertility coach Monika provides emotional, lifestyle & practical fertility support for women, helping them to increase their chances of conceiving and manage their emotions along the way.
She’s a 4-time IVF warrior turned fertility coach, mind-body teacher, health & life coach. Her own journey to becoming a mom (1 IVF, 1 naturally conceived baby) has made her passionate about helping make YOUR path easier.