Private low ovarian reserve treatment in the UK, by a consultant fertility specialist.

No. AMH predicts how many eggs a stimulation cycle will produce; it is a poor predictor of natural conception, particularly in women under 35. Many women with low AMH conceive naturally. What low AMH does mean is that time matters more, and that IVF, if needed, will yield fewer eggs per cycle.

No treatment increases the number of eggs remaining - reserve only declines. DHEA, growth hormone, CoQ10 and similar supplements are widely offered and may improve response in some poor responders, but the trial evidence is limited and inconsistent. Anyone promising to raise your AMH meaningfully is overselling.

A cycle excluding drugs runs £4,000–£7,000, and drugs for a poor responder add £1,500–£3,500 because doses are higher - so £5,500–£10,500 all in, per attempt. Quoted prices frequently exclude blastocyst culture, freezing and storage, so always ask for an all-in figure.

It depends far more on your age than on the AMH figure itself, because age drives egg quality while AMH drives egg quantity. A woman of 32 with low AMH may have a good chance per cycle from a small number of good eggs; the same result at 42 carries a much lower chance. Your consultant should give you a personalised figure rather than a clinic average.

It falls steadily with age, so the result only means something relative to your age band. Broadly, above 21 pmol/L suggests good reserve, 7 to 21 satisfactory, and below 7 low, with under 3 indicating very low reserve. Laboratories use different assays and units, so compare like with like and check the reference range printed on your own report.

If you have low reserve and are not ready to conceive, freezing sooner is better than later, since both number and quality decline. The complication is that low reserve means fewer eggs per collection, so several cycles are often needed to bank a useful number. That calculation should be made explicitly, with realistic numbers, before you commit.

It is worth discussing early rather than after several disappointing cycles. Donor egg cycles have by far the highest live birth rate once own-egg cycles have failed, because the limiting factor is egg quality rather than the uterus. Agreeing in advance how many own-egg attempts you will make makes the decision much easier when it comes.

The HFEA maintains a traffic-light rating of add-ons, and most sit at amber or red, meaning insufficient evidence of benefit or evidence of no benefit. They are marketed hardest to people with low reserve, precisely when willingness to try anything is highest. Check the HFEA rating for anything you are offered before agreeing to pay for it.

It is associated with an earlier menopause but is not a reliable predictor of when. Some women with low AMH continue to menstruate normally for many years. If periods have stopped or become very irregular before 40, that needs assessment for premature ovarian insufficiency, which has implications for bone and cardiovascular health as well as fertility.

Before chemotherapy or pelvic radiotherapy, fertility preservation is genuinely time-critical and should be arranged within days. Periods stopping before 40, or severe pain, heavy bleeding, fever or breathlessness after egg collection, also need prompt medical attention.