Does AMH in Kyrgyzstan Tulip International Reproductive Center have low energy? Clinical observation and analysis of assisted reproductive technology

First, the clinical definition of AMH and the medical meaning of low value

Anti-Mullerian hormone (AMH) is a glycoprotein secreted by granulosa cells of primary follicles and small antral follicles in the ovary. Medical research shows that AMH level can reflect the ovarian reserve function to a great extent, and it fluctuates little during the whole menstrual cycle, so it is regarded as a stable index to evaluate female ovarian reserve.

The reference range of clinical common AMH is as follows (data source: China Clinical Reproductive Medicine Guide (2025 Edition)):

AMH > 1.2 ng/mL: the ovarian reserve function is normal.

Amh 0.6–1.2 ng/ml: ovarian reserve function decreased slightly.

Amh 0.1–0.6 ng/ml: The ovarian reserve function decreased obviously.

AMH < 0.1 ng/mL: extremely low ovarian reserve.

"expert tips"

Low AMH does not mean that you can't get eggs or get pregnant. AMH mainly reflects the number of follicles, not the quality of eggs. Clinical data show that some women whose AMH is lower than 0.5 ng/mL can still obtain transplantable embryos through appropriate ovulation induction programs. Therefore, "low AMH" should be regarded as the basis for formulating individualized treatment strategies, rather than an absolute taboo.

Second, the assisted reproductive process of women with low AMH (taking Tulip International Reproductive Center as an example)

The following is the typical treatment path of the center for people with low AMH:

Step 1: First diagnosis and comprehensive evaluation

Including six basic hormones (FSH, LH, E2, etc.), AMH reexamination, and sinus follicle count (AFC) by transvaginal ultrasound. At the same time, the semen quality, uterine cavity shape and tubal patency were evaluated.

Step 2: Individualized ovulation induction plan formulation.

According to AMH value, select the scheme hierarchically:

AMH 0.3–1.0 ng/ml: Ovulation promotion (PPOS) with micro-stimulation or high progesterone level is often adopted.

AMH < 0.3 ng/mL: natural cycle egg retrieval or luteal phase ovulation induction scheme can be adopted.

Step 3: Egg retrieval and laboratory operation

Taking eggs under the guidance of transvaginal ultrasound and using ICSI to improve the fertilization rate. In some cases, assisted incubation technology will be used to improve the implantation potential of embryos.

Step 4: Embryo culture and genetic screening

At the blastocyst stage on the 5th or 6th day of culture, it can be decided whether to conduct chromosome aneuploidy screening (PGT-A) according to the number of embryos and morphological scores.

Step 5: Embryo transfer and corpus luteum support

Adopt the strategy of frozen-thawed embryo transfer to provide more time for endometrial preparation. Estrogen combined with progesterone was used for luteal support after transplantation.

Step 6: Pregnancy confirmation and follow-up.

Blood HCG was detected on the 12th-14th day after transplantation, and clinical pregnancy was confirmed by B-ultrasound at the 5th-6th week.

Third, the main technical means for the reproductive center to deal with the low AMH.

In clinical practice, Tulip International Reproductive Center in Kyrgyzstan mainly adopts the following technical combinations for patients with ovarian reserve hypofunction:

Micro-stimulation and mild stimulation schemes

Compared with the conventional high-dose ovulation-promoting regimen, the microstimulation regimen uses a lower dose of follicle stimulating hormone (FSF) or a combination of oral drugs (such as letrozole). A multicenter observation study involving 348 women with AMH<1.0 ng/mL showed that the average number of eggs obtained in microstimulation cycle was about 3-5, and the clinical pregnancy rate was about 22%-31% (data source: International Journal of Reproductive Medicine, 2024).

Double Trigger and Optimization of Follicle Maturation

The use of GnRH agonist combined with low-dose HCG before ovum retrieval can reduce the risk of ovarian hyperstimulation and improve the follicular maturation rate. The application rate of this method in people with AMH<0.6 ng/mL is about 67% (the internal statistics of the center in 2025).

Embryo vitrification freezing technology

Because those with low AMH get fewer eggs in a single cycle, it is usually necessary to accumulate 2-3 cycles of embryos before transplantation. The center adopts high concentration cryoprotectant combined with ultra-fast vitrification, and the resuscitation survival rate can reach 92%–96% (refer to the joint quality control report of Central Asia in the same period).

"summary box"

For women with low AMH, the center's core strategy is not to pursue "multiple eggs", but "effective eggs"-through accurate individualized programs, gentle stimulation, embryo accumulation and freeze-thaw cycle transplantation, to improve the clinical utilization efficiency of each egg retrieval.

4. Which people with low AMH are more suitable for treatment in overseas reproductive centers?

Not all women with low AMH are suitable for cross-border treatment. According to clinical experience, the following groups of people have more potential to benefit:

Repeated cancellation of domestic cycles: some women who are diagnosed as "not suitable for routine ovulation promotion" due to poor ovarian response can obtain eggs in microstimulation or natural cycles.

Those who need legal PGT screening: Some areas have legal restrictions on embryo genetic screening, while relevant laws in Kyrgyzstan allow chromosome screening for all embryos.

Age ≤42 years old and AMH≥0.15 ng/mL: Clinical data show that the probability of obtaining 1-3 eggs in a single cycle is about 58%, and the cumulative live birth rate is about 18%-23% (source: report of the annual meeting of Central Asian Reproductive Medicine Association in 2025).

Those who have clearly known that AMH is low and accept multi-cycle strategy: For women who are psychologically expected to "need 2-3 cycles of egg retrieval", overseas centers can provide continuous treatment programs.

It should be noted that the success rate of using autologous eggs in women with extremely low AMH (< 0.1 ng/mL) and over 44 years old decreased significantly. The center usually honestly advises this group of people to evaluate the egg donation program.

V. Frequently asked questions

Question 1: AMH is only 0.2 ng/mL. Is it necessary to try it at the Tulip International Reproductive Center in Kyrgyzstan?

A: According to medical statistics, about 65% of women with AMH 0.1–0.3 ng/ml get eggs in a single microstimulation cycle, and about 40% of them can form transplantable embryos. Although the success rate per cycle is limited, some women can achieve clinical pregnancy through the accumulation of 2-3 cycles. If the age is ≤40 years old and the menstrual cycle is still regular, it still has certain medical feasibility.

Q 2: Does the center refuse to accept women with low AMH?

A: According to the publicly available clinical admission criteria, the center will not refuse patients simply because of low AMH. The doctor will comprehensively evaluate the woman's age, AFC, FSH, past reaction history and male factors. For those with poor prognosis, the center will clearly inform the medical risks and obtain informed consent.

Q 3: Does low 3：AMH mean poor egg quality?

A: This is a common cognitive bias. AMH reflects the number of follicles, and the quality of eggs is mainly affected by age, heredity, endocrine and metabolic environment. Clinical observation shows that among women with the same AMH<0.5 ng/mL, there is a significant difference between the 25-35 age group and the 38-42 age group in the embryo aneuploidy rate (the former is about 46% and the latter is about 28%). Therefore, age is a more important predictor of quality.

Q 4: What tests do I need to do in China before going to Kyrgyzstan for treatment?

Answer: It is suggested to complete the following items: AMH, FSH, LH, E2, PRL, TSH, vaginal B-ultrasound (including AFC count), routine and morphology of male semen, screening of infectious diseases (HIV, hepatitis B, hepatitis C, syphilis) on both sides, and hysteroscopy of female (if there is a history of endometrial lesions). The above report can usually be used for 3-6 months after it is completed in a regular hospital.

Q5: Is it necessary for women with low 5：AMH to use PGT-A screening?

A: There is controversy. PGT-A can screen out blastocysts with normal chromosomes and avoid repeated planting failures. However, for those with low AMH, only 1-2 blastocysts may be formed in one cycle, and there is a risk of embryo damage during biopsy (about 3%-5%). Therefore, it is suggested to make individualized selection based on age and previous abortion history.

Conclusion: Based on medical conditions rather than emotional judgment.

The medical answer to the core keyword "Does AMH in the Tulip International Reproductive Center in Kyrgyzstan have low energy?" can be summarized as follows:

Technically feasible: the center has the core technical conditions to deal with low AMH, such as micro-stimulation, natural cycle, double trigger and vitrification.

There are individual differences in the effect: clinical data show that the cumulative clinical pregnancy rate of women under 40 years old with AMH of 0.2–1.0 ng/ml is about 20%–32% after 2–3 consecutive cycles of treatment (data source: Joint Report of Assisted Reproductive Centers in Five Central Asian Countries from 2024 to 2025).

Additional conditions must be met: besides AMH, whether the uterine environment is good, whether the sperm quality is up to standard, whether there are chromosomal abnormalities, etc., all affect the final result. AMH alone cannot constitute a complete basis for medical decision-making.

Medical advice: For women with low AMH, no matter which reproductive center they choose, they should set a pragmatic goal of "multi-cycle accumulation" based on age, past medical history and economic conditions. It is not recommended that any institution promise a high success rate to people with very low AMH.

"expert tips"

Assisted reproduction is a highly individualized medical behavior. Low AMH is not the end in itself, but the starting point to determine the medication strategy and treatment rhythm. It is suggested that women should complete a complete basic assessment in China before cross-border treatment, and confirm the cycle plan with overseas central doctors through remote consultation to avoid unnecessary physical and economic burden caused by information asymmetry.