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If a woman has low AMH as long as she produces a good number of eggs to freeze and the quality of those eggs are not very poor then yes you can. IF women have lower AMH what we suggest to do is to do more than one cycle of egg freezing so if your first cycle for example only produce six or seven eggs and out of the mature eggs that we got were not many then you can have subsequent egg freezing cycles where you can keep adding to the number that you have already stored.
In reality we say about 10 eggs would be needed for every IVF cycle post freezing your eggs.
If you wanted to obviously it may not be possible to get pregnant with the first IVF cycle, you may need more IVF cycles in order to achieve the pregnancy in the future and therefore you could benefit from freezing 20, 30 or 40 eggs in order to have a good chance for not only having one pregnancy but also to have siblings in the future.
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Testing AMH which has changed the way we practice and it is not a very old discovery, this AMH has come into practice around 12 years back, 12 to 14 years back so, it’s relatively a newer advance. AMH can be done on any day of the cycle and it’s a very easy way to indirectly indicate the ovarian reserve. The only direct indicator of fertility is when the pregnancy is actually created, there is no other way but when the AMH is low that means this woman would definitely benefit from fertility preservation.
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Can you freeze eggs based upon a low AMH? Answer; that is the person that we really want to freeze eggs for? Because what the AMH will tell us is that her egg reserve is low, and those are the patients that we identify to say yes, you definitely should freeze your eggs. Now, the AMH test determines for us how well someone is going to respond to fertility drugs or fertility hormones. So women what a low AMH we will let them know is that you’re not going to make the same number of eggs as someone that has… who’s your age and has a higher AMH, but the quality should still be good. So if I have a woman in her early 30s, and her AMH level is normal, which is over two, two and a half, she may make 10 to 15 eggs, whereas someone who is the same age who has a low AMH may only make like three or four eggs. Now the important thing is that the quality is determined by your age. So someone who’s younger, with a low AMH is still gonna have a good chance of success with fewer eggs compared to someone who’s older with a low AMH. The AMH is not designed to predict fertility potential. There are many women who have low AMH levels who get pregnant on their own without any difficulty. There are a lot of women walking around who have a low AMH you never know it because they’ve had multiple children. The AMH in combination with the antral follicle count is designed to discuss fertility preservation with young women who are career-oriented who are in very tough jobs where they won’t be able to have a child in the near future to have that conversation say okay, should you consider freezing your eggs at this point or do you have a little bit more time to wait? That’s how the AMH level is used.
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When we have a patient with Low Ovarian Reserve what we recommend is to make multiple cycles and to freeze at least 8 mature eggs. However we need to take into account the age of the patient – the older the patient, the more eggs we need to minimum success rate.
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Low AMH usually indicates low ovarian function which usually correlates to a lower number of eggs collected – meaning you may need to go through multiple cycles of stimulation to get a good number of eggs frozen. However this all depends on how your body reacts to the stimulation and how well stimulation is catered to you.
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AMH, the so-called Anti-Mullerian hormone, is a very reliable marker of ovarian reserve. So we use AMH in order to find out how many oocytes we can expect after such a procedure. Nevertheless, I have experienced during over 20 years in this field that AMH is only a marker; it’s not a real indicator of quality. Since a young woman with endometriosis, for example, has a diminished number of eggs after this treatment but these eggs have the quality that a woman of her age has. So AMH is a very important marker for us. But this is not the only indication we use in order to predict egg quality.
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Yes, you can freeze eggs with low AMH especially if you are young even if we get less eggs because low AMH means that ovarian reserve is lower, still if the quality of the eggs is good, the chance of achieving live birth would be also good. Probably we would need more than one cycle to get an optimal number of eggs meaning between 10 to 15 we will be comfortable with. We might need to do more than one ovarian stimulation cycle and one more oocyte retrieval but that would be the impact of AMH. More important than AMH of course is age because age has an impact on quality.
