#21

AMH is not variable. Especially not 40%. Can be measured at any day. plus, keep in mind thay my cycle shortened suddenly after taking first 6 mg rapa (there is my post about it from January) , so after 15 yrs if 33 days like a clock it became 28-30. I knew from years of reading on fertility that shortening cycle is a sign of reproductive aging. My long cycle and high AMH were as i said as 25-28 year old and they dropped very drastically right after rapa.

#22

My AMH never bounced it was always at 4.
And then dropped
Together with my circle shortening.
Your variations are small. What is your age?
It seems it went back down. Its not improvement from rapa.
I’ve seen such changes in people who don’t take it too.
But consistently 3 or 4 times over 1,5 yr having 28-29 and then 10 months later 16 is very rapid.

#23

Your first AMH is 0.98 and your last is 0.33 and you’re saying it went up overall?
Should I scream or laugh

#24

So based on her values it absolutely didn’t work for her. Her baseline very low AMH went even down further 3x

#25

I know this but they havent published anything. Plus there are always paradoxical reactions. Plus statistically significant difference in AMH rise might not be significant clinically so I don’t know what are they seeing but too many studies speak about harms ot rapamycin.

#26

Easy on the language please.

All things are not for everyone and I think you’ve discovered rapamycin is not ideal for you. You are smart to go off of it and back away.

Best of luck

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#27

I’m trying to understand the unit measures also, it seems (as is often the case) there are different measures in the US and other parts of the world. Here are some guidelines I found:

Here are data/measures from the UK / Manchester: https://www.manchesterfertility.com/blog/what-your-amh-levels-mean-understanding-and-interpreting-your-amh-test-result/

What’s the normal range for AMH?

Once your AMH level has been tested, our team will assess the result and see if it falls within a normal range. The table below outlines the expected AMH levels for your age. As you can see, there is overlap in the age ranges:

Age Range AMH (pmol/l)
20-29 years 13.1 - 53.8
30-34 years 6.8 - 47.8
35 - 39 years 5.5 - 37.4
40-44 years 0.7 - 21.2
45 - 50 years 0.3 - 14.7

Here are data/measures from the USA’s Cleveland Clinic: Anti-Mullerian Hormone (AMH) Test: Purpose, Levels & Results

What is a good AMH level for your age?

AMH levels naturally decline with age, so it’s normal to see a lower ovarian reserve in your 30s, 40s and 50s.

For actual numbers, consider these estimates, which are on the lower side of the spectrum for each respective age:

  • 25 years old: 3.0 ng/mL.
  • 30 years old: 2.5 ng/mL.
  • 35 years old: 1.5 ng/ mL.
  • 40 years old: 1 ng/mL.
  • 45 years old: 0.5 ng/mL.

Higher AMH levels aren’t always a good thing. AMH may be high in some people with polycystic ovary syndrome (PCOS).

and, in my efforts to understand these measures more
 I found this from CareHospitals: What is a Good AMH Level to Get Pregnant.

What is The Normal AMH Level for Getting Pregnant?

Medical experts generally consider AMH levels between 1.0-4.0 ng/ml as normal for women seeking pregnancy, though there is some debate among specialists about exact cutoff values.

The interpretation of AMH levels typically falls into these categories:

  • High (Often PCOS): Above 4.0 ng/ml
  • Normal Range: 1.5 – 4.0 ng/ml
  • Low Normal Range: 1.0 – 1.5 ng/ml
  • Low: 0.5 – 1.0 ng/ml
  • Very Low: Less than 0.5 ng/ml

AMH Levels as per Age Groups:

Age is essential in determining AMH levels, with values naturally declining as women age. AMH levels reach their peak around age 25, with median values showing a consistent decline pattern:

Age Group Median AMH Level (ng/mL)
20-25 years 4.23
26-30 years 3.48
31-35 years 2.43
36-40 years 1.28
40-44 years 0.52

Research has revealed important patterns in age-related AMH levels:

  • Approximately 14.5% of women under 35 years show low AMH values (below 1.1 ng/ml)
  • This percentage increases significantly to 50.5% in women over 35 years
  • Ethnic variations exist, with Caucasian women typically showing 25% higher AMH values compared to African and Hispanic women of similar age

Reasons for Low AMH Levels

The primary factors contributing to low AMH levels include:

  • Age-related Decline: The most significant factor affecting AMH levels, with natural decreases occurring as women approach their mid-30s and beyond
  • Medical Conditions: Issues related to the reproductive system, including endometriosis, ovarian cysts, and previous ovarian surgeries
  • Autoimmune Disorders: Conditions where the immune system affects ovarian function
  • Genetic Factors: Family history of early menopause or inherited genetic disorders
  • Vitamin D Deficiency: Studies show a direct correlation between vitamin D levels and AMH production
  • Poor Dietary Habits: A diet involving processed foods and excessive fats can negatively impact hormone production.
  • Emotional Well-being: It significantly influences AMH levels, with chronic stress and anxietypotentially leading to hormonal imbalances.
  • Previous Ovarian Surgeries or Treatments: Procedures related to ovarian cysts, endometriosis, or ovarian torsion may affect the ovarian reserve, leading to decreased AMH production.

Tips to Maintain Good AMH Levels to Get Pregnant

  • Diet:
    • A nutrient-rich diet forms the foundation for maintaining healthy AMH levels. The following foods have shown particular promise in supporting ovarian function:
    • Berries rich in antioxidants for egg protection
    • Fatty fish containing essential omega-3 acids
    • Leafy greens high in folate
    • Seeds and nuts providing vitamin E
    • Oysters offering zinc for fertility support
  • Physical Activity:
    • It is a key to maintaining hormonal balance and fertility health. Regular exercise helps regulate hormones, manage stress, and maintain a healthy weight.
  • Environmental Factors:
    • They significantly influence hormonal health. Women can protect their reproductive system by:
    • Using glass containers instead of plastic
    • Choosing natural cleaning products
    • Minimising exposure to endocrine-disrupting chemicals
    • Selecting BPA-free products
  • Stress Management:
    • Meditation, mindful breathing, and regular sleep patterns help regulate hormonal balance. These practices, combined with proper hydration and limited caffeine intake, create an optimal environment for reproductive health.
  • Supplements:
    • Vitamin D has shown particular promise in supporting AMH levels.
    • Supplements like CoQ10 and DHEA may benefit some women.
3 Likes
#28

No - here (below) are the measures she reported - as you can see it started at .24 and went as high as 1.36, then after stopping, went down to .33, so even after stopping it was still about a 50% improvement, but less than the 500% improvement she saw at the peak of treatment (the 1.36 measure over the 0.24 measure).

Initial (1 month off BC, pre-treatment): 0.24
Month 1 of treatment: 0.98
Month 2 of treatment: 0.31
Month 3 of treatment: 1.36
Month 4 (post-treatment): 0.99
Final assessment (6 months after last treatment, 2-3 months back on hormonal bc): 0.33

@Forever29 can you please share more about the days of the cycle that you measured. From what LilyD said, in the Columbia university study they were very much focused on a specific timing of the AMH testing and it sounds like if they deviated from that schedule/timing the numbers may have been off, (not representative of actual results). So I’m wondering if perhaps you did the tests on different days of the cycle, during different months, you may get numbers that are misleading.

for example, in the Columbia University study, LilyD is saying that:

“my understanding is that the day of the cycle matters a lot because those numbers move around quite a bit but are pretty stable in cycle day 2 or 3 especially.”

Can you share what day of the cycle you did each test on? Where they the same as how the Columbia Study did the tests; on day 2 or 3?

Perhaps the problem here is that you are measuring on different days, when AMH is fluctuating a lot, so your numbers are not actually accurate as you’ve measured them.

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#29

Doing a little research here, it seems that there can be a large swing in month to month variations (from 28% to 44% is common) of AMH measures, even if they are done on the same schedule (e.g. day 3 of the cycle, as is typically recommended from what I can see).

@Forever29 , you mentioned:

So it dropped in 10 months (probably less because i didnt measure in August-November/December 2024) by 40%

But if we can see month to month variations from 28% to 44% in test results in people normally (with no treatments), It seems that you can’t really be sure your 40% decrease is real or if it is unusual, as its in the normal “noise” level of inter-test variability see from month to month in normal populations of women.

See this study:

Results

A total of 79 patients were included in the final analyses. Significant cycle-to-cycle variation in serum AMH levels was observed, with a median variation of 44.3%. Normal responders exhibited a mean change of 0.60 ± 0.46 ng/ml, while poor responders had a mean change of 0.28 ± 0.28 ng/ml. Approximately 20% of patients were reclassified between normal and poor responder categories based on the second AMH measurement. The controlled ovarian stimulation cycle AMH levels showed a stronger correlation with both total oocyte count (r = 0.871, P < 0.001) and MII oocyte count (r = 0.820, P < 0.001) compared to preceding cycle AMH levels.

Conclusion

AMH levels can exhibit significant variations between consecutive cycles, potentially leading to misclassification of patients. Measuring AMH in the early follicular phase of the COS cycle provides a more accurate prediction of the numbers of total and MII oocytes collected. Consistent and repeated AMH measurements can help clinical decision-making.

Source: Inter-cycle variability of anti-MĂŒllerian hormone: implications for predicting controlled ovarian stimulation cycle outcomes | Journal of Ovarian Research | Full Text.

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#30

You mentioned pmol/L and I’m not sure if that’s the same as ng/mL and some of the other measures mentioned in your post vs the ones in my report

5 Likes
#31

I found this conversion factor for those who want to do it:

Users who adopt the unit ng/ml for AMH can refer to the conversion formula: 1 ng/ml = 7.18 pmol/l

Source: Correlation between three assay systems for anti-MĂŒllerian hormone (AMH) determination - PMC.

3 Likes
#32

I am certainly not questioning your experience, I was just trying to offer some comfort in case there was a possibility the measurements weren’t apples to apples. It sounds like you’re confident they are; I didn’t mean to offend.

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#33

This is very upsetting, and regardless of whether it turns out to have truly led to ovarian aging, I don’t blame you for feeling terrified, angry, and distraught.

We are all here, weighing and taking risks, in the hopes of improving our current and future health. Those of us who dabble in new, unproven therapies, all do the best we can with limited and imperfect information. However, even when we follow the mainstream, established, ‘fda approved’, standard of care, we may later find that the science and/or the treatment was flawed.

I’m sorry for the distress that you are feeling, but commend you for sharing your experience. We need to hear all of the experiences and not just the positive. I do want to echo what others have said here about not determining a final outcome from a small amount of data, but I sense that that may come across as invalidating of how you are currently feeling.

10 Likes
#34

You’re totally right, I missed that you had done the conversion calculation and were obviously aware of the different metrics. Apologies for projecting my own confusion

#35

Because Rapamycin inhibits cell division it is likely to inihibit all types of cell division. That is why I concentrate on the trough.

1 Like
#36

thank you. finally some normal reply. all other were dismissive, stating nonsense about the meausre rages etc.
Maybe women with VERY LOW AMH like Lily here which is considered aged ovary have benefit, but my ovary was of very young age with high AMH, and for such it might be harmful according to that one study i posted where younger rates had 30/40% loss of their primordial follicles thanks to RAPA, which is exactl\ my experience

#37

i measured at 2n day of cycle but it-s not considered variable to be needed to measure other days. ALSO as I AGAIN SAY, after firt rapamycin pill my CYCLE SHORTENED afer 15 years of 33. Means my rapid decline in aging started, then, and I know something is wrong and I ocnfirmed it with AMH that fell instead of by 2-3 points maximally it went from 29 to 16
 aging me on average 6-7 yrs.

Columbia sticks to measuring hrmones on day to 2 or 3 because FSH, estrogen etc, not because of AMH, the date of measuring AMH has little importance.

#38

i am very skeptical that people with low AMH can be compared with people with high/normal, because at the end stage of ovarian aging, AMH is so low, under 1, that is very advanged stage, so it varies more because its menopause hormones go up and down unexpectatly, hot flashes
 but it’s less variable at my age for someone who is far from menopause.
so a raw data from Univeristy of California would be very needed.

also you didnt comment the researhc where low dose daily rapamycin made ovaries drastically age especially in young animals, in older it made no difference, but in young made drastic aging

#39

Disclaimer: I’m a man, I don’t know much about ovarian aging and I don’t take rapa.

This paper is very interesting:

The primordial follicle pool was decreased in young (3,939 pre-treatment vs. 2,219 post-treatment), but similar in old (555 pre- vs. 574 post-treatment) females after rapamycin. The number of transitional primordial follicles was greater before rapamycin than after in both young (14,920 vs. 4,924) and old (1,915 vs. 1,311) females. The number of primary follicles before (2,617) rapamycin was greater than after (560) in young and old females (518 pre- vs. 428 post-treatment). A similar proportion of follicles positive for p16 was seen before and after rapamycin in both young and old females. Similar findings were also observed for AMH immunostaining, except there are fewer positive follicles in the rapamycin-treated older group. The proportion of follicles staining positive for both p53 and p21 was increased in both young and old monkeys after treatment.

So “rapamycin (bid, IM, 0.02mg/kg) for 10 months” had a negative impact on young females but neutral on older females. So we must convert twice daily intramuscular injections in monkeys to daily oral doses in humans. ChatGPT says that the human oral equivalent of this dose would be 5.2 mg/day in a 60-kg adult. If correct, that’s a lot. The VIBRANT study at Columbia used 5 mg/week ( ClinicalTrials.gov ). So about 7x less.

Then the age groups were “young (n=2, 6–9 yr) and old (n=2, 17–21 yr) adult female rhesus macaques”. ChatGPT says that this is equivalent to “~18–27 human years (young adult)” and “~51–63 human years (mid-older)”. The VIBRANT study looked at “women aged 35-45 years”, “In the menopausal transition stage -3a”. ChatGPT says that although female rhesus macaques do not have a distinct menopause, they do go through a gradual reproductive decline and appear to have a stage equivalent to the human menopausal transition Stage -3a at approximately 15–18 years. So females in the VIBRANT study were probably a bit younger than the female monkeys in the “old” group in this study.

We don’t have the full results of VIBRANT yet, but they seemed very positive and from a serious institution. So, assuming the results are correct, then it seems that:

  • High-dose rapamycin (~ 5 mg/day) in young (~ 20yo?) females is harmful
  • Low-dose rapamycin (~ 5 mg/week?) in older (~40yo? pre-menopausal?) females is beneficial

@Forever29, your experience suggests that 2 to 6 mg/week can be detrimental. You’re 35yo but “on a level of 25-30 yr olds”, so, effectively biologically young. I guess females with high AMH should not use rapa? When did you stop it and how long after stopping it did you test AMH? Hopefully it will go back to baseline :pray:

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#40

One of the criteria for the Columbia study was that you have low AMH for your age, I wonder if this could be the reason for that

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