Our patients who are trying to conceive question us – almost on a daily basis – about our ability to influence their FSH and AMH levels. Many of our patients have been told that these numbers can’t be changed and, if your FHS is high or your AMH low, that your reproductive future has been determined. At Reproductive Wellness we have seen and believe otherwise.
If you would like more information on what your FSH and AMH levels mean, you can visit our other blog post which explains this in greater detail. In this post, I would like to explain our theory regarding these 2 fertility markers and what we do at Reproductive Wellness to improve high FSH and low AMH.
We have heard our patients tell us thousands of times that FSH and AMH can’t be improved. And yet we have seen improvement of FSH and AMH levels in these patients, which is also typically when patients conceive. While most Fertility Clinics will base your IVF protocol on your highest FSH reading and lowest AMH reading, these clinics also are aware that your FSH will fluctuate from cycle to cycle. They also know your response during your IVF cycle will be better on those cycles where your FSH levels are on the lower side.
FSH is an indicator for egg quality in current or future cycles. At Reproductive Wellness we believe there are so many factors which influence FSH levels, the most fundamental of which are stress management, having a balanced exercise program, cleaning up your diet and having a functional medicine supplement program. We also find that acupuncture, reproductive massage, and Chinese herbs can speed up the progress we are aiming for. That being said, each plan needs to be customized according to the individual because no two cases are identical.
Moving our discussion toward AMH, this is an area where I often find patients have more questions and concerns. Current AMH testing is thought to be an indicator for a woman’s ovarian reserve. If AMH testing was truly a reflection of ovarian reserve, this number would never improve with time or treatment. The number of follicles/eggs a woman is born with is finite and never increases. As we age this number decreases and at certain times in a woman’s life more dramatically so than at other times. It would only make sense to see this number decrease and never go back up.
At Reproductive Wellness our clinicians have seen AMH levels improve with appropriate treatment. In theory, if AMH was truly testing ovarian reserve, improvement should not occur – but it does. Why is this? We paid closer attention to this and began, after a minimum of a 3 month treatment period, retesting this value and found an increase of levels in about 40% of patients. To give some background, imagine that there is a pool of eggs/follicles that the body pulls from each month. And on any given cycle there is a conveyor belt that some of the follicles ride on until they are ready to be selected for ovulation. This process is known as folliculargenesis. I believe that what current AMH tests actually measure is how many follicles are on that conveyor belt rather than the core pool of finite follicles. We are able to influence and enhance the process of folliculargenesis by restoring function and enabling the body to push more follicles on the belt towards ovulation. It is when this happens that we see the AMH value increase!
If these tests are not measuring what they claim, than what value do they serve? Ultimately, it is important to keep in mind that these tests are only reliable as indications. I believe that these tests are still valuable in that they show the health of folliculargenesis and we can use these values as a way to gauge progress. To keep some perspective, FSH was considered the main indicator of fertile health some years ago. AMH has now come into the spotlight, and while it has not completely replaced FSH, most offices now use AMH as the main indicator of reproductive health. Soon AMH will become obsolete and a new test will replace it claiming to be the superior test for ovarian reserve and quality. At the end of the day while lab values are important in determining reproductive health, they should not be the only factors to focus on.
To improve and influence FSH and AMH the following areas should be addressed:
- Stress management
- Balanced exercise program
- Cleaning up your diet
- Creating a functional medicine supplement program
- Reproductive massage
- Chinese herbs
Watch this video to learn more about FSH- AMH levels, what the numbers mean and what could be done to improve yours.
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