Rajeev Agarwal։ What Does an AMH of 0.29 Really Mean?
Rajeev Agarwal, Director of Renew Healthcare, shared on LinkedIn:
“What does an AMH of 0.29 really mean?
Saheli’s story shows why AMH must be interpreted in context.
A very low AMH suggests a small remaining ovarian reserve and that IVF stimulation may produce fewer eggs. But it does not mean she cannot ovulate, that her eggs cannot fertilise, or that natural conception or IUI is impossible.
Saheli also had vaginismus — involuntary pelvic-floor tightening that can make intercourse, examinations and fertility procedures difficult. She chose vaginal dilators and committed to them for four months.
We also addressed other barriers: her thyroid needed optimisation, and an endometrial polyp was removed hysteroscopically.
Then came the decision: IUI or IVF.
Despite an AMH of 0.29, her age, sperm parameters and overall circumstances allowed us to offer a carefully time-limited IUI trial rather than automatically moving to IVF.
She developed three follicles — and conceived in her first IUI cycle.
The initial triplet pregnancy also reminds us why stimulation must be carefully monitored. The goal isn’t to produce as many follicles as possible. It is to achieve one healthy pregnancy as safely as possible.
Two lessons from her story:
Don’t let a low AMH report take away your hope. But don’t let reassurance make you waste precious time either.
And if intercourse has been painful or impossible for months or years, please ask for help. Vaginismus is a medical problem, it deserves proper diagnosis, and it can often be treated.
That’s what the PREPARE approach is about: understanding every barrier before deciding how much fertility treatment a couple actually needs.”
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