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AMH & FSH: What These Numbers Mean For Your Fertility

In this video I went live to talk about AMH & FSH and what those mean for your fertility.  #fertilityjourney #yesyoucangetpregnant #fertilityadvice

Get your free Eating for Egg Quality Guide here: aimeeraupp.com/eggquality

Today we're going to talk about a topic that I talk about a lot, and I have some awesome giveaways for you too at the end, so hang around for some helpful ways that you can optimize your FSH and your AMH. So we did a post on Instagram, and on Facebook, about a woman who improved her AMH through working with me. She's 45 now, and her AMH is higher now at the age of 45 than it was three years ago before she gave birth to her second child. So she's currently trying for her third child, and her AMH went from about a 0.4 to a little over a 0.5. So it went up by a tenth, but that's kind of significant in the world of AMH if you pay attention to those numbers.

So AMH and FSH are kind of what defines a woman in the world of fertility treatments, in the world of western medicine fertility treatments like IUIs and IVFs. And I'd love to hear from you guys if you've been defined or not by those numbers. A lot of people commented they didn't know what AMH was and I wanted to let… So first I'm going to define these numbers for you. Basically, when I first started practicing… So again, we're almost 17 years into me practicing. FSH, which is follicle stimulating hormone was the gold standard, and so what they used to say was you're only as good as your highest FSH. So basically as FSH increases, the theory is… And it's a theory, it's not proven. As FSH increases… And I'll tell you why it's not proven because there're some points where yes, it has a role for certain.

But as FSH increases, ovarian reserve goes down. So the goal is… To do fertility treatments many doctors want your FSH to be at a 12 or lower.

Anyway, FSH increases as ovarian reserve goes down. That's the basic premise. So I talk about FSH in Yes, You Can Get Pregnant because it was around back then. So I'm just going to read to you guys from Yes, You Can Get Pregnant, about FSH. So FSH, which again stands for follicle stimulating hormone, should be tested on cycle day two, or three with day one being the first day of bleeding. If it is tested at any other point in the cycle, it is not accurate. So I have had so many women be traumatized by their FSH number when it was tested outside of the normal days. It should only be tested on cycle day two, or three of a menstrual cycle. When it is tested outside of those two days it is completely irrelevant. Do not pay attention to it because then basically it continues to climb as you get towards ovulation, then it kind of drops and it's very … What's the word? It just jumps around a lot.

It's very uneven for the rest of the cycle. So the only time to test follicle stimulating hormone is cycle day two, or cycle day three. I have had girls tested when they haven't had a period in a while, and then the doctor comes back, “Hi,” and the doctor says, “Well, guess what? You're in menopause,” and that's actually not true. You can only test it once you get a cycle again. So yes, you should be a cycling woman, but some women miss mensies for stress reasons, for many reasons. You could miss a menstrual cycle, and if your FSH gets tested during that time, it's very inaccurate. Another time it's very inaccurate is when you first go off the pill. It takes a while for FSH to start working again because the pill shuts down the whole hypothalamus, pituitary, ovarian axis, and so FSH is not a true read.

I've had many women be tested… Their FSH tested after they stopped the birth control pill, and doctors have told them things like, “You're in premature ovarian failure,” or, “You're going into early menopause,” and it's extremely traumatic, and in my clinical experience it has been untrue every time because these women have gone on to either restore normal cycles and, or get pregnant. So, FSH is tested on cycle day two, or three, with cycle day one being the first day of bleeding, and your doctor wants to see FSH around a 10, 11, 12, or lower. Okay? FSH is secreted by the pituitary gland, which is in the brain, and that tells the ovaries to start recruiting mature, and maturing follicles.

So basically, your brain says, “Okay, I'm going to release follicle stimulating hormone.” It travels down to the ovaries… I have a pretty picture of it in Yes, You Can Get Pregnant. I like my little picture. Where is it? Here it is. You guys see that? So it goes brain, hypothalamus, gonadotropin releasing hormone, pituitary gland, then you secrete FSH and LH, and then that acts on the ovaries, and then that acts on estrogen and progesterone, and that acts on the uterus. So again, it's released and it goes and talks to the ovaries and it says, “Start growing and maturing follicles.”

So basically, if FSH is higher, what's that saying? What's that saying is, is that your body's requiring more FSH to get the ovaries working. So that's a sign that ovarian function, or ovarian reserve is diminished. But there could be many reasons that FSH is high. One of them in particular being stressed, another one in particular being hormonal imbalance. So if your hormones are imbalanced, your FSH is not going to be an accurate read.

And if you're using toxic bath and beauty products on a regular basis, if you're not eating organic, if you're eating a lot of soy and corn, and farm raised animal products, guess what? FSH is not going to be an accurate read, because your hormones are out of balance. Important to know. FSH is not static, meaning it varies from month to month. So these poor women that get these high FSH reads, and then are told, “Your ovarian reserve is declined, and you're never going to get pregnant,” or “You're going to have a hard time getting pregnant,” or “You need to freeze your eggs now,” or “You need to do IVF now,” is not based on solid information, and that is not conveyed enough to all of us out there. I'm getting lots of questions over here. “Was told with AMH that I needed to look for an egg donor.”

Yeah. Then we're going to get to AMH next. High FSH levels can suggest diminishing ovarian reserve but they don't mean you will not be able to get pregnant naturally. In fact, many women with poor ovarian reserve do get pregnant naturally. So poor ovarian reserve is just defined by either high AMH, or low… I mean, high FSH, or low AMH. So let's move on to AMH. So AMH isn't in Yes, You Can Get Pregnant, because that's how new it is to the game. They weren't really talking about AMH for many years. So AMH is a little different. So FSH comes from the brain. From the pituitary. AMH comes from the ovaries. So AMH is secreted by… It's a hormone that's secreted by y.

our ovaries, and by the follicles inside the ovaries, and it gives us an idea again, just like FSH, of how many eggs we have left. Right? But it doesn't… Neither of these… FSH or AMH do not tell us at all about egg quality. So keep that in mind. Okay? When AMH is low or FSH is high, I want you to also remember that we're still dealing with hundreds, if not thousands of eggs. It's not like you have four eggs left. Right? “So I have a 11 FSH and 0.3 AMH. What do you think that means for you?” I think that means you're fine. You're perfectly fine. Those are fine numbers, and I wouldn't get too caught up in the numbers. And that's really why I came here to talk to you guys today, because what I see is a woman gets really defined by those numbers, and that creates a major stress, a trauma, and that will really impact your ability to get pregnant. So more than the numbers, the reaction, the internalization of this information, is what's going to affect you when getting pregnant.

So I've pulled up this too, that I wanted to read. First of all, your AMH level tells you only how many eggs you have left and nothing about the quality, or genetic health of those eggs, which is actually much more important when it comes to getting pregnant. There is no test for egg quality, but it does decline with age in a predictable way. And that also is up for argument. This is from Extend Fertility, but AMH levels can't tell us if we have fibroids, or scarring, or any other condition like endometriosis, or PCOS. Well, sometimes they image can tell us about PCOS. If AMH is really high, which girls are psyched about, it's usually an indicator of PCOS.

So to understand, and there are charts out there, but I also want you to take it into account. So there are charts out there of like, what's a normal AMH for a woman at 40? It's well, around one. Right? For as she gets older, it'll go lower than one. As you're younger, it goes higher than one. But remember this is a brand new hormone, so we don't have a ton and ton of data on what are our normal rates, and we're really only testing these numbers in women that are having fertility challenges. So it's very skewed, and it's not exact by any means. And the other thing to keep in mind is these numbers will change from month to month. You can improve. So the way you really go after improving the FSH numbers, is your managing that stress response in the brain, your managing that hypothalamus, pituitary, ovarian axis through diet, through lifestyle, really a lot through lifestyle and diet, limiting hormonal exposures. Meaning in your foods, and your bath and beauty products. Limiting oxidative stress, basically.

So anything that's going to age us before our time, and I have a total protocol to follow in here on how to do exactly that. And I also have a really nice guide for you guys. If you stick around a little bit longer, I'll give you a link to a free guide on things you can do to optimize your FSH and your AMH. AMH is a little different because it's secreted by the follicles in the ovaries. So to improve AMH, I think it's still about balancing hormones, of course, because by doing that you balance and you improve ovarian function. But it's also about blood flow, and circulation to the ovary. So things like acupuncture, things like castor oil packs, things like mayan abdominal massage, and Chinese herbs, a good, healthy sex life. Regardless of if you're trying to conceive.

If you're in a same sex couple it doesn't quite matter. Just like orgasms, and fun, and being in touch down, they're really healthy for those ovaries and keeping them very juicy, but those are types of things so there're kind of two different approaches to work on FSH and AMH, but the true determining factors that doctors should be looking at when they're looking at these numbers is they should take all three… These three things into consideration. FSH, AMH, and something called antral follicle count, which is how many follicles are in your ovaries, kind of at zero point, around cycle day two or three. If one of them is an aberration, like FSH is really high, but AMH is pretty steady, and antral follicle count looks good. You kind of want an antral follicle count, at least four to six in each ovary. So eight to 12, maybe higher. Then we're not worried about ovarian reserve. And then also remember these numbers change month to month. There's lots of questions coming in.

Day 10, 22.5. So that's your FSH and your AMH is 0.43. So I think, again, this is like an aberration. This is a perfect example, Amethyst, where the FSH doesn't line up with the AMH, because that's a very healthy AMH for 42. Maybe some doctors would say it's a little low, but that's a pretty normal AMH. 22.5 is a little high on FSH, but day 10. So again, that was not taken at the correct time. FSH should only be tested on cycle day one, or cycle day two. So it's not an accurate number. Can you improve FSH and AMH? Yes, you can. This book is all about it. So basically, here's a general recommendation. If you can improve quality of your hormones, and you can balance your hormones, and you can regulate the menstrual cycle. If you can improve the quality of your skin, if you can heal and recover from things like diabetes, or heart disease. Basically if you can improve the quality of cells in your body, guess what you can improve these numbers.

It's all about… Optimizing the machine is what I would say. So fertility is an extension of health. They are not separate. So these numbers are not in a vacuum. Right? And they're not static again. They change month to month. So if you want to improve FSH, you really have to work on balancing hormones on every level, and really managing the stress level. You want to improve AMH, those things as well. The FSH things, plus really improved circulation of blood flow to the ovaries and the uterus, and together you will create more balanced numbers. But I also have news for you. I don't think the numbers mean shit. They don't really mean anything. I've seen girls with AMH as a 0.01 and FSHs of eighty something get pregnant naturally. And I've seen the eighty something FSH recover because at that point she was diagnosed with premature ovarian failure. Recover from premature ovarian failure, which many doctors would tell you is unrecoverable, and got pregnant naturally.

So again, these numbers are not set in stone. They change based on lifestyle, diet, supplements, activity levels, mindset, belief systems, sex life… They change based on so many things, so it's you who needs to live. And this isn't a blame game by any means, but there are lifestyle, and diet, and supplement choices that you can make to really support your hormones, which will then drive these things into better balance.

I did acupuncture for three months and took Chinese herbs to that regulate my cycle, my numbers kept the same. In that case too, I would say that you… As long as you're menstruating and ovulating, you can still get pregnant. So again, not letting the numbers define you. I also think that we should test them three months in a row to get an idea because there's not… What would I say? Again, they change all the time, so they're not static. So I think they shift a lot. But again, FSH and AMH, there's interesting research out there that shows women with high FSH and low AMH, compared to women with normal ranges of FSH and AMH at the end of one year of actively trying to conceive, they had equal pregnancy outcomes. So what that means is FSH and AMH actually don't mean much at all. Where they mean something is if you're doing fertility treatments. Even then they can be manipulated.

A doctor will just put you on the birth control pill for a couple of days, it'll lower the FSH. Then you're going to respond better to the meds and they'll get the number of eggs that they want so that they can create these embryos for you. But that's where it matters most, is with fertility treatments. It doesn't matter so much when you're trying naturally on your own at home. And if you're doing fertility treatments, those numbers can be manipulated. So, that's the other thing. They're just a lab readout to tell us the propensity of how well you're going to respond to medications because IVF is going after treating… Getting many follicles to grow in hopes of getting many eggs out of you to create many embryos. Right? And so it's all about how you're going to respond. So it's a numbers game, and that's where FSH and AMH are really the most important to the doctors.

Yeah. 0.43 AMH and always great antral follicles. So that's… And this is across the board from reproductive endocrinologists that I really respect and admire, that I've worked with for many years. They say you have to look at all three FSH, AMH, antral follicle count, and you take kind of the best two and you look at those. And so there's a general idea of “Okay her antral follicle count is good. Her AMH is pretty good. Her FSH is a little high. That's the aberration. We're going to ignore that. She's got a decent ovarian reserve. She's good to go.”

Again, remember if you're menstruating and you're ovulating, there's a shot guys. Menstruation, ovulation. Those are the keys, and you really want a nice, healthy ovulation, and a nice, easy breezy period. Not a lot of clots, not a lot of cramping. A nice, bright red flow that doesn't lay you out. You don't get headaches or, have to miss a day of work or diarrhea. Those are all signs to me that there's kinks in your system hormonally, and when you work those out, your hormones are going to get more balanced. Okay? Remember the most important thing for these numbers is how you're going to respond to a fertility treatment.

What I want you to focus on is, how is my health? How is my ovulation? How is my period? Are those in healthy shape? Because if they're not, that's where you work, and you work to restore a normal, healthy menstrual cycle, and then from there, fertility thrives. Drinking wheat grass daily mixed with pineapple juice. What's your thoughts on wheat grass and royal jelly and CoQ10? Are they worth it? Yeah, they're definitely worth it. They'll help improve egg quality. They're powerful antioxidants. Okay. We have a free fertility eating for egg quality guide for you guys as well.

So when you regulate the insulin resistance, you should normalize the AMH. But girls that already have a normal, or lower AMH, it doesn't seem to be impacting them. But that's so interesting because that just came up in my group the other day. I would just continue. So if you are doing all my book recommendations, things that I would point out is, have you tried the Body Belief diet? Maybe you need to get a little more aggressive from an autoimmune perspective. And I hear from a lot of people, and I'm not judging, I'm just passing comments, that they say they're following everything, but they're really not. Are you really eating six to eight servings of vegetables a day? Are you getting in your fat every day? Are you drinking your bone broth every day? Are you taking your liver pills every day? Are you doing your fish oil every day?

Are you eating three ounces of protein with every single meal? Are you eating within the first hour of waking up? Right? Those things are super duper important. And if you are doing all those things and it's still not working, then you've got to go to the Body Belief diet, which is basically autoimmune paleo, and you need to remove even more foods, and basically do an elimination diet because your body's just not being able to absorb the nutrition, which then it just can't make the blood to regularly menstruate.

And I only say that from… I think we're close to 20,000 of these sold and I get feedback a lot and I know it works, and so I say it from a place of really understanding my demographic, and my people, and how that when they do commit to the lifestyle, and the diet, and the supplements, and the meditation, and the mindset piece. It does work to regulate things. I'd also strongly recommend castor oil packs, acupuncture, Chinese herbs, mayan abdominal massage, all the things to really restore function.

About Aimee Raupp, MS, LAc

Aimee Raupp, MS, LAc, is a renowned women’s health & wellness expert and the best- selling author of the books Chill Out & Get Healthy, Yes, You Can Get Pregnant, and Body Belief. A licensed acupuncturist and herbalist in private practice in New York, she holds a Master of Science degree in Traditional Oriental Medicine from the Pacific College of Oriental Medicine and a Bachelor’s degree in biology from Rutgers University. Aimee is also the founder of the Aimee Raupp Beauty line of hand-crafted, organic skincare products. This article was reviewed AimeeRaupp.com's editorial team and is in compliance with our editorial policy.


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