AMH and its Importance in Fertility

Women are born with their ovarian reserve, a finite number of eggs. This reserve not only diminishes in quantity as a woman ages, but the quality of the eggs also decreases. While several tests can assess a woman’s fertility, one stands out as an essential tool for fertility specialists: the Anti-Müllerian Hormone (AMH) test.

AMH is produced by the cells surrounding the egg follicles in the ovary. Generally, the younger a woman is and the more follicles she has, the higher her AMH levels will be. As a woman ages and her ovarian reserve depletes, her AMH levels naturally decline. Therefore, AMH is a good indicator of ovarian reserve and should correlate with the number of antral follicles a woman has at the start of her cycle.

This is why, along with the usual “Cycle Day 3 tests” (which measure sex hormones and include a pelvic ultrasound performed at the beginning of the cycle), the AMH test is crucial. Fertility specialists use it to assess the chances of natural conception and to guide decisions regarding the best fertility treatment options.

Unlike other sex hormones that fluctuate throughout the menstrual cycle, AMH levels remain relatively stable. This means it can be measured anytime through a simple blood test. Understanding AMH levels is an important piece of education for any woman who wants to understand her fertility potential, especially if she’s considering postponing parenthood into her 30s or later.

AMH levels vary from woman to woman, but doctors refer to age-based reference ranges. Since the ovarian reserve diminishes over time, a normal AMH level for a 25-year-old will differ from that of a 45-year-old.

Low AMH

A low AMH level generally indicates a reduced ovarian reserve. It’s crucial to understand that a low AMH level alone does not mean natural conception is impossible. However, it can be a red flag, especially if the woman is young and expected to have a normal ovarian reserve. In such cases, fertility preservation might be recommended. The general consensus is that a low AMH level is a value under 1.3 ng/mL, keeping in mind that lower levels are expected in older women. When AMH levels are low, a patient’s response to fertility treatments might be reduced, necessitating a tailored approach to optimize conception chances.

High AMH Levels

While a good AMH number typically indicates a healthy ovarian reserve, abnormally high AMH levels might indicate Polycystic Ovary Syndrome (PCOS). PCOS is a condition where the ovaries produce too many small follicles that often fail to grow, mature, and ovulate. This can lead to severe hormonal imbalance, irregular periods, anovulatory cycles, and ultimately, infertility. A proper diagnosis is important so that appropriate treatment can be prescribed and future family planning can be discussed.

As mentioned, AMH levels are age-dependent, typically peaking in a woman’s 20s and beginning to decrease after age 30. While the drop isn’t sudden, it usually becomes more pronounced after 35.

The short answer is no, AMH levels cannot be improved. Since AMH reflects the ovarian reserve, a woman is born with, which naturally declines with age, improving AMH would equate to improving the ovarian reserve, which is unfortunately impossible.

However, the quality of a woman’s eggs may be influenced by long-term lifestyle changes. A healthy lifestyle can improve overall health and positively impact fertility. Maintaining a healthy weight, managing stress, engaging in moderate but consistent exercise, adopting a balanced diet, and ensuring good, restful sleep can all influence fertility by maintaining optimal hormonal balance and improving general health.

For women concerned about their AMH levels or who anticipate postponing maternity beyond their mid-30s, fertility preservation might be an excellent option. Our fertility specialists can explain the entire process and guide you toward an informed decision.

Make your appointment today and let us be part of your journey.