Rubina Dilaik says she had only 4 months to conceive naturally: ‘I was frustrated…socha tha kuchh karna hi nahi hai’

But, what is AMH? 

Dr Sonal Singhal, senior consultant – obstetrician and gynaecologist, Motherhood Hospital, Gurugram, explains, “Anti-Müllerian Hormone (AMH) levels serve as a marker of ovarian reserve, indicating the quantity of a woman’s remaining egg supply. Low levels of AMH typically suggest a reduced ovarian reserve, which may impact fertility.”

Dr Anita K Sharma, senior director and head at Max Hospital, adds, “Around 4 ng/ml is the normal value. This value keeps declines with age and anything less than 1 ng/ml is considered low. It means that the conception process should be fast-tracked as the number of eggs is declining. The value becomes imperceptible after menopause.”

IVF or IUI for women with low AMH levels

Dilaik also admitted in the podcast that she would have to opt for medical assistance like in vitro fertilisation (IVF) or intrauterine insemination (IUI) if she surpassed the four months given to her by her doctor. “Women with low AMH levels sometimes get set timelines from their doctors for conception, for example, trying naturally for 3-4 months in Rubina’s case,” says Dr Sandeep Talwar, fertility expert, Nova IVF Fertility, Vasant Vihar.

This scenario is common among couples battling mild fertility issues, she elaborates, especially if the woman is attempting to conceive at an advanced age. When faced with low AMH levels, couples have various alternatives, including timed intercourse, fertility drugs, IUI  and IVF. 

Dr Talwar continues, “Fertility is dependent on both male and female factors. Both genders face infertility issues. Just like how women may face issues with AMH levels, men can also have low sperm parameters. Individual circumstances determine the course of treatment, and couples need to consult with a fertility specialist to determine the best option for their situation.”

Hormonal changes during pregnancy and breastfeeding can affect sexual desire and arousal, according to Dr Sonal Singhal, Senior consultant – obstetrician and gynaecologist , Motherhood Hospital, Gurugram (Source: Freepik)

Unexpected conception after a period of trying

Despite trying to conceive for three months Dilaik expressed her disappointment at being unsuccessful. “I was frustrated that it’s not happening,” she said. 

She then decided to take a break from actively trying, and surprisingly, she became pregnant in the same month. “Woh mahina, jis dinn socha tha ki kuchh karna hi nahi hai… jaane do (When I decided I won’t do anything in that month… let it be); in the same month, I conceived!” she said. 

Dilaik’s story highlights the unpredictability of conception and the emotional challenges faced by many couples dealing with fertility issues. Dr Sharma agrees that the mind and body have a deep connection. “If all other factors are normal a woman can conceive once her anxiety is allayed. Scientifically this is called the hypothalamic pituitary ovarian axis which means the brain controls the pituitary gland which, in turn, controls the ovary.”

Dr Talwar concurs, “Stress reduction, lifestyle improvements, and better timing of intercourse may all help increase the probability of pregnancy. Individual variations in fertility and reproductive health can also affect the chance of spontaneous pregnancy.”

Although unexpected pregnancies are possible, she says, couples with fertility issues should seek customised recommendations and assistance from fertility specialists.

Lack of intimacy post pregnancy

Following the birth of her baby, both Dilaik and Awasthy candidly discussed how intimacy with their husbands dwindled. They attributed this decline to a lack of time and feeling too exhausted to engage in intimate moments. 

Many new parents can relate to this situation, as the demands of caring for a newborn can leave little room for personal time or romance. “Physical exhaustion stemming from childbirth and the demands of caring for a newborn can lead to decreased libido and limited energy for intimacy,” Dr Singhal remarks. 

Hormonal changes during pregnancy and breastfeeding can also affect sexual desire and arousal. Additionally, the emotional adjustments and stress associated with new parenthood can further contribute to a decline in intimacy. 

What’s worth considering according to Dr Sharma is that many women feel insecure because of body changes like weight gain,scars, enlarged/ sagging breasts and so on. Additionally, postpartum depression is a well recognised phenomenon wherein a woman feels unhappy, insecure and depressed, and it takes time to recover from all these changes. 

“To navigate these challenges, it’s essential for couples to communicate openly about their needs and feelings, prioritise self-care, and seek support from healthcare professionals if necessary. Scheduling intimate time, exploring non-sexual forms of intimacy, and gradually reintroducing sexual activity as both partners feel ready can help couples reconnect and revive their intimate relationship postpartum,” Dr Singhal recommends.