Is AMH Level Of 30 A Cause For Concern?

Posted on Tue, 12 Jul 2016

Question: Hi,
I'm a 41 yo female with extensive hx of recurrent stage 4 endometriosis, andenomyosis. I've had 4 previous surgeries for endometriosis, most recent was 50/52 ago. Also have Hashimoto's Disease (dx'ed aged 11) and Type 2 Diabetes Mellititus. Have previously tested +ve for Lupus antibodies, although none present currently. Elective c-section October 2013. We have been trying to fall pregnant naturally for 2 years with no success. IVF has recently been recommended. A recent AMH blood test returned a score of 30

Debilitating endometriosis pain returned 16/52 ago. Pain most prevalent 8-9 days prior to ovulation, the worst of the pain radiates out from left ovary into my back, hip, buttocks and left thigh. Pain has been increasing in severity every month. 2/52 pelvic u/s confirmed endometrinoma AND benign ovarian cyst on left ovary. Endometrinoma is 6cmx4.5cmx3cm. Benign cyst 2cmx1.5cmx1cm. Right ovary is diminished in size and only contains 2-3 follicles. Laporscopic surgery to excise both cysts and endometriosis has been scheduled for next month. Extensive endometriosis and andenomyosis was also detected in the u/s.

Q1) Should I proceed with surgery and risk losing part, or all of my "good" ovary?

Q2) If I don't proceed with surgery, what are the chances of successful egg retrieval for IVF with the endometrinoma in situ?

Q3) Will I be able to take strong analgesia whilst taking IVF hormone treatment?

Thank you in advance :)

Answered by Dr. Deepti Verma (9 minutes later)

Brief Answer:
Detailed answer beliw

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
1. Surgery is recommended with such a size of endometrioma, and only the cyst part is removed, and not the good part of ovary.
2.Chances of egg retrieval are less if endometrioma and ovarian cyst are not removed.
3.Yes, you will be able to tolerate general anaesthesia while taking hormones.
The drug dosage are adjusted accordingly.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (3 minutes later)

Thank you for this advice Doctor. I shall proceed with surgery.

After the surgery to remove the cysts, how long would you suggest I wait before commencing IVF?

Answered by Dr. Deepti Verma (9 minutes later)

Brief Answer:
As soon as possible

Detailed Answer:
Hi dear, IVF treatment should be started as soon as possible after surgery.
This is so because the chances of recurrence of endometrioma is high as the interval increases.Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (1 minute later)

Thank you doctor :)

Answered by Dr. Deepti Verma (14 hours later)

Brief Answer:
Happy to help

Detailed Answer:
Hi dear,
I am happy to have helped you.
You can get back to me for further queries by asking a direct question to me on the health care magic.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar