Timeforafamily, AMH is the Anti-Mullerian Hormone. My doc tests AMH (it's a pretty new test, only around for the last couple of years, apparently) instead of FSH to measure ovarian reserve. Essentially, all of the eggs that are still sitting in your ovaries emit AMH, so by testing AMH, they can tell how many eggs you have left. (Higher AMH level = more eggs.) One benefit of the AMH test is that it can be done at any time of the month, not just on days 2-3. In addition, it supposedly does not fluctuate the way that FSH levels can, so it's supposed to be more accurate. Furthermore, AMH levels can start declining before your FSH starts to rise, so some clinics say that finding out you have sub-optimal AMH levels acts as an early warning system that your fertility is waning and that you should get started on pursuing more aggressive treatments if you want to have a child.

That is all the theory. In practice, since it is such a new test, it seems that there is some disagreement over what the measurement actually means, as far as what the cutoffs are, what is normal, and how likely you are to respond to fertility treatment. Apparently people with normal fertility will have an AMH level between 14 and 44. Higher than that apparently indicates PCOS. According to my FS, lower than 14 indicates lower than normal fertility (I think this means that you have a diminished ovarian reserve). But I've read somewhere (on the website of that Indian doctor, Dr. Malpani, I think) that 7-14 can be considered "low normal", and on the Repromed website (they processed my test), I found a chart showing that for women my age, my score is right on the borderline between normal and low for women my age, even though it is still, objectively, a low score. So some doctors might interpret the result more strictly or more optimistically than others. The other thing is that if your ovarian reserve is low, you would apparently have a higher likelihood of being a poor responder to stimulation meds. But that is not always the case. So while the test is a useful tool, it's not perfect.

In my case, since I've been on my first cycle but am 38 -- not a spring chicken! -- my doc was going to start me on a low-ish but not super low Puregon dose of 225. When my AMH results came back a few days before I was to start injecting, he decided to increase my dose to 275. That's higher, but still does not seem to be as high as some of the poor responders require. I just got back from my EPU a few hours ago, and am happy to say that mid-range dose fetched me 6 eggs. So my poor AMH level did not destroy my chance of having a successful IVF cycle. Now we just need to see how the eggies fertilize. Go eggies go!

KitKat72