An Anti-Mullerian Hormone (AMH) test is used to gauge ovarian reserve and glean insights into fertility issues. Here’s what AMH readings mean, and why low levels needn’t be a source of worry.
Anti-Mullerian Hormone (AMH) is often brought up when discussing female fertility. By measuring AMH levels your fertility specialist can gauge how many potential egg cells you have remaining.
This information is certainly useful for couples facing fertility challenges, but take heed that AMH test results by themselves are not indicative of your ability to get pregnant.
So what is AMH exactly, and what does it mean if your levels are low?
The role of AMH in female fertility [1]
AMH is secreted by granulosa cells in the ovarian follicles (small, fluid-filled sac that contain immature eggs), and the amount of the hormone produced decreases as the follicles grow. When follicles reach 8mm in diameter, AMH production ceases.
Low levels of AMH tells us that there are lower antra follicular counts — and therefore, lesser potential eggs — remaining [8]. Indeed, this is confirmed by observations that AMH levels among women naturally decline with age.
For this reason, readings of AMH levels are used to gauge an individual’s ovarian reserve (or ‘egg count’), and low levels of AMH can indicate that your supply of eggs is running low. This information can be valuable in alerting you to take action early to head off potential challenges in getting pregnant later.
However, AMH levels only tell you the quantity of eggs remaining, and nothing about the quality. This means AMH test results don’t provide the full picture when it comes to your chances of getting pregnant.
AMH and Follicle Stimulating Hormone (FSH) [2]
On a related note, another reproductive hormone besides AMH is also used as a marker of your ovarian reserve.
FSH is released by the body to stimulate ovarian follicles to grow and mature, culminating in the release of a mature egg (ovulation). When young and with abundant follicles to choose from, only a small amount of FSH is required for ovulation to take place.
However, with age, or decreased ovarian reserves (i.e., lesser follicles available), it takes a higher amount of FSH to cause a follicle to grow, mature and release an egg.
As such, high levels of FSH at the beginning of your menstrual cycle may indicate diminished ovarian reserves, just as low AMH levels can.
Can you still conceive if you have low AMH levels [3]?
Yes, you are still able to conceive naturally even if you have low AMH. After all, you only need 1 healthy egg to have a successful pregnancy, and having a lower quantity of eggs remaining needn’t be an issue as long as the eggs are of good quality.
However, having a smaller ovarian reserve may mean that you have a shorter timeframe to have a baby through natural methods. In comparison, someone who has a higher egg count, is likely able to wait a longer time before getting pregnant.
How do you test for AMH?
AMH is present in the blood, and remains more or less at constant levels throughout the ovulation cycle. As such, an AMH test may be performed using a blood test at any time, without any special preparation beforehand [4].
As AMH levels vary by age, it is important to have the test done with the help of a medical professional who is able to interpret the results in your context. Finger-prick tests that only indicate a binary ‘normal/abnormal’ reading for AMH levels are unlikely to offer much useful or relevant information [5].
For a more detailed assessment, an AMH test should be performed the traditional way — with a blood sample drawn from the vein, and sent to a lab for a thorough and accurate measurement. Of course, this would require a trip to the doctor’s office.
For those who want a detailed reading of their AMH levels, but prefer the privacy and comfort of giving blood in their own homes, consider the twoplus Fertility Hormone Test Kit.
Once you’ve ordered the Hormone Test online, our phlebotomist will pay you a visit at a time and place of your choosing for a quick blood draw, and deliver your samples to a certified lab on your behalf.
Designed to provide a clear view of your reproductive health, our Hormone Test Kit tests for key fertility hormones, such as AMH, FSH, and Thyroid-Stimulating Hormone (THS). Simply order the hormone test online and you'll receive your personalised report soon after.
What can an AMH test tell you? [4]
Why you’re facing difficulty conceiving
As explained earlier, your AMH levels can indicate the status of your ovarian reserve, providing clues as to why you may be finding it difficult to get pregnant on your own.
The insights gleaned from an AMH test (along with others) can help your healthcare provider formulate a more targeted fertility treatment plan.
How your body might respond to IVF
Measuring your AMH levels will also be helpful in determining how you might respond to IVF treatment, part of which involves ovarian stimulation to produce mature eggs that can be harvested for fertilisation, or cryogenically preserved for the future.
AMH readings can also help your fertility specialist titrate an appropriate level of fertility medications to enhance your results.
Whether you have PCOS
Polycystic ovary syndrome (PCOS) is a common hormonal disorder, and is often indicated by high levels of AMH. Your doctor may use AMH tests to help diagnose and monitor the condition as part of your fertility care treatment plan.
What is a normal AMH level [6]?
The following figures are estimates of normal AMH levels by age.
|
Age |
AMH level (ng/ml) |
|
25 |
3.0 |
|
30 |
2.5 |
|
35 |
1.5 |
|
40 |
1.0 |
|
45 |
0.5 |
It is worth bearing in mind that low AMH levels on their own do not automatically mean you are infertile. A 2017 study involving 750 women between 35 and 44 years old who had no history of infertility found no difference in pregnancy outcomes between those with normal AMH levels and those with low AMH levels [7].
AMH levels may offer clues to fertility challenges
Your AMH levels are not the only (or the most crucial) factor in pregnancy.
Remember that having low AMH alone does not make it more unlikely for you to have a child, although your readings can help you decide whether you should put off your pregnancy to a later date.
Additionally, knowing your AMH levels can offer some insights and clues if you've been facing fertility challenges. An AMH test can help your fertility specialist determine how well you will respond to IVF treatments, and may be helpful in determining an appropriate dosage of fertility drugs to be used.
In conclusion, knowing your AMH levels are simply another data point in the myriad combination of factors to be considered as you embark on your pregnancy journey, and are best taken in the context of your overall circumstances.
Are you taking too long to conceive? Check out our Getting Pregnant 101 Guide for must-know TTC tips below & above 35 years old.