BONUS 206: Anti-Müllerian Hormone 101

May 10, 2019

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Fertility Centers of Illinois

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Carmine has been through three IVF cycles, with only one normal embryo. The question is about research that shows some success with transferring abnormal embryos and whether PGT testing is reliable.
  • Chantel has good egg reserve and has never been pregnant, but has experienced spotting with Clomid and Letrozole cycles for IUI. Now considering IVF, she asks if her intense exercise is affecting implantation, and if there are other tests she should have done.
  • Lily has secondary infertility after four failed IUIs and an early miscarriage. She asks about the workup her doctor wants to do and what her best chances are for her one remaining embryo.
  • Liz has had two early miscarriages and seven unsuccessful IUI cycles. She asks about any preliminary tests she should do and Dr. Rodgers’ advice about her upcoming IVF with ICSI and PGT.
  • Tracy had two miscarriages last year, and her doctor diagnosed her with borderline PCOS. Clomid or Letrozole has been recommended for her next cycle, but she wants to know if she should ask about Metformin.
  • Michelle has been diagnosed with mild endometriosis. She’s concerned about Chlamydia that she had over a decade ago, if the effects of that infection can look like endo, and if a hysteroscopy can tell the difference.

Dr. Rodgers and Heather continue the episode by discussing everything you need to know about anti-Müllerian hormone:

  • Let’s start with a foundation. What is anti-Müllerian hormone, and where and how is it produced?
  • What is ovarian reserve, and how is it determined?
  • Is AMH a CD3 test? Or can it be performed on any day?
  • What is the expected AMH for each age range? (32 or younger, 33-37, 38-40, 41+)
  • Do AMH levels fluctuate? If so, why?
  • Low AMH:
    • What might cause a listener’s AMH to be low? Are there any symptoms she might have?
    • Does a low AMH mean a woman is less likely to become pregnant?
    • What are her fertility treatment options? Do you have cutoffs for AMH levels in terms of what fertility treatments you recommended to patients? If so, what are they for timed intercourse, IUI, IVF, and IVF with donor egg?
    • Are there any actions she can take to increase her AMH level? Supplements? Lifestyle changes?
  • High AMH:
    • What might cause a listener’s AMH to be high? Are there any symptoms she might have?
    • Does a high AMH mean a woman is less likely to become pregnant?
    • What are her fertility treatment options?
    • Are there any actions she can take to reduce her AMH level? Supplements? Lifestyle changes?
  • Let’s talk more about AMH and PCOS. Even though a patient’s AMH level is technically not a diagnostic criteria, can it be useful in any way when diagnosing PCOS?
  • Let’s say a patient wants to pursue a fertility treatment you wouldn’t necessarily recommend based on her AMH level. How would you approach that cycle to give her the best chance? (Go over both low and high AMH for timed intercourse, IUI, and IVF.)
  • Is there any new research in the area of AMH and/or ovarian reserve?
  • Do you have any success stories you can share about patients who had AMH levels that were either too high or too low for their age?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to listeners who’ve been worried about their AMH levels?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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