ALI 12

7 Posts
Reply Posted on: May 10, 2014 at 5:34am
Hi Dr Braverman,

I'm a previous patient of yours-our cycle with you resulted in our gorgeous baby girl. :) We're hopefully trying again for a sibling this Summer and plan to be 'under your wing' again!

I contacted you about this recently ..we're just getting ourselves organised with the ivf clinic before we can set things up with your team.

My question though is relating to amh...Are there any immune (or other) reasons you're aware of for amh to fluctuate dramatically or can a test be inaccurate due to 'unknown suppressive factors'?!

The reason I ask- The ivf clinic here (scotland) wanted to update my amh test and the results were...a bit of a shock.

SO, I'm nearly 33 yrs old and 3 years ago my amh was 15- told normal.
We did a standard ivf protocol got 7 eggs, 3 good embryos..didn't get pregnant.
A few months later moved to a different clinic (this current clinic), retested amh, told 2.3!!!!! Devasted. Did 2 more ivf cycles with them (1st a flare protocol got 4 eggs 1 embryo- pregnant but miscarried) then your letrozole protocol ( with pretty high dose stimms..6 eggs, 2 embryos) pregnant with your immune drug protocol and monitoring, and carried to term.

So now they've retested my amh and it's come back as 19.5?!

I don't understand how I could go from 15, to 2.3 (in a matter of months) then to 19.5..2 years later.

is it safe to assume 2.3 test was wrong?! Or this latest 19.5 is unlikely correct going by the number of eggs I get? The crucial question I suppose I'm asking is - - has my ivf response to date been one more of a 2.3 person or a 19...? In your experience.

Embryos always were good quality (I have endo so did a lot of your prep before cycle 2 and 3... Had a lap, supplements etc)

My antral follicle is 10 ish I think..

Have you ever seen this before? Should we ask them to repeat? Is there any point if protocol recommendation will be from you anyway?

on the form the have said this change was 'not common' and that the previous test they did must have had 'unknown suppressive factors'.. Do you know what suppressive factors there are to reduce it to that much (15 to 2.3 in 3 months?)

Can immune issues 'suppress' amh?

thanks for your take on this, I have a meeting with them next week but trust your brain..

looking forward to working with you again soon


Dr. Braverman

2026 Posts
RE: AMH Posted on: May 10, 2014 at 5:40am
I think the endo is responsible for the lowering of the AMH. YOu have to also understand that the AMH is such an unreliable test as each lab does it differently and rarely are they the same. If you want a true reading I would send a sample here to the lab in the US that we use.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.