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AMH Levels and Fertility: Are My AMH Levels Low?

Trying to get pregnant can be a stressful experience. You’re bombarded with many tips, tricks, and tests that claim to help you understand what’s happening or, rather, what’s not happening. One such fertility check is the anti-mullerian hormone (AMH) test. The test determines your anti-mullerian hormone levels to convey information about your fertility and overall reproductive health. 

Continue reading to learn about anti-mullerian hormones and when to consider getting 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. It’s a protein (peptide) hormone produced in both sexes’ reproductive organs. The secretion of AMH starts immediately after conception.

Your baby will start to produce anti-mullerian hormones while in the womb as soon as it develops sex organs corresponding to its genetic makeup. Male babies have higher levels of AMH than their female counterparts, which helps the foetus prevent the development of female sex organs. Both males and females keep producing AMH after their birth. In females, however, the role of AMH changes soon after puberty.

The follicles in the female ovaries start to produce AMH once the female enters puberty. The level of anti-mullerian hormones corresponds to the number of eggs produced in the ovary. The more eggs produced, the higher the AMH levels. In short, your anti-mullerian hormone levels can indicate the number of egg cells in your ovaries, called the ‘ovarian reserve.

Why Should I Know My AMH Levels?

Your AMH levels can significantly fluctuate as you age. In females, AMH levels are the highest during puberty. As you age, your ovarian reserve declines. The number of viable eggs that can be released from the ovaries during ovulation decreases, and with this comes a drop in anti-mullerian hormone levels. After menopause, your AMH levels drop to zero, 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 no preventing the decline of AMH levels, as this is a natural occurrence with age. So, what should be the normal AMH levels of healthy women? While there is a debate from expert to expert on what the optimal AMH levels are, there is a consensus on the normal range being:

Average: Between 1.0 ng/mL to 3.0 ng/mL.

Low: Under 1.0 ng/mL.

Severely low: 0.4 ng/mL.

It is important to note that this number will vary depending on your age. Additionally, the results of any testing completed may vary between different labs due to different equipment and technology.

How Levels of 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 fertilised. Properly functioning follicles produce AMH, so your levels also indicate your ovarian function. Although the levels can vary greatly between women, it is still considered a great tool to determine fertility.

The levels of AMH are fairly constant on a month-to-month basis in women aged between 18-24. That said, there can also be fluctuations in the anti-mullerian hormone levels in these women. Women with higher levels tend to show larger shifts and changes, while women with lower levels show less fluctuation. As younger women have a higher basal level of AMH than older women, they show greater fluctuation. 

The biggest change in your hormone levels comes with age, where they can drop significantly. These lower levels of AMH also can affect your fertility, especially if you are still relatively young. Keep reading to know how these changes affect your chances of conception.

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 fertile woman with an appropriate amount of the anti-mullerian hormone, the AMH levels are about 1-3 nanograms/mL in the blood. If your anti-mullerian hormone level is below one nanogram/mL or above four nanograms/mL, it might indicate an underlying health problem. 

How are AMH Levels Tested?

The process of testing AMH levels is fairly straightforward. 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 use a sterilised needle to extract the blood.

As with any blood test, you might feel a bit of a prick during the procedure. As only a small amount of blood is required, most women don’t experience any lightheadedness or fainting.

Age AMH levels
17-20 4-9 ng/ml
20-25 2-8 ng/ml
25-30 2-6 ng/ml
30-35 1-5 ng/ml
35-40 0.5-5 ng/ml
40-45 0.4-2.4 ng/ml
45-50 0.2-1.5 ng/ml
51-60 0.2-1.5 ng/ml

 

AMH testing – what’ s it for?
When should AMH be tested?

What is AMH Testing Used for?

Aside from indicating your egg count, testing your AMH levels can also be used to diagnose many other conditions, including:

  • Causes of early menopause
  • Cause of amenorrhoea (absence of menstruation before menopause during fertile years)
  • Polycystic Ovary Syndrome (PCOS)
  • Certain types of ovarian cancers
  • Predicting menopause

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 ready to conceive. If you want to conceive, your fertility expert may start you with some treatments to overcome this hurdle. Knowing AMH levels can be crucial in assessing your chances of successfully using assisted reproductive technology (ART). 

Remember 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 other words, you can’t measure your fertility window just by measuring AMH levels.

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 fertilised. In other words, you have time to conceive. 

However, 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 can release an egg. As a result, the remaining follicles develop into cysts.

Does low AMH always mean low ovarian reserve?

Anti-mullerian Hormone FAQs

Can I Get Pregnant With Low Levels of AMH?

The simple answer to this question is that you can get pregnant even with lower hormone levels, but you might need some help from services such as assisted reproductive technology. 

Women with low AMH levels might need fertility treatments, and understanding 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 external help or intervention.

How Can I Increase My AMH Levels?

Unfortunately, the theory that increasing your AMH levels will increase your chances of getting pregnant is not scientifically supported.

There is no way to increase your chances of pregnancy other than freezing your eggs to preserve them. Despite increased AMH levels, once your eggs die off, they are not coming back. 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 also experience losing eggs in their 20s and 30s. 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 an Anti-mullerian Hormone Test?

If you visit a fertility expert, it may be recommended that you take an AMH test. Women under 35 years of age who have been trying to fall pregnant for a year to no avail should get tested. For women who are over 35 years of age, this time limit is around six months. AMH levels are also checked if your doctor suspects that you have perimenopause. Anti-mullerian hormone levels can be a good indicator of your approaching menopause as well.

What is the cost of an AMH test in Australia?

The cost of an AMH test can vary widely depending on the location and the specific laboratory conducting the test. You might expect to pay between AUD $70 to $150 on average. It’s important to note that Medicare does not typically cover this test unless it’s part of a broader fertility investigation. Some private health insurance plans may offer partial coverage. Always check with your healthcare provider and insurance company for the most accurate information.

How can I interpret my AMH test results?

Interpreting AMH test results can be complex as they are often considered with other factors such as age and overall health. Generally, a higher AMH level indicates a larger number of remaining eggs, while a lower level suggests a reduced egg count. However, AMH levels alone do not determine fertility potential or the likelihood of successful pregnancy. Discussing your results with a healthcare professional who can comprehensively understand your reproductive health is always best.

What are the symptoms of low anti-mullerian hormone levels?

Low AMH levels themselves do not typically cause noticeable symptoms. They are  an indicator of a reduced ovarian reserve, which can lead to difficulties in conceiving. Some women with low Anti-mullerian hormone levels may experience irregular periods or notice that their periods become lighter or shorter. However, these symptoms can also be caused by various other factors. If you’re having trouble conceiving or are concerned about your fertility, it’s advisable to consult a healthcare professional.

Are there ways to increase AMH levels naturally?

While there’s no proven way to significantly increase AMH levels, as they are largely determined by the number of eggs in the ovaries, maintaining a healthy lifestyle can support overall reproductive health. This includes a balanced diet, regular exercise, adequate sleep, and avoiding smoking and excessive alcohol. Some studies suggest that certain supplements, such as Vitamin D and Coenzyme Q10, may positively impact reproductive health, but their effect on Anti-mullerian hormone levels is unclear. Always consult a healthcare professional before starting any new supplement regimen.

What is the relationship between anti-mullerian hormone levels and IVF success in Australia?

Anti-mullerian hormone levels often indicate ovarian reserve, influencing the response to ovarian stimulation during IVF treatment. Generally, women with higher AMH levels are likely to produce more eggs during an IVF cycle, which can increase the chances of successful fertilisation and embryo transfer. However, AMH levels are just one piece of the puzzle. Other factors, such as age, overall health, sperm quality, and the quality of the embryos produced also play significant roles in IVF success.

What is the lowest AMH level for IVF?
What is the lowest AMH level for IVF?

Falling pregnant and anti-mullerian hormone

Falling pregnant can be difficult at the best of times, let alone when you are also battling fertility issues. If you’ve been trying to grow your family for a while now, you’ve undoubtedly spent more money than you want on pregnancy tests. The good news is that Fertility2Family is here to help with our range of affordable, accessible pregnancy and ovulation tests. Contact us if you have any queries about our products, and we will do our best to assist.

Sources:

Fertility2Family only uses trusted & peer-reviewed sources to ensure our articles’ information is accurate and reliable.

Anti-mullerian hormone (AMH) and age (2019) Anti-Mullerian Hormone (AMH) and Age – An Indian laboratory retrospective analysis | Asian Journal of Health Sciences. Available at: http://ajhs.biomedpress.org/index.php/ajhs/article/view/449/865#content/figure_reference_3 (Accessed: 04 October 2023).

Cleveland Clinic (2022) Anti-mullerian hormone (AMH) test: Purpose, Levels & Results, Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diagnostics/22681-anti-mullerian-hormone-test (Accessed: 03 October 2023).

Clinical Labs Australia (2024) AMH (anti-mullerian hormone), Testing AMH (Anti-Mullerian Hormone) | Clinical Labs. Available at: https://antenatal.clinicallabs.com.au/patient/fertility/amh (Accessed: 03 October 2023).

Copp, T. et al. (2021) Anti-mullerian hormone (AMH) test information on Australian and New Zealand Fertility Clinic websites: A content analysis, BMJ Open. Available at: https://bmjopen.bmj.com/content/11/7/e046927 (Accessed: 03 October 2023).

Holland, K. (2018) A breakdown of the fertility timeline, Healthline. Available at: https://www.healthline.com/health/fertility-timeline#Ages-41-to-45+ (Accessed: 03 October 2023).

IVF Australia (2022) Anti Mullerian hormone (AMH) Test & Ovarian Reserve, IVF Australia. Available at: https://www.ivf.com.au/planning-for-pregnancy/female-fertility/ovarian-reserve-amh-test (Accessed: 03 October 2023).

Lindberg, S. (2020) Anti-müllerian hormone (AMH): What your levels can tell you, Healthline. Available at: https://www.healthline.com/health/fertility/amh#test-results (Accessed: 03 October 2023).

Queensland Fertility Group Australia (2022) Anti Mullerian hormone (AMH) Test & Ovarian Reserve Australia, Queensland Fertility Group. Available at: https://www.qfg.com.au/tests-treatments/fertility-tests/anti-mullerian-hormone-amh-test-ovarian-reserve (Accessed: 03 October 2023).

WebMD (2022) Anti-mullerian hormones: How do they impact your health?, WebMD. Available at: https://www.webmd.com/a-to-z-guides/what-to-know-anti-mullerian-hormone-levels (Accessed: 03 October 2023).

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Evan Kurzyp

Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.

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