What is anti-Müllerian hormone (AMH)?
The anti-Müllerian hormone is a hormone produced be granulosa cells of growing follicles (during early stages of their development) in the ovaries. This hormone determines ovarian reserve in other words it defines the quantity but not the quality of follicles in the ovaries.
The anti-Müllerian hormone is tightly related to issues of fertility and of high importance to those who are trying to conceive. It has been used as an ovarian reserve marker since 2002.
Are you being examined for infertility? If so, you will most likely have to check your AMH levels.
If you're getting treatment for infertility, the anti-Müllerian hormone test will give you an answer to a couple of important questions:
- Do you have enough eggs for a successful IVF?
- Should you change your diet and lifestyle to get pregnant?
- Are there any undetected health issues intervening with a successful pregnancy?
Anti-Müllerian hormone levels
In healthy women the anti-Müllerian hormone levels initially increase until early adulthood, and then slowly decrease with increasing age until becoming undetectable. It happens approximately 5 years before menopause when the pool of growing follicles is exhausted.
The AMH level interpretation is given below. But don’t try to make any conclusions on your AMH levels yourself, leave it to your doctor.
|Over 3.0 ng/ml||High (often an indicator of PCOS)|
|Over 1.0 ng/ml||Normal|
|0.7 – 0.9 ng/ml||Low normal range|
|0.3 – 0.6 ng/ml||Low|
|Less than 0.3 ng/ml||Very low|
Factors that influence AMH levels
There are multiple factors that might be contributing to your low AMH. Here are some of them:
- Age. AMH naturally decreases as you get older. There might be a link between your fertility and age, as AMH starts decreasing after the age of 35.
- History of hormonal disorders and medical conditions related to reproductive system also might affect your AMH levels.
- Women with the history of ovarian surgery due to endometriosis, ovarian cyst or ovarian torsion, ectopic pregnancy, have a higher risk from low anti-Müllerian hormone level.
- Stress is one of the biggest negative influences on AMH. Women who are living under constant stress and mental pressure often find it hard to conceive until their stress levels reduce.
- Improper nutrition. Unhealthy diet saturated with fats and processed foods aren't good for your AMH levels. Obesity also has a negative effect on AMH levels.
- Vitamin deficiency, particularly vitamin D, is known to have a connection with fertility issues and AMH levels.
What is an AMH test?
An AMH is a very simple laboratory blood test that measures the hormone levels. It requires 3 ml of blood and as AMH levels do not change during the menstrual cycle, the test can be performed on any day. Reports come back usually within a couple of hours up to a couple of days depending on the country or the hospital where you're taking the test.
If your local hospital and private clinics don't offer this testing, perhaps you will have to travel to another city or to another clinic to do the test. If you have to do this keep in mind that you don't have to undergo any special treatment or following a special diet regimen in order to be prepared for the test. However, if you want to schedule other infertility treatments, make sure to coordinate your appointments with other treatments that are related to the days of the menstrual cycle.
What does the AMH test results mean?
Here are some AMH levels reference:
An AMH level over 3,0 ng/ml, is usually the indicator of polycystic ovarian syndrome (PCOS). It means that there lots of growing follicles in the ovaries. And this potentially puts you at risk of Ovarian Hyperstimulation Syndrome (OHSS), if you are planning to go for ART (assisted reproductive treatment).
The level of AMH between 3 and 0,7 ng/ml means that your ovarian reserve is normal and there are other reasons for infertility. If your AMH levels are normal and you still haven't had success in getting pregnant, you might need further examination, besides you'll have to improve your overall health with better nutrition, exercise, and more relaxation.
Anywhere between 0 and 0,6 ng/ml will require IVF or the FSH stimulation. This score might indicate to your doctor that you have a low ovarian reserve. The ovarian reserve is also a strong indicator of the outcome of pregnancy treatment. With this test result, you'll most likely receive additional treatment to increase your AMH levels.
If you're trying to conceive, and there are no issues with sperm count, a doctor who discovers that your AMH is optimum (the value that shouldn't affect the ability to conceive) will advise treatment to remove other health factors that might negatively affect conception. If both you and the partner are theoretically able to conceive, your doctor will then move on to advise treatments and lifestyle changes to improve your chances of getting pregnant.
How to increase an AMH level?
If you were told by your doctor that you have lower AMH levels than those needed to achieve a successful pregnancy, you are basically told that your ovarian reserve isn’t high enough and that you may face problems with conceiving.
A well-tailored IVF protocol, along with DHEA supplementation, should give you a better chance of getting pregnant. Still, there's a lot you can do to boost your AMH levels.
Low AMH basically means that you have a low ovarian reserve. This is normal to some degree with the aging process, particularly over the age of 40.
However, if you're trying to conceive you should do everything you can to increase your AMH levels which will give you a better chance of getting pregnant. While no one can predict or put an exact number to how many eggs will you have available and what your account is right now, there is still a way to increase their quality and count.
Here are a couple ways for you to increase AMH levels naturally:
Vitamin D supplementation
Studies have shown that women with sufficient vitamin D were more likely to face Low AMH. How will you choose to increase your vitamin D levels? This is up to you.
You can boost your vitamin levels with supplementation or through a natural diet. You should still take a blood test to measure your vitamin D levels.
L-arginine supplementation is known to improve ovarian function. However, to make a difference with your ovarian functioning you should take 4 to 5 milligrams of this supplement. If you are getting treatment from any conditions like endometriosis, autoimmune disease or infections, make sure to check if they're affecting your ovarian functions.
Increasing circulation to ovaries is important to increase ovarian functioning. Abdominal massage can help with that.
Your menstrual cycle can give you clues about when the time is right for sperm and egg to meet.
Flo is a widely used tool that provides accurate data on fertility.
Acupuncture, acupressure, and herbs
Homeopathic medicine is known to be helpful with ovarian function. You can also learn self-acupressure so that you can practice it at home without any additional costs. Acupressure will help increase circulation into your ovaries.
As you're trying to conceive you will have to get as much rest as possible. Allowing yourself more rest and taking better care of yourself, getting counseling, and pretty much do everything you can to de-stress will increase your AMH levels.
Bone broth is healthy regardless if you're trying to get pregnant or not. Needless to say, make sure you get healthy, organic bone broth. You can cook the meal at home. If available you can also purchase a finished dish at your local stores or order them through online catering, as long as the broth isn't processed. Bone broth will nourish your body inside out.
Knowing your anti-Müllerian hormone levels together with other tests and examinations results will allow you to find the best type of infertility treatment. It allows your doctor to tailor your treatments so that you'll get the optimal results.
This gives you better chances to achieve pregnancy faster than you normally would.