Treatment for Low AMH: DHEA Supplementation & Tailored IVF Protocols
Unfortunately, many fertility centers don't use age-specific hormone levels during ovarian reserve testing. Because of the natural change in hormone levels with age, using a universal cut-off value may miss some younger women with beginning stages of premature ovarian aging (POA, premature loss of ovarian reserve), leading to treatment delays. At CHR, however, we do utilize the age-specific AMH and FSH levels, developed in-house, to accurately assess a woman's ovarian reserve status. We strongly encourage women who are thus diagnosed with low AMH levels to not delay fertility treatment because AMH and ovarian reserve continue to decline with age.
Additionally, many fertility centers still would not offer fertility treatments to women who fall below universal cut-off levels of AMH and/or FSH. This approach may ensure higher pregnancy rates for the fertility centers (because women with smaller pregnancy chances are rejected and do not appear in their pregnancy rate statistics), but obviously it leaves women with low AMH and/or high FSH levels with no recourse for pregnancy, rightly feeling abandoned. CHR has no arbitrary cut-off value and works with each patient to explore best treatment options for each patient’s clinical circumstances and preferences.
DHEA Supplementation with Low AMH Levels
Women with low AMH typically benefit the most from well-managed IVF protocols. Treatment plans for women with low AMH at CHR most likely involve DHEADHEA supplementation, which has been shown to be effective in improving IVF pregnancy rates in women with low AMH. Published CHR studies over the last 8 to 9 years have shown significant improvements in AMH levels after DHEA supplementation. Women younger than 38 saw a bigger improvement in AMH concentrations after DHEA treatment, compared to older women. Improvements in AMH levels after DHEA supplementation were found to be one of the most reliable prognosticators for a successful pregnancy with IVF.
With the introduction of DHEA supplementation and research-driven treatment plans modified to best suit individual patients, CHR doctors have become world-renowned experts in diagnosis and treatment of diminished ovarian reserve, an umbrella term covering both premature ovarian aging (POA) and natural, age-related loss of ovarian reserve. We serve many patients from all over the world who seek out CHR’s expertise in treating women with low AMH levels. While, unfortunately, not everyone becomes pregnant with their own eggs, we are happy to say that our clinical pregnancy rates are quite respectable considering the poor-prognosis patient population we serve.
IVF with low AMH Levels
Probability of success with an In Vitro Fertilization (IVF) cycle largely depends on a woman's ovarian reserve and her ability to produce a large number of high-quality eggs in a cycle. Low AMH, as well as abnormally high FSH levels, suggests a compromised ability of the ovaries to produce a good number of high-quality eggs, denoting a relatively poor fertility prognosis and low probability of success with IVF.
Very low AMH, usually considered AMH below 1.05 ng/ml, has been associated with extremely low pregnancy chances and many IVF centers flat out deny treatment to women with such low levels of AMH. However, recent CHR research, published in the journal Human Reproduction, suggests that even women with undetectably low AMH levels (below 0.16 ng/ml) can still conceive and successfully carry pregnancies to term, if given proper treatment involving DHEA supplementation and well-designed ovarian stimulation protocols.
Last Updated: November 15, 2014