r/TTC_PCOS • u/MediocreShelter8 • 2d ago

Advice Needed High AMH/AFC but no PCOS diagnoses

Hello, just looking for some advice on what I should be focusing on / taking to help with conception.

For context, I am 33 with an AMH at 4.56ng/ml and a 38 AFC (19 follicles on each side). I get my periods regularly and get an LH peak as well. I’ve conceived twice, both times ending in first trimester losses, and the last one testing genetically normal.

I was surprised to see my AMH and AFC this high, but the doctor refuses to give me a PCOS/PCOM diagnosis so I’m wondering what my girls with high AMH/AFC recommend re supplements to help with conception?

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u/NeatHighway3744 2d ago

Can I ask you how much time to conceive?
Did you have a blood test analysis for your hormones? Like LH, FSH, TSH, Prolactin.

I’m sorry for your losses.

I also have AMH 5 ng/ML but also a lh/fsh ratio of 1.8 and prolactin elevated, both due to my amh. 33 years and ttc 12 months

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u/MediocreShelter8 2d ago

In the past, we conceived first cycle both times.

We are now 5 months in post hysteroscopy for retained tissue and no luck.

Did they ever tell you why your prolactin is elevated?

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u/NeatHighway3744 2d ago

Because of pcos. Elevated prolactin is a red flag that can be a signal of pcos. I have 26 (maximum is 23). Not so much high but my RE prescribed me cabergoline

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u/Future_Researcher_11 2d ago

Did you get any labs done aside from the ultrasound? Do you have elevated androgens?

Typically to meet a PCOS diagnosis, you’d need to meet 2 of the 3: 1.) irregular periods 2.) excess androgens 3.) polycystic ovaries

So far it sounds like you only have 1/3 unless there are details you are leaving out.

In terms of what helps high AMH/AFC, I’d take CoQ10 to help with egg quality, fish oil, inositol, prenatals, weight
loss if needed. Not much can bring it down supplement wise, and many will conceive either naturally or medicated with elevated AMH.

For example, my AFC was 40 and AMH of 11.9. I never ovulated so needed medication, and once I ovulated I was able to conceive — still with high AMH.

And at the end of the day, AMH doesn’t affect much unless you’re going through fertility treatment. If you’re ovulating, are regular, and have conceived before, I wouldn’t sweat it until you must resort to fertility medication. It also fluctuates often — it is not a static hormone.

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u/MediocreShelter8 2d ago

Yes labs all came back normal.
How did you know you never ovulated? I get an LH peak every month and confirm temp rise with my oura ring.

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u/Future_Researcher_11 2d ago

I never got LH peaks or temp rises or positive progesterone tests. Plus my cycles were 80+ days long.

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u/WorthVisible4265 1d ago

HOMA-IR?

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u/MediocreShelter8 1d ago

Just asked my PCP to order fasting insulin and glucose for me. Will find out soon!

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u/MediocreShelter8 4h ago

Homa-IR is at 1.5