Can a woman with very low amh ( lower than 0.7 pmol/l) in hypo gonadotropin hypogonadic female have own baby with her own egg? : How to proceed for ovulation induction in such cases ?

Can a woman with very low amh ( lower than 0.7 pmol/l) in hypo gonadotropin hypogonadic female have own baby with her own egg?  : How to proceed for ovulation induction in such cases ?

A)         Scope 1:- Can we initially offer Oestrogen?? Is there any trophic role of estrogen? Some researchers have claimed that if oestrogen is supplemented in cases of HH( hypo gonadotropin hypogonadic female ) then  AMH can rise. At least researchers claim like that  . They claim that priming with any gonadal steroid be it  estrgen, androgen or LH  can in casses of  hypo gonadotropin hypogonadic ) help to function the population of  antral and pre antral follicles .As such AMH can rise. In these cases pool is too immature to secrete amh. Priming with estrogen for 3 to 6 months will improve the ovarian volume and also  one can  start seeing the antral follicles by USG.   Antral and pre antral follicles are the AMH producing follicles population.  But another group claims that it has to be primed with gonadotropins. The physiological reset of gonadostat has to be done artificially in hypo gonadotropin hypogonadic female.. But ovarian failure, dysgenesis has to be ruled out. In cases of normal puberty initially hormones like fsh and lh are high and amh is low in prepubertal age. The initial gonadostat has to be reset

B)         physiological. An hallmark of puberty where the FSH LH levels come within reproductive range. Now amh is secreted by preantral follicle and not by immature primary oocyte level These immature primary oocyte needs to triggered in hypo hypo and that's a very difficult task .

AMH and gonadotropins are two different subset of markers of female reproduction. In a case of hypogonadotropic hypogonadism   gonadotropins correlate with intactness of hypothalamic pituitary axis, but AMH is a denominator of ovarian function in terms of the existent pool of pre-antral and natural follicles . Some tiny antral and pre antral follicles often escapes hide in imaging process and become evident later. AMH slowly rises if gonadotrophins are administered. Well, in Hypo hypo case, the uterus usually is so small that most of gynaecologits would have primed them sufficiently with E+/- P for sometime to get a better uterine size

In the case of hypogonadotropic hypogonadism hypog waiting for becoming sensitive to FSH. of functional amenorrhoea( read hypothalamic) this pool is intact so is the AMH . Scientists are not clear and the matter of  rise of AMH after gonadotropins Inj is  still debatable & so also rise of  AMH levels or is it an inherent coexisting defect which is affecting the hypothalamopitutary axis as well as the follicular pool.