HomeAnswersObstetrics and GynecologyabortionI have a history of abortion, and my AMH levels are low. Are the chances for me to conceive?

Are there possibilities of conception in a woman who has experienced an abortion previously?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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iCliniq medical review team

Published At August 26, 2022
Reviewed AtJanuary 16, 2024

Patient's Query

Hello doctor,

I am an adult weighing 70 kilograms and having a height of 5.3 feet. I have a problem conceiving with a history of one abortion, and my vitamin D levels are a bit low. My anti-mullerian hormone level is 1.25 ng/mL. I have no thyroid issues. As per the references in the report, it is mentioned as low fertility. Please check the reports that I have attached and clarify if it is the concerned range. Can I conceive naturally, or is treatment required? I have regular periods of 28 days with five days flow, no stomach pain, and no other issues.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have gone through the reports (attachments removed to protect the patient's identity). The information you have given is not enough to make a proper evaluation. I need to know more to suggest to you.

  1. How long have you been married?
  2. Since when are you trying to conceive?
  3. When did you have the miscarriage? Was it spontaneous?

Your anti-mullerian hormone level is slightly on the lower side. The fact that you have had a miscarriage and your regular periods is a good indicator that you can conceive. I suppose it could be secondary infertility. So I suggest you do more laboratory tests, including FSH (follicle stimulating hormone), LH (luteinizing hormone), vitamin D2, and serum progesterone levels, and upload the results. I would also suggest you lose weight, which will help. I can give you further opinions on following up with your results. Alternatively, you could consult a fertility specialist who will do what is necessary.

Hope this helps.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

It has been four years of marriage. I conceived during the sixth week. Bleeding happened after the scan, and the baby did not have a heartbeat, so dilation and curettage were done. We had one year gap, and I suffered from a coronavirus infection. I have been trying to conceive for the past five to six months. My FSH (follicle-stimulating hormone) level is in the normal range. I have also been trying to reduce weight and using capsule Fol 123 for the past six months. The doctor suggested an abdominal and pelvis scan on the 14th day of the cycle. I am attaching my husband's semen analysis report. And tell me can I get pregnant naturally? Or is it difficult?

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

I have gone through the reports (attachments removed to protect the patient's identity). Semen analysis is fine. I suggest getting an ultrasound of the pelvis. If you do not have PCOD (polycystic ovary syndrome), the chances of getting pregnant spontaneously are good. But you do need to lose weight as that again increases the chances. As I said, you got pregnant once, so why should you not conceive again? I would suggest you take M2 Tone syrup one teaspoon once daily for three months. It is ayurvedic and helps to regulate the menstrual cycle, improve ovulation, and support fertility.

Hope this has addressed your concern.

Thank you and take care.

Patient's Query

Hello doctor,

Thanks for the reply.

I do not have PCOS, and my pelvis and abdominal scan are normal. My AMH is low, and today on the 14th day of my cycle, a dominant follicle in the left ovary was seen, and I was given an HCG injection with G2 tone syrup and vitamin D tablets. I am attaching the prescription. Kindly go through that.

Hello,

Welcome back to icliniq.com.

I understand your concern.

The attached (attachment removed to protect the patient's identity) report is unclear. Yes, please try for six months. I suggest you have intercourse on alternate days during ovulation. Do not stress. Relax. Go away for a holiday if necessary. There is no reason for you not to get conceived. Try to reduce stress and relax.

Hope this helps.

Thank you.

Patient's Query

Hello doctor,

Thanks for the reply.

This is the last month I took HCG's first shot, but we missed intercourse for three days due to emergency training at work in some other place. Again I got my period on the 28th day of my cycle. My doctor is telling me about regular transvaginal scans and follicular studies, and she is saying we will give FSH and HCG injections this time. I do not know whether it is a safe treatment or does it have any side effects. Is it necessary to go for hormonal injections, or can we try for some more months without going for injections? I am not able to decide. Please suggest. I am attaching scan reports and prescriptions again.

Hello,

Welcome back to icliniq.com.

I understand your concern.

You have to be sure that you are ovulating. If you have intercourse during the middle ten days of your cycle, you will probably get pregnant. If you are not ovulating, then you need the HCG injection. There is no harm in trying to conceive spontaneously. Get a smartphone application to track your ovulation. Note your cervical discharge during ovulation when it becomes a clear white glassy discharge. That is a sign of ovulation. Check your basal body temperature. When the temperature rises, you are ovulating.

Hope this has addressed your concern.

Thank you.

Patient's Query

Hello doctor,

Thanks for the concern.

I am now nine weeks pregnant, and the baby's fetal heartbeat is good, but for the past two days, I have had severe vomiting, headache, and fever. For that, I have taken Doximate and Ecospirin tablets given by the doctor. But suddenly, yesterday morning, I had brownish spotting initially, and I immediately went to the doctor. She checked the heartbeat and told me everything was fine and gave Hydroxyprogesterone injection and asked me to continue for four weeks weekly once the injection was done. Still, after coming home, a blackish-dark brown tissue-like clot nearly 4 to 5 cm passed, and now no spotting or such tissue passed. Is it a miscarriage or any other thing of concern?

Hello,

Welcome back to icliniq.com.

I understand your query and concern.

If you have a tissue-like substance, then a scan is imperative. If the heartbeat is strong, then do not worry. Continue the Progesterone as suggested by your doctor. The first trimester is crucial, and the chances of a miscarriage are more. So take adequate rest, continue the Progesterone, and I am sure all will be well. But you need to have another scan to make sure there is a heartbeat. I will suggest you a USG (ultrasound). A probable diagnosis of your condition could be a threatened miscarriage. Take rest and continue Progesterone as suggested. Follow up with your gynecologist.

Hope this helps.

Thank you.

Patient's Query

Hello doctor,

Thanks for the suggestion.

Today I did USG. The fetal heartbeat is good, and CRL in the 10th week is 3 cm. I have taken the second dose of Progesterone injection, but the urine test found a trace amount of albumin protein. Is this anything serious? Hb is 9.6 g/dL, and RBC and MCV are below the range.

Hello,

Welcome back to icliniq.com.

Sounds like everything is fine. Hemoglobin is a bit low. So I suggest you have iron-rich foods. If you have antenatal care, they will advise you regarding everything. Are you taking Folic acid? If not, then take Folic acid 5 mg daily. Trace albumin in the urine is alright. Most importantly, do not stress. Pregnancy is physiological, not a disease. Enjoy it.

Revert in case of queries.

Thank you.

Patient's Query

Hello doctor,

Thank you.

I have completed four doses of Progesterone injections weekly once, and now I am in the fourth month. Again my doctor suggested Progesterone tablets and Aspirin tablets daily. I do not have any bleeding. I think my body is not accepting Progesterone and Aspirin as the daily doses cause me severe headaches, fatigue, drowsiness, and low blood pressure if I take Aspirin. I intimated to this my doctor and she told me there are no other options. Here I am attaching my reports and doctor's prescription. Please go through them and suggest me a solution. How do I manage to continue my pregnancy without any bleeding? And if I take calcium, also I have a full stomach upset. The NT scan screened positive for preeclampsia and FGR.

Hello,

Welcome back to icliniq.com.

I understand your concern.

You are 32 years old and had some problems in conceiving. So this is considered a precious pregnancy. Because of your age, pre-eclampsia is a possibility. So you need to take Aspirin until delivery. There is no other choice. Progesterone is given to prevent premature labor. Your obstetrician has prescribed it, and I cannot ask you to discontinue it. Calcium is necessary too, but if you can take plenty of curds and milk every day I suggest you may take calcium two to three times a week. These are some of the factors that a woman has to undergo during pregnancy. So have a positive attitude, think of your baby, and take the medications your doctor has prescribed. If you keep saying I cannot, or I feel sick, etc, that is how you will be feeling throughout your pregnancy.

I hope this has addressed your concern.

Kind regards.

Patient's Query

Hello doctor,

Thank you.

If it is compulsory to take Aspirin and Progesterone tablets, can I take them weekly two times, or should I take them daily? And is preeclampsia a serious condition?

Hello,

Welcome back to icliniq.com.

Yes, you have to take both tablets every day. Pre-eclampsia is a very serious condition both for the mother and the baby. And I cannot change anything that your doctor has prescribed for you. Please follow the medications prescribed by her as they are necessary in your case. This will help prevent complications that may happen to you or your baby.

Hope this helps.

Follow back in case of queries.

Kind regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Usha Sadanand Rao
Dr. Usha Sadanand Rao

Obstetrics and Gynecology

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