Patient: Dr. Malpani, I’m really anxious. I recently had some routine blood tests done, and my gynecologist told me I have a low AMH level. I’ve only been trying to conceive for six months, but I was immediately referred to an infertility specialist. He said I need IVF as soon as possible because my ovarian reserve is depleting rapidly. I’m only 28, and I have regular periods. Is it really that serious?
Dr. Malpani: I completely understand why you’re worried. A low AMH (Anti-Müllerian Hormone) level can sound alarming, but let’s take a step back. First, let me reassure you that having a low AMH doesn’t automatically mean you won’t be able to conceive naturally. AMH is just a number, and while it gives us some information about your ovarian reserve, it doesn’t predict your ability to get pregnant.
Patient: But the infertility specialist was very insistent. He said if I wait, my AMH will decline even further, and I may lose my chance of having a baby altogether.
Dr. Malpani: I hear this all the time. It’s important to remember that doctors are not fortune tellers. We can’t predict the future of your AMH levels with certainty. The reality is, AMH fluctuates, and what matters more is how your body is functioning right now. You’re young, have regular cycles, and have only been trying for six months—that’s a very positive sign.
Patient: But why would he push for IVF if it wasn’t urgent?
Dr. Malpani: Sadly, some clinics focus on treating reports, not patients. Low AMH has become a buzzword in fertility clinics, often used to nudge women into IVF prematurely. Let me be clear—low AMH doesn’t mean low fertility. It simply means you may have fewer eggs compared to someone else your age, but that doesn’t mean the eggs you have aren’t healthy. In fact, it only takes one good egg to make a baby.
Patient: I’ve been reading a lot online, and everything I find seems to confirm what the doctor told me—low AMH means IVF is my only option.
Dr. Malpani: That’s the tricky part. Most of the information you find online about AMH comes from IVF clinic websites. And what’s their goal? To get more patients into their clinics. You rarely hear stories of women with low AMH who conceived naturally, because those women never had to visit a doctor. They were too busy enjoying the process in their bedrooms!
Patient: So, you’re saying I might not even need IVF right now?
Dr. Malpani: Exactly. IVF is an amazing technology, but it’s not a one-size-fits-all solution. You haven’t been trying long enough to justify jumping straight to IVF. In fact, it would probably be more fun and far less stressful to keep trying naturally for a bit longer. Enjoy the process, and remember—making a baby in the bedroom is far more enjoyable than doing it in a lab!
Patient: I guess I just feel pressured. Everyone keeps telling me time is running out.
Dr. Malpani: I get it. It’s easy to feel rushed, but fertility isn’t as fragile as it’s often made out to be. Panic leads to poor decisions, and fear is often the biggest barrier to natural conception. The truth is, at 28, with regular cycles and no history of infertility, your chances of conceiving naturally are still very high.
Patient: But what if I wait and my AMH drops even more? Won’t it be too late by then?
Dr. Malpani: AMH naturally declines with age, but that’s part of the normal reproductive process. What’s important is to focus on what you can control—leading a healthy lifestyle, reducing stress, and trying regularly. There’s no evidence that rushing into IVF simply because of a low AMH guarantees better results. In fact, unnecessary IVF cycles can sometimes lead to disappointment.
Patient: I never thought of it that way. It’s refreshing to hear a different perspective.
Dr. Malpani: I’m glad. Good doctors treat patients, not just reports. The context of your medical history, age, and overall health is far more important than a single blood test result. I encourage my patients to take charge of their fertility journey and not let fear dictate their decisions.
Patient: I feel much more at ease now. So, what should I do next?
Dr. Malpani: Keep trying naturally for at least another six months to a year. If nothing happens, we can revisit and explore your options. In the meantime, stay informed but be cautious about where you’re getting your information. Fertility is a marathon, not a sprint.
Patient: Thank you, Dr. Malpani. This conversation has been incredibly reassuring.
Dr. Malpani: I’m happy to help. And remember—if you’d like a second opinion, you can fill out the form on our website with your reports, and I’ll provide a free second opinion here.
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