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AMH Levels and Fertility: Are My AMH Levels Low?

AMH levels & Fertility: Understand Anti Mullerian Hormone Blood Test Level Results

Struggling to get pregnant can be a stressful experience. You are bombarded with a ton of tips, tricks, and tests that claim to help you understand what’s happening or, rather, what’s not happening. One such fertility test is the anti-mullerian hormone (AMH) test. The test determines your anti-mullerian hormone levels to convey a ton of information about your fertility and overall reproductive health. If you are interested in understanding more about this topic and what AMH does, this article will help explain everything you need to know about your anti-mullerian hormones and when to get tested.

Anti-Mullerian Hormone (AMH)
Anti-Mullerian Hormone (AMH) and Age – An Indian laboratory retrospective analysis.

What is AMH?

In contrast to many fertility hormones such as hCG and progesterone, the anti-mullerian hormone is found in both males and females. Its a protein (peptide) hormone that is produced in the reproductive organs in both sexes. The secretion of AMH starts immediately after conception.

The baby starts to produce anti-mullerian hormone as soon as it develops sex organs corresponding to its genetic makeup. Male babies have higher levels that help the fetus to prevent the development of female sex organs. On the other hand, female babies have a lower level while they are developing in the uterus. Both males and females keep producing AMH after their birth. In females, however, the role of changes soon after puberty.

The follicles in the female ovaries start to produce AMH once the female enters puberty. The level of anti-mullerian hormone corresponds to the number of eggs produced in the ovary. More eggs produced, higher the AMH levels. In short, your AMH levels can be a good indicator of how many egg cells you have in your ovaries, called the ‘ovarian reserve.

What are AMH levels?

It is interesting to note that your hormone levels don’t change during your menstrual cycle. That said, the levels can significantly fluctuate as you age. Hence, in females, the AMH levels are the highest right at puberty and keep decline as she ages. As you age, your ovarian reserve declines, and so do your hormone levels. The number of viable eggs that can be released from the ovaries during ovulation declines with age. After the age of about 25 years, you start to lose viable eggs at an accelerated pace. The rate peaks again around 30-35 years of age and drops to zero after menopause, along with your ovarian reserve. If you are trying to conceive, you need viable eggs in your ovaries, and determining anti-mullerian hormone levels can give you an indication of just that.

AMH levels by age

There is plenty of scientific evidence indicating that the number of viable eggs in the ovaries declines as you age. Consequently, the levels of AMH also decline as you age. A scientific study confirmed that in women between the ages of 26 and 45, AMH levels are negatively affected by age. So, what should be the normal AMH levels of healthy women? Well, here is a chart that gives an approximate picture:

 

Age AMH levels
17-204-9 ng/ml
20-252-8 ng/ml
25-302-6 ng/ml
30-351-5 ng/ml
35-400.5-5 ng/ml
40-450.4-2.4 ng/ml
45-500.2-1.5 ng/ml
51-600.2-1.5 ng/ml

 

How Anti-mullerian hormone changes over time?

The levels of AMH are directly proportional to the number of healthy, viable eggs in your ovaries that can be potentially fertilized. Healthy and properly functioning follicles produce AMH, so your levels are also an indicator of your ovarian function. Many studies have indicated that AMH levels correspond to the number of healthy follicles in the ovaries. Although the levels can vary greatly between women, it is still considered to be a great tool to determine your fertility. That said, the levels of AMH don’t change during your cycle that much.

The levels of AMH are fairly constant on a month-to-month basis in women aged between 18-24. That said, there can be fluctuations in the anti-mullerian hormone levels in these women as well. Women with higher levels tend to show larger flections, while women with lower levels tend to show less fluctuation. As younger women have a higher basal level of AMH compared to older women, they show a greater degree of fluctuation. The biggest change in your hormone levels comes with age. As you age, your levels can drop significantly. The lower levels of AMH also can affect your fertility. Keep reading to know how these changes affect your chances of conception.

Anti-mullerian hormone and fertility

The AMH levels can help to decide the best time for conception. As you age, the levels of AMH decrease, but the hormone level also vary from woman to woman. So, if you already have low AMH levels, it will only decline as you age, and it is better if you start trying to get pregnant before you run out of time.

AMH and Ovarian reserve

As we have discussed already, anti-mullerian hormone levels can be a good indicator of the number of viable follicles in your ovaries. The number of these eggs only decreases with age. The number sharply declines after you turn 35. Thus, it is not surprising that your AMH levels also start to decline during this time.

AMH and infertility

If you cannot get pregnant naturally, your doctor may want to check your AMH levels to determine your ovarian reserve. For a normal, fertile woman, the AMH levels are about 1-4 nanograms/mL in the blood. If your anti-mullerian hormone level is below 1 nanogram/mL or above 4 nanograms/mL, it might indicate an underlying health problem. We will discuss these later in this fertility2family article.

AMH and miscarriages

AMH level of fewer than 1 nanograms/mL might mean that you are suffering from infertility. A lower level of your anti-mullerian hormone can also increase the risk of miscarriages once you are pregnant. One very interesting study found that women with AMH levels less than 0.4 nanograms/mL stand at a significantly higher risk of miscarrying their pregnancy. The miscarriages were at the highest risk between weeks 6 and 7 of the pregnancy.

How are AMH levels tested?

The process to test AMH levels is fairly straightforward and simple. It’s a low-risk procedure that involves drawing a small amount of blood from the vein of your arm. The technician will identify the vein, clean the area with alcohol and draw a small amount of blood using a needle.

As with any blood test, you might feel a bit of prick during the procedure. As only a small amount of blood is required, most women don’t have a feeling of lightheadedness or fainting. There is no need for special preparation, such as fasting before the test.

What is AMH testing used for?

AMH levels indicate your egg count, but apart from it, it can also be used to diagnose many other conditions, including-

Causes of an early menopause

Cause of amenorrhoea (absence of menstruation before menopause during fertile years)

Diagnosis of Polycystic Ovary Syndrome (PCOS)

Certain types of ovarian cancers

Predicting the menopause

Testing anti-mullerian hormone levels is a routine procedure that is often used to determine your ovarian reserve. Your fertility expert uses the AMH levels data to determine whether you have decreased the number of viable eggs in your ovaries. The doctor might even suggest freezing your eggs if you are not immediately ready to conceive.

If you want to conceive, your fertility expert may start you on some treatments to overcome this hurdle. The knowledge of AMH levels can be crucial in assessing your chances of successfully using assisted reproductive technology (ART). If you have a normal AMH level, it might indicate that you have enough eggs, and many eggs can be harvested for procedures such as freezing or IVF.

That said, anti-mullerian hormone levels are not the only indicator by any means. Understanding the levels can be a crucial piece of information that fits in the larger scope of things.

One thing to always keep in mind is that your anti-mullerian hormone levels are merely an indicator of the present condition of your ovarian reserve. It can’t be used to determine how quickly the number of viable eggs will decline in the future. In other words, you can’t measure your fertility window just by measuring AMH levels.

What does it mean to have low AMH levels?

If you have low AMH levels, it means that you have a lesser number of viable eggs remaining in your ovaries. Remember, the AMH will continue to decline as you age. Hence, having a low AMH count certainly indicates that the fertility window is closing. The number of eggs in your ovaries is called ovarian reserve, and the AMH levels indicate your ovarian reserve. If you have a low ovarian reserve, it can pose challenges to conceive.

What if you have high AMH levels?

A high AMH level is indicative of a good ovarian reserve. That means you have plenty of eggs in your ovaries that can be fertilized. In other words, you have time to conceive. That said, dramatically high hormone levels are not good. An abnormally high level of AMH might indicate PCOS, which causes excessive follicles to grow in the ovaries. Women with PCOS tend to have multiple mature follicles in their ovaries, but not all of them are capable of releasing an egg. As a result, the remaining follicles transform into cysts. If a woman has abnormally higher AMH levels, it does not mean that she will be more fertile. It might be an indication of PCOS.

Anti-mullerian hormone FAQs

In this article, we took a detailed look at AMH levels and how they affect fertility. If you still have some questions in mind, let’s head on to the FAQ section, where we try to answer some of these questions.

Can I get Pregnant with low levels of AMH?

It is one of the most frequent questions regarding anti-mullerian hormone. The simple answer to this question is that you can get pregnant even with lower hormone levels, but you might need some help. Assisted Reproductive Technology might be able to help you in such a case. Women with low AMH levels might need fertility treatments, and knowing your hormone levels can help you predict your success with procedures such as IVF. That said, each individual is different. Some women have low AMH levels and have conceived without any external help or intervention.

How can I increase my AMH levels?

There is little scientific evidence of any sure method of increasing AMH levels. However, some studies have indicated that vitamin D and Dehydroepiandrosterone (DHEA) Might help. But, the notion that increasing your AMH levels will increase your chances of getting pregnant is not scientifically supported.

There is no way other than freezing your eggs to preserve them. Once they die off, they are not coming back, despite increased AMH levels. As a result, even if you can increase your AMH levels, you can not increase your ovarian reserve.

What are some of the causes of low AMH?

Aging is one of the primary causes of low AMH levels. However, some women might experience losing eggs in their 20s and 30s as well. Some of the reasons for this might include:

Poor Genetics- You might start losing more eggs because of your genetics.

Certain medical conditions- Many illnesses, including endometriosis and autoimmune disorders, can lead to lower AMH levels.

Scarring and injury to the ovaries might also diminish the ovarian reserve.

Should I get AMH test?

If you visit a fertility expert, you are more likely than not to get an AMH test. Women under 35 years of age and trying unsuccessfully to get pregnant naturally for a year should get tested. For women who are over 35 years of age, the time limit is around 6 months. AMH levels are checked if your doctor suspects that you have perimenopause. Anti-mullerian hormone levels can be a good indicator of your approaching menopause as well.