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Conceiving with diminished ovarian reserve, or low AMH? It's all about egg quality!


What is ovarian reserve?


When born with ovaries, we are also born with a vault, a reserve of follicles or eggs. This is the reserve that we are given for our child bearing life. As we age, we release eggs each month, and the reserve declines. This is a normal and natural process, and not much can be done to prevent this.

Some women have a bigger reserve, some a smaller one. No amount of supplement, vitamins or magic can change this. BUT, stay with me, this is just one part of the equation, and not necessarily the most important one.

How is ovarian reserve it measured?


2 ways:

  • a blood test for AMH, a hormone called Anti-Mullerian Hormone

  • an ultrasound at cycle day 3 that measures your antral Follicle Count


The combination of these 2 numbers gives an estimate of your egg reserve, and can compare you to the average of your age group, to determine good, fair, or low egg reserve.



Anti-Mullerian hormone (AMH) levels vary by age, and can indicate ovarian reserve and the timing of menopause. This is an average or AMH levels by age

  • 25 years old: 3.0 ng/mL

  • 30 years old: 2.5 ng/mL

  • 35 years old: 1.5 ng/mL

  • 40 years old: 1 ng/mL

  • 45 years old: 0.5 ng/mL



Typically, IVF clinics recommend an AMH level above 1 to have a fair shot at a successful pregnancy. BUT, like I said, this is a very very very dangerous shortcut that gets my patients in a terrible headspace when it is really not necessary.


Some women are diagnosed with diminished reserve in their thirties, and some have ample reserve in their forties. It is all fine!


AMH is not the end all!


  • First of all, the levels of AMH fluctuate from month to month.

  • Secondly, it does not always go down down down and never up.

  • Sometimes a high AMH is a sign of PCOS


You read that right, AMH can go up! I have seen patients' levels fluctuate up from 0.1 to 0.7 in the span of 2 months of acupuncture and herbs.


If you take the opposite end of the spectrum, with patients in their forties with AMH levels above 2, it can also be deceiving. They sometimes grow 20 follicles in an IVF round and still end up with only 1 embryo. Or it might indicate that they suffer from a condiction called PCOS, which impacts egg quality in a negative way.


The point is, when it comes to conceiving, it is all about egg quality. Which is good news, because unlike the volume of egg reserve that cannot be change, the quality of the eggs can absolutely be improved with treatment.

Yes, there is a correlation between lower AMH and lower egg quality, but it is absolutely possible to improve your egg quality with rigorous lifestyle changes, supplements and acupuncture! We see it in the clinic all the time.


Success stories: all it takes is ONE



I have seen many patients conceive naturally with AMH levels as low as 0.5, in their thirties and in their forties.


I have also seen patients go through gentle IVF cycles, retrieve 1 egg per cycle, but thanks to treatment 1 egg turned into 1 blastocyst, euploid at genetic testing, and 1 transfer then 1 baby.



Acupuncture for low ovarian reserve and egg quality


Multiple studies have found that acupuncture can improve egg quality [1]

  • Blood flow: Acupuncture can increase blood flow to the ovaries and uterus by relaxing blood vessel walls. 

  • Egg quality: Acupuncture can increase the number of mature eggs and the rate of high-quality eggs. 

  • Embryo quality: Acupuncture can improve embryo quality, which can lead to a higher chance of pregnancy. 

  • Follicle count: Acupuncture can increase the antral follicle count (AFC). 

  • Anti-mullerian hormone (AMH) levels: Acupuncture can increase AMH levels. 

  • Pregnancy rates: Acupuncture can increase pregnancy rates, especially in women with unexplained infertility. 

  • Fertilization rate: Acupuncture can increase the rate of fertilization. 



So talk to your experienced fertility acupuncturist today!


citations

[1] Kursuma et al, 2019 Kusuma AC, Oktari N, Mihardja H, Srilestari A, Simadibrata CL, Hestiantoro A, Wiweko B, Muna N. Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization. Med Acupunct. 2019 Oct 1;31(5):289-297. doi: 10.1089/acu.2019.1368. Epub 2019 Oct 17. PMID: 31624528; PMCID: PMC6795274.







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