Anti-Müllerian Hormone (AMH)

Anti-Müllerian Hormone (AMH) is a key hormone produced by the small follicles in the ovaries. It serves as an important biomarker of a woman’s ovarian reserve, which refers to the number of eggs she has left. AMH levels are commonly used in fertility assessments and can provide valuable insights into reproductive health. In this blog, we will explore what AMH is, how it is measured, what affects AMH levels, and what they mean for fertility and overall health.

What is AMH?

AMH is a glycoprotein hormone secreted by the granulosa cells of developing ovarian follicles. It plays a significant role in follicular development and ovarian function. In men, AMH is also present and is involved in the regression of Müllerian ducts during fetal development. However, its primary clinical relevance is in female reproductive health.

Why is AMH Important?

AMH is considered an excellent marker of ovarian reserve. Unlike other reproductive hormones, AMH levels remain relatively stable throughout the menstrual cycle, making it a reliable indicator of ovarian function. High AMH levels suggest a good ovarian reserve, while low levels may indicate diminished ovarian reserve (DOR), premature ovarian insufficiency (POI), or an impending decline in fertility.

AMH and Fertility

AMH Levels and Ovarian Reserve

A woman is born with a fixed number of eggs, and this number declines with age. Since AMH is produced by small growing follicles, its levels correlate with the remaining egg supply. Women with high AMH levels tend to have a larger ovarian reserve, whereas low AMH levels may indicate reduced fertility potential.

AMH and Assisted Reproductive Technology (ART)

AMH testing is commonly used in fertility clinics to predict a woman’s response to ovarian stimulation in procedures like in vitro fertilization (IVF). High AMH levels suggest a better response to fertility treatments, whereas low levels may indicate a reduced likelihood of retrieving a significant number of eggs.

AMH and Natural Conception

Although AMH provides an estimate of ovarian reserve, it does not directly predict a woman’s ability to conceive naturally. Other factors like egg quality, tubal patency, sperm health, and overall reproductive health also play crucial roles.

How is AMH Measured?

AMH levels are measured through a simple blood test, which can be performed at any time during the menstrual cycle since AMH levels do not fluctuate significantly. The test is often included in fertility evaluations and can help determine the best course of action for those experiencing difficulties in conceiving.

AMH Level Ranges

AMH levels are measured in nanograms per milliliter (ng/mL) and can vary based on age and individual reproductive health. Below is a general reference:

• High AMH (>4.0 ng/mL): May indicate polycystic ovary syndrome (PCOS) or a high ovarian reserve.
• Normal AMH (1.0 – 4.0 ng/mL): Suggests a good ovarian reserve and typical reproductive potential.
• Low AMH (<1.0 ng/mL): May indicate diminished ovarian reserve or approaching menopause.
• Very Low AMH (<0.5 ng/mL): Associated with a significantly reduced ovarian reserve and possible infertility.

Factors Affecting AMH Levels

Several factors can influence AMH levels, including age, lifestyle, medical conditions, and environmental exposures.

1. Age

AMH levels naturally decline with age as ovarian reserve diminishes. The highest levels are typically found in young women, while a sharp decline occurs in the late 30s and early 40s.

2. Polycystic Ovary Syndrome (PCOS)

Women with PCOS often have higher AMH levels due to an increased number of small follicles in the ovaries. However, despite a high ovarian reserve, PCOS can still lead to fertility issues.

3. Premature Ovarian Insufficiency (POI)

POI is a condition where ovarian function declines before the age of 40, leading to reduced AMH levels. It can be caused by genetic factors, autoimmune diseases, or medical treatments such as chemotherapy.

4. Chemotherapy and Radiation Therapy

Cancer treatments can have a detrimental impact on ovarian function, leading to a significant decrease in AMH levels and, consequently, fertility.

5. Endometriosis

Endometriosis is associated with lower AMH levels, particularly when ovarian cysts (endometriomas) are present. The condition can cause ovarian damage and reduce reproductive potential.

6. Lifestyle Factors

Smoking, excessive alcohol consumption, and exposure to environmental toxins have been linked to lower AMH levels and accelerated ovarian aging.

7. Genetic Factors

Some women naturally have lower AMH levels due to genetic predisposition. Family history of early menopause may indicate a lower ovarian reserve.

Can AMH Levels be Improved?

While AMH levels primarily reflect the number of remaining eggs and cannot be significantly increased, certain lifestyle and dietary changes may support overall ovarian health:

• Healthy Diet: A diet rich in antioxidants, healthy fats, and lean proteins may support egg quality.
• Regular Exercise: Moderate physical activity helps maintain hormonal balance.
• Avoiding Toxins: Reducing exposure to smoking, alcohol, and environmental pollutants may help protect ovarian function.
• Supplements: Some studies suggest that supplements like Coenzyme Q10, DHEA, and Vitamin D may support ovarian health, though more research is needed.

AMH Testing and Reproductive Planning

AMH testing is an invaluable tool for women considering pregnancy, fertility preservation, or undergoing assisted reproductive treatments. It can help guide decisions on egg freezing, IVF protocols, and early interventions for potential fertility issues.

Who Should Get an AMH Test?

• Women struggling with conception
• Those considering egg freezing or IVF
• Women with irregular periods or PCOS
• Those with a family history of early menopause
• Cancer patients undergoing chemotherapy

AMH is a vital marker of ovarian reserve and fertility potential. While low AMH levels may indicate diminished ovarian function, it is not the sole determinant of a woman’s ability to conceive. Understanding AMH levels can help women make informed decisions about their reproductive health, whether they are trying to conceive naturally, exploring fertility treatments, or planning for the future. If you have concerns about your AMH levels, consult a fertility specialist to discuss your options and develop a personalized reproductive plan.

To get your AMH levels checked or consult a Gynecologist at Sparsh Diagnostic Centre, call our helpline number 9830117733.

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Disclaimer:

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.