16 April 2018
10 things to know about AMH
1 What is AMH?
The Anti-Mullerian Hormone (or AMH) is produced in a woman’s ovaries by the primary follicles (small clusters of cells that surround immature eggs). Levels of AMH can give you an indication of your ovarian reserve (ie how many eggs you have left) compared to other women of a similar age.
2 Why is it important?
Unlike men, who continually produce sperm, women are born with their lifetime supply of eggs. It can be important to know what your ovarian reserve is when considering having a baby. However, it is also important to remember that an AMH level does NOT predict your chances of a natural conception in the near future.
3 What is the AMH test?
It’s a hormonal blood test that estimates the number of eggs at left in a woman’s ovaries. This gives your fertility specialist a good idea of what the ovary is capable of, how suitable you are for certain fertility treatments (such as IVF and egg freezing) and how successful those treatments are likely to be.
4 Who should have an AMH test?
Women planning IVF or fertility treatment will usually have an AMH assessment, alongside other markers of ovarian reserve such as an ultrasound antral follicle assessment. It creates the opportunity to personalise a strategy to achieve the best possible outcome.
5 What factors contribute to a low AMH?
Age affects every woman’s AMH level, plus every woman starts out with a different number of eggs. However, whatever a woman’s starting point, her ovarian reserve will dramatically reduce over time. Eggs are steadily lost until the age of 30, at which point the rate of loss increases, and accelerates even further after 35 years. There are some circumstances where a low AMH level is inaccurate, such as when AMH is measured in women using the pill or who have hypothalamic dysfunction.
6 How are the results of the AMH test measured?
An AMH test is not a measure of egg quality but of quantity – and can indicate how many eggs can be expected to develop in a fertility treatment cycle. It is important to interpret the AMH result in context of other factors that influence fertility.
7 What is a healthy range for an AMH test?
AMH levels can vary widely, even amongst fertile women. Interpretation of the AMH level should be considered in the context of a woman’s holistic situation and her plans for future fertility. A low AMH should not necessarily be considered as a stand-alone concern, and is not associated with a reduced monthly chance of getting pregnant. However, if a woman has many factors affecting her infertility, a low AMH can reduce her chance of having a baby. A low AMH can also influence whether or not a woman is a good candidate for preventative strategies like elective egg freezing.
8 What can a woman do if she has a low AMH?
There is no known therapy that can increase the number of eggs in the ovary. What we can do is take proactive action. If a patient comes to clinic with a low AMH and has presented a history of infertility, more advanced treatment would be advised sooner. Proactive family planning strategies, such as frozen embryo banking if she wishes to have more than one child in the future, would also be advised.
9 How can I determine the quality of my eggs?
Age is the best indicator of egg quality. Other lifestyle factors such as being overweight, smoking and exposure to environmental toxins might affect a woman’s egg quality. Over time, eggs can become metabolically fatigued which makes them more prone to genetic changes.
10 How do I get an AMH test?
Any woman who wants to know more about her fertility should seek advice from a specialist. Your GP can refer you, or get in touch with the clinic directly. And remember, AMH is not a standalone measure of a woman’s current or future fertility. The result should be interpreted in the context of an individual and her plans for future fertility, as a part of a comprehensive assessment with a fertility specialist.