Accutane and low AMH
Can accutane cause low AMH and in turn affect fertility? YES! As a fertility acupuncturist in Tampa, FL, I work with couple who are trying to get pregnant naturally and who are using reproductive technology like IUI and IVF. I’ve had quite a few patents who had low AMH levels after taking accutane, so I decided to dive into the research to see what I could find!
Let me give you an overview of a recent study titled: The effect of isotretinoin on ovarian reserve based on hormonal parameters, ovarian volume, and antral follicle count in women with acne (PMID: 25660129)
This study evaluated 82 women of reproductive age with acne who were treated with oral isotretinoin (the chemical name of Accutane).. The patients were evaluated for ovarian reserve prior to therapy and re-evaluated 6 months after isotretinoin (accutane) treatment with regard to hormonal parameters, AMH, OV, and AFC.
How much can Accutane affect AMH (and fertility potential)?
- Significant differences were found between the pre and post treatment measurements for AMH – close to a 50% decrease in AMH levels.
- There was about a 25% decrease in Antral Follicle Count
- There was a 35% decrease in ovarian volume.
In a follow up that looked at women 12 months after stopping Accutane, the authors conclude that “The deteriorative effects of systemic isotretinoin (accutane) treatment on ovarian reserve, which can be accepted as an indicator of female fertility, diminish in time. (PMID 27292185).
What does this mean?
This means that AMH levels began to rebound in time but they did not return to the baseline in 12 months, there was still a slight decline from before starting accutane.
Should you take Accutane (isotretinoin) if you ever plan on getting pregnant?
When it comes down to it, taking Accutane will affect your fertility. That effect is certainly present during and for a period of time after you finishing taking it. The real question is what are the long term effects? Unfortunately the scientific literature is unclear – studies show that AMH and ovarian reserve markers do rebound but they DO NOT rebound to the original levels in the intervals that were studied.
What this means to you is that you need to really consider the use of Accutane if at any time you want to have children. In my personal opinion, the risk vs reward doesn’t make sense. Taking Accutane can make it very difficult to have children and it’s already statistically hard enough, why throw another variable into the mix?
A Natural Approach to Treating Acne
A simple vitamin protocol was proposed and used by Dr. Lit-Hung Leung way back in 1997 with great success. Dr Leung explains that acne can be reduced or eliminated with the use of Vitamin B5, also called pantothenic acid. The vast majority of acne is caused by excess oil in the skin (also known as sebum). This oil comes from sebum secretion by the sebaceous glands at the root of the hair follicles. This oily build up occludes the pores in the skin causing blockage and infection.
Vitamin B5 works by reducing the oil production of the sebaceous glands. This is done by increasing Coenzyme A (Co-A) which increases the metabolic breakdown of oils by normal activity of cell physiology.
A common complaint was that the large amount of pantethine (10 grams) that Dr. Leung recommended was hard to take, causing unwanted side effects like bloating.
After doing more research, I discovered that Dr. Jeffrey Dach suggests a “modified Leung B5 protocol with Pantethine 750 mg with 250 mg of L Carnitine three times a day.”
You can find the products I recommend here on Amazon.
No Adverse Side Effects
Unlike Accutane which may have serious adverse side effects. Using Vitamin B5 has little or no adverse side effects.