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AMH Levels Explained

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Written by Jack Pearson

Jack Pearson

Dr. Jack Pearson is a previously HCPC registered Embryologist with a PhD in reproductive medicine. Prior to joining Natural Cycles leading Medical Affairs, he worked for more than 10 years in a clinical setting working at some of the busiest fertility clinics in the UK. Today he spends most of his time working with experts at the world’s leading institutions to carry out important research with the vision to further the field of female health. He earned his PhD from the University of Sheffield specializing in Sperm Metabolism and currently lives in London.
Today we are discussing Anti-Müllerian hormone or AMH for short. This hormone can often cause quite a stir, so whether you’re thinking of having your levels of AMH measured or you’ve received the result of a test, we’re going to take a look at what you need to know about it. We’ll discuss what AMH is, what it can tell you, and more importantly, what it can’t tell you! We’ll also look at AMH's relation to egg retrieval for IVF and how the result may be interpreted by your healthcare professional.

What is AMH?

Anti-Müllerian hormone is a substance produced by cells within the ovaries, and is measured through a simple blood test. The American College of Obstetricians and Gynecologists (ACOG) states that the level of AMH often reflects how many follicles (sacs that contain eggs) are in reserve in your ovaries - in simple terms, AMH can be an indication of the number of eggs left in the ovaries.

What AMH cannot tell you

AMH does not predict fertility. Fertility is impacted by many things and, in fact, the biggest predictor of fertility is age, as this is directly linked to the quality of female egg cells. AMH is often referred to as a ‘fertility test’. However, this is misleading because your fertility is dependent on multiple factors and those of us with a low AMH can often still get pregnant. 

ACOG recommends those without underlying fertility problems avoid AMH tests. It has also been suggested that if you are younger than 35 and have not been diagnosed with subfertility, AMH testing may result in unnecessary stress. 

What AMH can tell you

Generally speaking, a low AMH means that there are fewer eggs in reserve in your ovaries. However, this does not mean that your fertility is affected. It is just one of multiple factors that determine your overall fertility. For example, you may have fewer egg cells than normal but they may be good quality and you may still be set to ovulate regularly for years to come. 

If you are undergoing in vitro fertilization (IVF), AMH levels can be used to predict the number of eggs that you may produce during the treatment. Remember that we’re all different and each individual responds to IVF differently, this means a good number of quality eggs may still be retrieved despite a lower AMH level.

AMH values by age

AMH levels vary considerably and are often measured using different units: (pmol/l) or (ng/mL). There is also a high degree of variation in cutoffs between laboratories. To get a fuller understanding of your result it’s always a good idea to consult with a healthcare professional. 

If we look at median AMG levels, by age range, we can see that those in the age group 20-29 have a median AMH range of 13.1-53.8 pmol/l. As we age our AMH levels begin to decrease, and the range for AMH in individuals aged between 40-44 is 0.3-14.7 pmol/l. As you can see the range is large, which makes it even harder to use AMH as a reliable fertility indicator. 

Can AMH levels be increased?

Unfortunately, your AMH level cannot be increased; however, you can maximize the quality of the remaining eggs by leading a healthy, balanced lifestyle and by stopping smoking, and maintaining a healthy weight. 

AMH and IVF

When it comes to IVF, AMH may be one of the initial fertility tests performed (alongside semen analysis). The AMH level is associated with the number of eggs retrieved. However, if you are in your 20’s and early 30’s, the quality of the eggs in reserve tends to be higher. 

As mentioned above, age is a significant predictor of fertility so someone in their 20’s or early 30’s with a low AMH is more likely to have a few yet good-quality eggs retrieved. Age and quality are very important, not just quantity.

Get pregnant faster with Natural Cycles

Thanks for reading up on the Anti-Müllerian hormone. At Natural Cycles we’re dedicated to increasing knowledge and awareness around reproductive health one topic at a time. 

Did you know you can also use the world’s first birth control app to plan a pregnancy? In fact, research has shown that those who use NC° Plan Pregnancy conceive in three cycles on average! How does it work? Our algorithm uses your temperature data to find your unique fertile window. Get started, or find out more about planning pregnancy with Natural Cycles today.

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