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Low AMH, Normal FSH, High TSH

Dear Sir/Madam, I have received the results from my advanced fertility test yesterday and realised that my AMH is very low (1.7 pmol/L), my FSH is 6.1 IU/L though. I have a Hypothyroidism caused and my TSH is always on the upper border 4.18 mu/L (0.27-4.20). I am not taking any medication to lower the TSH as my GP didn't recommend any, but I think it might be influencing my fertility (ovulation) and possibly the low AMH. I am 37. Could you kindly advise? Many thanks.

Our Expert’s Answer

Thanks for your interest in 'Ask the Expert'. Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Unfortunately your AMH level is lower than normal for what is expected for women of a similar age. AMH blood levels are thought to reflect the pool of the remaining egg supply - or "ovarian reserve". With increasing female age, the follicles decrease. Likewise, their blood AMH levels and the number of ovarian antral follicles visible on ultrasound also decrease. It does not indicate the quality of the eggs or the prognosis of the pregnancy naturally. It is a useful test for an IVF ICSI treatment as it predicts the response to stimulation and is helpful to decide the dose of stimulating hormones. Lower AMH levels correlate with much higher cancellation rates, retrieval of less or no eggs, failed fertilisation and lower chance for a suitable embryo.

I would recommend you to be seen by a fertility specialist and if you are already trying for a baby naturally, to consider a fertility treatment. 

It is recommended that women who have subclinical hypothyroidism and are trying to conceive or are undergoing fertility treatment, their TSH should be <2.5mu/L.

If you would like to know more about the fertility treatments we can provide, please telephone our team on 0161 300 2730.

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