Why Should I Know my AMH Levels?
With all the lab tests and blood work you have done it can be difficult to keep track of what each one is for. One of the most important hormones to track if you struggle with infertility is AMH or the anti-mullerian hormone (more on fertility hormones here).
What is AMH?
Anti-mullerian hormone is a protein hormone found in both males and females and is produced in reproductive tissues. Soon after conception a baby starts developing reproductive organs aligned with their genes.
Males will have higher levels of AMH which keeps female sex organs from developing. In females, the levels of AMH start low to allow for reproductive organs to develop.
As a female enters puberty the role of AMH changes. At this point, the ovarian follicles begin making AMH. The more egg cells that are made the higher the level of AMH.
For females, the level of AMH in the blood can help your doctor estimate the number of follicles in the ovaries and your egg count. Your AMH levels are a good indicator of ovarian reserve.
Testing your levels of AMH is as easy as a blood test. It doesn’t matter where you are in your menstrual cycle since levels stay mostly stable throughout your cycle.
Your levels of anti-mullerian hormone do change as you age however. Levels rise throughout childhood and peak right before puberty. As a woman progresses through her most fertile years her level of AMH gradually decreases as her ovarian reserve decreases.
As you enter puberty and your reproductive years, your egg count and AMH begins to drop. After age 25 you begin to lose eggs at a higher rate. Then again at 30 and 35 the loss becomes more rapid, until you reach menopause and your egg count becomes zero. As your egg count goes down so do your AMH levels.
Levels between 1.0ng/mL and 3.0ng/mL are considered “normal” and typically mean you have a regular supply of eggs for your age. If you have levels below 1.0ng/mL you may have a diminished ovarian reserve. If you are considering getting pregnant later in life you should discuss testing your AMH levels with your doctor.
What is AMH testing used for?
Besides current egg count, AMH levels can be used to diagnose or predict several conditions:
- The reasons behind early menopause
- The causes for amenorrhea
- Help diagnose polycystic ovary syndrome (PCOS)
- Monitor the health of women suffering from certain ovarian cancers
- Predict the start of menopause
Testing AMH is very common when working with a fertility specialist. If your levels are found to be lower than what is considered appropriate for your age group you will be considered to have diminished ovarian reserve. Your doctor may recommend egg freezing if you aren’t ready to get pregnant or other fertility treatments.
Knowing your AMH levels can help understand your chances at successfully using fertility treatments for conception. If you have normal levels for your age there is a good chance that a larger number of eggs will be retrieved for freezing or IVF.
Remember, your AMH levels give you a picture of what your current ovarian reserve looks like. It cannot be used to indicate what it will look like in the future or how quickly the number of eggs available will change. However, it is a great starting point for conversations with your doctor about your fertility plans.
Causes of low AMH
Your anti-mullerian levels naturally decrease with age, but there are several other reasons for low AMH:
- Your genes could play a part in why you are losing eggs at a faster rate than the average population.
- Medical conditions. Chronic illnesses such as endometriosis and some autoimmune disorders can lead to lower ovarian reserve.
- Surgery on the ovaries. Surgical treatment for ovarian cysts, endometriosis, and other reproductive organ conditions can sometimes result in low AMH.
Can I get pregnant with low AMH?
It is possible to get pregnant naturally with low AMH, but it is less likely. Those that have low AMH are more likely to need fertility treatments to conceive. Your anti-mullerian levels can be used as an indicator for your chances of success with treatments such as IVF.
If you already have fewer eggs to retrieve for treatments your chances of successfully using those eggs is lower than if you had a large number of eggs. Every woman is different and it does happen on occasion that a woman with AMH conceives without any intervention.
Is AMH all I need to know?
While AMH is a great indicator of your current egg count and your fertility curve it can’t tell you yes or no when it comes to conceiving. It is also important to know that AMH levels don’t tell you anything about the quality of the eggs. When it comes to successfully conceiving it is often more about quality than quantity.
Knowing your AMH levels is only one piece of the puzzle and gives you important information to help make your fertility plan.
✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.
Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).