If you're watching this video, you might be trying to get pregnant and want to improve your
egg quality. Maybe you were told you have low AMH or high FSH or maybe both. Or maybe just trying
and knowing how important it is to have good quality eggs when trying to conceive is why you're
watching this video. Maybe you're over 35 and been told that this is what you should be focusing on,
and now you're kind of obsessed with it and obsessed with your AMH and what you can do
about it. Sound like you? Well, great. You're in the right spot because I've helped thousands of
women improve their egg quality, fertility and get pregnant over the last 20 years. If you are
new here, first, let me say welcome. Second, as a fertility expert, I get many questions daily
here and on all my other social media platforms and many of them are all about, guess what? The
one and only egg quality. That's right. So I thought I could compile some of the
most popular questions that I get so you can get as much information with just one video.
Sound good? Well, if you're excited about this video, then I want to ask you to like the video
and subscribe so that you make sure that you know when I put out more videos just like this one for
you. Now let's get started. So the first question comes from Carmen. "What about a 30 year old with
no periods in the past five months, low estrogen and AMH is low at 0.02. Also with hot flashes. Is
there hope?" Well, I think the first thing that I want to say is answering the last question. "Is
there hope?" I am a man who thinks very positively about life. I think of the glass half full. And
so to that question I'm going to say absolutely, there is hope. But we've got a lot of work to do.
There's a lot of things that we need to improve and change. So the first thing I want to comment
on here is that no 30 year old should go without a period for five months. That's not okay and that's
not what we're looking for. So that's number one. Two, if you have gone without a period for
any length of time, but in this case five months, then I would expect to have low estrogen and low
AMH. I would not expect to see anything different, quite frankly. I'm not saying you shouldn't have
had your labs done. I'm saying that I wouldn't have expected anything different, especially when
you say that you also have some hot flashes. So with that, I want to say we need to do a couple
of things first. One is we need answers. So, yes, I want labs and I want more than just you telling
me that there's low estrogen and low AMH. I want to see those and I want to see all
your other labs. I want to see what's going on with your thyroid, with your iron levels,
with your cholesterol, with your vitamin D, with all your other hormones. I want to see it all. So
that's the first thing that I would say here. Second is once we have all that information,
I think we might actually have to do a more advanced test called a Dutch test where we
can actually see what the hormones are doing in your body and what other things might be
impacting them. So I would recommend that as well. Once we've got that information, now we
need to make a plan and the first thing that I want to see change is your cycle. We need to see
that come first. So I'm not really worried about the frequency that the cycle comes, I just want to
see it come first and foremost, and then we want to get it to become more regular and consistent.
And then after you've had a cycle for about three months or three cycles, I should say,
then I want to say I want to look at your hormones and retest and rerun your hormones
and see what they say. So we could say the same thing regardless of age. The thing that your age
allows you to do right now is being thirties. It gives you a little bit of time and flexibility. It
gives you time to figure some of this out and give yourself the ability to make changes and see the
change and get your cycle back before you have to take more extreme measures. And I actually would
say that you've got plenty of time, so let's use that time, let's get your labs done, let's make a
plan and let's get the results that you deserve. By the way, this is exactly what I do in my Hope
coaching program for all my members. If you were in my program and you presented just like this,
we'd be talking about what labs you need to do. We'd be interpreting those lab results. We'd
be creating a customized plan for you, and then we'd be following you and supporting you to get
the results that you deserve. All right, question number two. This one says, or ask, "Can low AMH
cause a miscarriage?" I do not equate those two together. Maybe we could say that if we've got low
ovarian reserve that we might also have, although it's not the same thing, also have low egg quality
and maybe that egg quality could be contributing to recurrent pregnancy loss or miscarriage. But
that in of itself is not an indicator for me. So, no, I would not worry about one causing the other.
And if you've got low AMH and you've had a history of a miscarriage, then I think
more importantly is we need to figure out why you're having those losses first and foremost and
simultaneously we need to support your AMH levels. The next question comes from Sarah. Sarah says,
"I'm wondering if you'd be so kind as to share if you are able to get your AMH tested frequently
somehow on your own, or if you have a great doctor who orders labs for you." I order labs for all the
people who work in my coaching program. So that's where I would send you because that's what I do.
Can you order these labs on your own? You can, there are many resources online to just order
your own blood work and you just be a cash patient for that, right? You just pay cash
and then order the lab and go ahead and do it. Often it's much less expensive for you. So I do
recommend that if that's something you're looking for. But the tests I don't like are the finger
prick tests that allow you to test it at home and just send it in. I just don't find them to
be the most accurate currently to get consistent results. I've seen a lot of variability in those
labs. So my preference is that you actually have a real blood draw, go to the lab and
have that tested. Now your other question as part of this is, "Can we test AMH frequently?"
You can test your AMH frequently, although I don't necessarily recommend it. I think it's nice to
track progress, but I wouldn't be testing it more frequently than every three to six months. I think
that's frequently enough, quite frankly. And if you're talking about checking it more than that,
then I think we would start to increase our stress levels and maybe drive ourselves a
little bit crazy. So I would opt not to do that. So hopefully that answers your question, Sarah,
and helps you moving in the right direction. But, yes, you can get that tested regularly.
I recommend three to six months at the shortest timeframe and you can do it on
your own. But I do also recommend that you get guidance and support and work with someone who
can help support you through that process. Okay. Next question is from Thoughtful Pro and she says,
"I'm starting to understand and have now been instructed by my doctors that those markers,"
meaning AMH, I'm assuming she's saying, "are more used for egg retrieval and IVF,
not ability to conceive or get pregnant." Correct. She's a 100% correct here. Now, AMH markers,
and for that matter, FSH as well, is important to look at and valuable, but it's much more
valuable as a predictive indicator for success in terms of IVF specifically not if you're trying
naturally. And I've seen many women with high FSH, low AMH conceived naturally on their own.
So in of themselves, they are not the end-all, be-all in terms of markers. And this is exactly
something that I've spent a lot of time trying to educate my members, the couples that I work
with in my coaching program, because we get all consumed and worried about AMH. And I'm
not saying it's not a variable and hormone that we need to be aware of and address and support,
but it's just one variable and there's many other pieces to the fertility puzzle that
we need to account for and that you should be accounting for and not just focusing on this AMH.
And I know I've mentioned a couple of times my coaching program, if you are interested in
learning more about how we work with couples and support them, if you are ready to get more support
and have someone like myself and my team dive deeper into your case and create a personalized
plan for you, then I want to invite you to apply to join my Hope coaching program. All you have
to do is use the link in the description below. All right, so Uni asks, she says, "Hello, doctor,
I'm 36, AMH is 0.01 and going on IVF program, but always gets canceled because the egg always too
small and my FSH is always high. FSH being 21, 23 or 26, what should I do?" So first,
we can't continue to do the same thing over and over and over and expect a different
result. That's the definition of insanity. So we want to get out of that hamster wheel
and we want to see change. I want to see these numbers improve, and more importantly,
I want to see an IVF cycle that is successful for you where we have eggs that are maturing. So two
or three different things that I would recommend. And first and foremost, the first thing I would
do is take a step back, take a break from IVF. I would recommend that you dive deeper to finding
out the root cause as to why these things are happening. Low AMH is a symptom, high FSH is a
symptom. We have to figure out why those things are happening. So I would encourage you to dive
deeper to figure that out first and foremost, exactly what we do in the coaching program,
by the way. And then from there, we need to create a solid plan to make those numbers change,
to see those numbers change and to prepare your body for a healthy and good IVF cycle.
That's not what's happening at the moment. We're just on this hamster wheel going forward
and forward and we're not taking a step off to actually breathe and figure out what's going on.
That's the first thing I would say here. Second is I think you need a different approach. When we
start to see low AMH and high FSH numbers like we're seeing here, then I think the solution
or a better path forward, I should say when we're talking about IVF, is a lower dose of medication,
not a higher dose. We're not looking for quantity here, we're looking for quality. And I think
you just might need a slow and steady to get there. So lower doses of medication. And third,
have a good team of providers who are willing to work with you and support you
both on the preparation side of things and on the IVF side of things, who are going to
work in tandem with you to get those results. So this is a tricky situation. I do think that
this can be improved and I have seen it improved, but you really need a solid plan forward and a
good way to address this. Okay, so this next question, I wasn't sure if she meant AMH,
which is why I included it because what she says is FSH, and you'll understand in a second,
but I figured I would talk about this in both ways. So Lydia says, "What is considered high FSH?
I did my labs the other day, I got my results back and it says 3.5. The guide says I'm in the range,
but is that okay in the luteal phase or should I try to improve it?" So if we're truly talking
about FSH, follicle stimulating hormone, then 3.5 might be a little bit too low, actually. We'd like
to see that somewhere between five and 10. But we also need to see this in relationship
to LH and estradiol so this is a incomplete number, quite frankly. So I would not say that
this is too high when we're talking about 3.5 if we're actually talking about FSH and the time of
the cycle definitely matters. So doing your FSH reading in the follicular phase on cycle day two,
three or four, it would be what I'm looking for. But if we're talking about AMH, which is what I
thought maybe she was talking about here, then 3.5 could be considered too high, depending on
your age. 3.5, is that borderline where we think could be too high or not? And when we're talking
about AMH, anything above 3.5 might give us an indication that you might have polycystic
ovarian syndrome or variation of polycystic ovaries. So that's something to look into.
And the older you are with the higher FSH, let's say three or above, then that definitely starts
to kind of get us thinking about that as well. So this was an interesting question, but I figured I
would answer it both sides if it was FSH or LH. Now I've got two more questions. These kind of
go hand in hand. The first one says, "I'm 32 and my AMH is 1.58 and was told it was low. When I
look at the normal ranges, it comes up that I'm normal. Am I low or normal?" And then the next
person says, "1.5 AMH is a normal range at the age of 35. Can I conceive naturally?" So yes,
with both of these you can absolutely conceive naturally, but either one is actually,
they're both could be considered fine. But at 32, we might want to see that be a little
bit higher than 1.58. We might want to see that closer to two. I think you're in an okay range,
but we potentially might want to see that higher. I'm still not concerned about either one of these
individuals being able to conceive naturally with an AMH of 1.5 and their ages being roughly 35 and
32. I think there's a lot of positive to take out of this. Now we do need to look at everything else
and make sure everything else is in tip-top shape and working well. But all in all, I feel really
positive about this situation for both of them and wish them a lot of luck. But keep trying and
let's see if we can get those results. All right, so I thought that these questions were interesting
questions and hopefully informative for all of you, but I also want to hear your questions. So
if you've got questions about the answers that I gave to these questions or you have completely
different questions about your fertility and you want my eyes on them, then I want to invite you
to comment below, leave a question or comment down below, and I will do my best to get back
to you either there or in another video just like this one where I'm answering questions.
If you are serious about getting pregnant and having a baby is something that you really,
really want, I highly recommend you click on the link in the description below this video to apply,
to qualify, to speak to a real person on my team to see how we can best support you on
your fertility journey. And I look forward to supporting you on your journey. I'm also going
to leave you a video in this series all about egg quality for you to check out also below
this video. Hopefully that was helpful for you. And until the next video, stay fertile.