The anti-Müllerian hormone is a hormone produced by 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. It can also be used as a PCOS marker.
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. The ovarian reserve is also a strong indicator of the pregnancy treatment outcome.
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:
- What is you ovarian reserve?
- Do you have enough eggs for a successful IVF and how will the ovaries respond to stimulation?
- Do you have to consider egg freezing or planning a pregnancy sooner?
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|
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. For example, women with PCOS usually have higher levels of AMH.
- Women with the history of ovarian surgery due to endometriosis, ovarian cyst or ovarian torsion, ectopic pregnancy, have a higher risk of 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.
- Vitamin deficiency, particularly vitamin D, is known to have a connection with fertility issues and AMH levels.
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.
Here are some AMH levels reference:
An AMH level over 3,0 ng/ml means that you have too many small follicles. Usually, it is the indicator of polycystic ovarian syndrome (PCOS). This may potentially put 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.
The AMH level anywhere between 0 and 0,6 ng/ml indicates to your doctor that you have a low ovarian reserve. It doesn’t mean that you have no chances to conceive naturally but it means that you should consider trying to get pregnant sooner or you may require IVF or the FSH stimulation. It doesn't mean that you have no chances to conceive naturally. Low AMH levels also mean that you are likely to have an earlier menopause.
If you're trying to conceive, and there are no issues with sperm count, a doctor who discovers that your AMH is normal 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.
Low AMH basically means that you have a low ovarian reserve but it doesn’t mean that you are not able to conceive naturally.
Unfortunately, there are no ways to increase your AMH levels. However, if you're trying to conceive, you should do everything you can to boost your chances to become a parent.
Here are a couple ways that can be helpful:
Studies have shown that women with insufficient vitamin D are 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.
Increasing circulation to ovaries is important to increase ovarian functioning. Abdominal massage can help with that.
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, going for yoga, and pretty much doing everything you can to de-stress will increase your chances to get pregnant.
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.