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Question 2: Effect of pregnancy on AMH & FSH hormone levels

Question:

Can being pregnant and giving birth change your AMH and FSH results or are they always as bad as your most recent test? My last test was performed roughly 12 months ago (I have since given birth) and my AMH was 0.7 and FSH 14.

I recently gave birth to a donor egg conceived baby, and have a very low AMH and high FSH. What are the chances of falling pregnant naturally with my own eggs or are we likely to face further IVF using donor eggs again in order to achieve a second pregnancy?

Answer:

Women are born with a finite number of eggs (oocytes) that are continuously being depleted. This is known as ovarian reserve, that is, the quantity and quality of eggs that determine reproductive potential. The depletion of your ovarian follicular pool governs your reproductive life and fertility, and is most closely related to your age and determined by your genetic endowment. Anti-Müllerian Hormone (AMH) is part of a family of growth factors that influence tissue growth and differentiation. It’s expressed in the ovary by growing eggs (once they’ve been recruited for development) and is then released into your general circulation. AMH levels are highest during puberty, then progressively decline as ovarian reserve decreases and eventually become undetectable after the menopause. Low AMH levels represent both reduced quantity and quality of oocytes and is associated with a reduced fertilisation rate, a reduced chance of falling pregnant and an increase in the likelihood of miscarrying. Follicle-stimulating hormone (FSH) is produced by the brain to induce egg follicle development. High FSH levels are indicative of an ovary that is failing to respond to normal (physiological) stimulus. In IVF, this equates to an increased likelihood of poor response to stimulation with possible cycle cancellation.

Both the AMH & FSH will get progressively worse with time. Having a pregnancy will not improve these parameters. Ideally AMH should be >1ng/ml and day 3 FSH <10IU/L. The likelihood is that if you have required donor eggs to conceive in the past (due to reduced ovarian reserve), you would require this for subsequent pregnancies too.

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