AMH, or the Anti-Mullerian Hormone is a protein hormone that is secreted by the developing egg sacs or ovarian follicles. This test helps in assessing the ovarian reserve – or the number of eggs left in the ovaries – of a woman. Low AMH count indicates a declining level of fertility. However, this can be addressed with a combination of options.
When Do You Take the Test?
The AMH test is prescribed when a woman has been trying unsuccessfully to conceive over six months. This test is also recommended before the start of any fertility treatment. AMH level does not change during the menstrual cycle and can be taken at any time. The test requires a blood sample which is analyzed in a laboratory.
Reading the Test Results
Higher AMH level indicates a higher number of eggs in the ovaries. Conversely, a lower number indicates a lesser number of eggs in the ovaries. With age this number keeps reducing, indicating reduced fertility. Low AMH may not be a cause of reduced fertility – this is merely a test which assesses a woman’s ovarian reserve. Reduced reserve means that with fewer eggs in the ovaries, the chances of a healthy egg being released for fertilization decreases.
The “normal” level for every age is variable, and you should compare your test result with what is normal for your age. Typically, the AMH level of 1.0 – 3.0 ng/ml is considered “normal” for a fertile woman. A count of less than 1.0 ng/ml indicates a reduced ovarian reserve. A very low AMH count is common in women approaching menopause.
While age is the primary factor that impacts AMH level, stress, improper nutrition, vitamin deficiency and cancer treatments such as chemotherapy and radiation could also play a role in decreasing one’s AMH level.
The test does not assess the quality of the eggs and cannot predict the chances of natural conception or success of any form of fertility treatment.
Treatment Options for Low AMH
Mostly a low AMH level is not reversible, so for those who wish to conceive, doctors suggest using assisted reproductive technologies.
- For women who do not wish to conceive immediately, fertility preservation, where they can freeze their eggs for future is recommended.
- Based on the doctor’s estimation, if your AMH level is sufficient for an IVF cycle, then IVF is recommended. Here the egg is retrieved (after stimulation) via the egg retrieval procedure, and fertilized in a lab, and implanted into the woman’s uterus. Your IVF clinic should assess other pre-existing conditions including PCOS, endometriosis and cysts before starting the IVF procedure.
- If a regular IVF cycle proves to be unsuccessful or your doctor does not recommend it, the next suitable option would be an egg donation. Here, the egg is donated by another donor, and the embryo is implanted back into the woman’s uterus.
Improving the Health of Your Ovarian Reserve
While the ovarian reserve itself may not improve naturally, a healthy lifestyle will impact the quality of the eggs.
- You can test for vitamin D, and speak to your doctor about supplementation. Often doctors recommend multivitamin supplementation before starting IVF.
- Avoid stress! Try to work on meditation techniques to keep stress at bay. Get sufficient rest, sleep well, and take better care of yourself.
- Watch your diet. Speak to a nutritionist to understand more about fertility superfoods. A balanced diet with a good serving of fruits & vegetables is recommended.
- Get moderate exercise into your routine. This will also help you to de-stress.
Finally, if you have shown a low AMH level in your test consult with a fertility specialist to discuss further options. There are multiple options available which have clinically proven to be successful.