Anti-mullerian hormone or AMH is produced by granulosa cells (cells lining the egg sacs or follicles) within the ovary. Testing a woman’s AMH levels is one of the many valuable tools employed here at Hellobaby’s partner fertility clinics to estimate how many eggs a woman has remaining, also called ovarian reserve.

AMH can also help reproductive endocrinologists predict a woman’s response to ovarian stimulation and to determine the best strategy for IVF treatment.

Who can benefit from AMH testing

  • Women over 36 not able to conceive after 6 months of trying
  • Women under 36 who have been trying to get pregnant for about 12 months
  • Patients considering IVF or egg freezing, as low levels of AMH can indicate a potentially poor response to ovarian stimulation
  • Women who have had chemotherapy or radiation to the pelvic region who want to know if it has affected their future fertility

How to test AMH

Your primary care physician, OB/GYN, or reproductive endocrinologist can order AMH testing. This is a simple blood test.Unlike other hormones, AMH levels do not fluctuate during the menstrual cycle, so the blood sample can be taken at any time of the month.

AMH test results

As a general guideline, the following levels (in nanograms per milliliter) represent the lower limit of serum AMH values by age:

  • High levels are above 5.0 ng/ml.
  • Borderline high is between 3.5 ng/ml to 5.0 ng/ml.
  • Normal is between 0.7ng/ml to 3.5ng/ml.
  • Borderline low is between 0.3 ng/ml to 0.7 ng/ml.
  • Low levels are below 0.3 ng/ml.

The above levels are considered conservative estimates, and the cutoffs also depend on the lab. Any results should be reviewed with the doctor who ordered the test.

A high level alone cannot diagnose PCOS since AMH levels typically decrease with age. As such, doctors will compare a woman’s age with the AMH results and use those to help make a diagnosis.

Low AMH is an indicator of low ovarian reserve, meaning that the patient is producing few eggs that can be used for fertilization later on. When trying to conceive naturally or with fertility treatments like in vitro fertilization, a woman with low AMH levels will have lower chances of conceiving. In addition, AMH test results that come back low usually indicate poor egg quality. This is because egg quantity and egg quality typically go hand in hand. In combination with other tests and clinical history, the Hellobaby’s partner fertility clinics’ IVF specialist will be able to best advise you on how your AMH levels affect your own personal fertility chances — and what can be done about it.

Relation of AMH to FSH

Follicle stimulating hormone (FSH) is made by your pituitary gland and is involved in sexual development and functioning. FSH stimulates the eggs in the ovary to grow, which causes estrogen and later progesterone to rise. A higher FSH usually indicates low ovarian reserve, while a lower AMH indicates low reserve. While FSH can be a helpful tool, most experts agree that AMH may be a more reliable predictor of ovarian reserve because the levels stay consistent throughout the menstrual cycle — and from cycle to cycle.

Low AMH fertility treatment

Women with low AMH typically benefit the most from well-managed IVF protocols. Treatment plans for these patients most likely involve DHEA supplementation, which has been shown to be effective in improving IVF pregnancy rates when AMH is low. While, unfortunately, not everyone becomes pregnant with their own eggs, if the AMH levels and ovarian reserve are so low that this form of intervention is unlikely to succeed, the IVF specilist may advise the use of egg donation.

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