Anti-Müllerian Hormone (AMH), its relationship with ovarian reserve, and your chances of conceiving

The protagonist of today’s article is the Anti-Müllerian Hormone (AMH), well-known in assisted reproduction processes as one of the main indicators of a women’s ovarian reserve.

Next, we will deeply understand the function of this protein, the mechanisms to measure it and how to interpret its level in patients who are seeking to become pregnant.

What is the Anti-Müllerian Hormone and what is it used for?

As previously mentioned, the AMH is a glycoprotein that, in women, is produced by the granulosa cells of the ovarian follicles. This hormone has the powerful ability to serve as a biomarker of the ovarian reserve of a woman, that is to say, the quantity of eggs she has at a given time.

Knowing the levels of Anti-Müllerian Hormone allows reproductive medicine specialists to have more information about their patients’ fertility status, as well as predict their response to ovarian stimulation carried out in assisted reproduction treatments.

The AMH test, always included in ovarian reserve tests, is one of the first steps recommended by the IVF-Life fertility experts for their patients. It allows having a preliminary test, recommending other relevant tests, and establishing a treatment plan.

According to the Sociedad Española de Fertilidad o SEF, it is important to highlight that AMH levels do not indicate the quality of a woman’s eggs, but rather estimate the number of eggs that would be viable after hormonal stimulation.

How is AMH Measured and how are its values interpreted?

Measuring AMH is simple and non-invasive for the patient, as it only requires a blood test. The extraction can be done at any time during the menstrual cycle, since the ovarian reserve does not vary throughout it. However, since other hormones (such as FSH) influence AMH expression, it is always recommended to conduct the ovarian reserve study between days 3 and 5 of the cycle, at the beginning of period.

Interpretation of anti-Müllerian hormone values

The results of AMH are generally presented in nanograms per millilitre (ng/mL). Although each clinic, laboratory and even country may follow different reference values, they tend to be quite similar, with values above 1 ng/mL considered as normal. However, higher figures such as 6 ng/mL, may indicate that the patient suffers from Polycystic Ovary Syndrome (PCOS) or has a higher risk of suffering from ovarian hyperstimulation syndrome.

For these reasons, it is important that the results are interpreted by an expert team in assisted reproduction along with other relevant information, such as that obtained through ultrasound in an antral follicle count or the analysis of other hormones (FSH, LH, or oestradiol).

Anti-Müllerian Hormone and age: how are they related?

As is well-known and has been explained on numerous occasions, age is a key factor of ovarian reserve. As a woman ages, the quantity and quality of her eggs decrease, with a significant decline starting in her mid-thirties and becoming nearly depleted as she approaches menopause. Consequently, AMH levels also decrease, as illustrated in the following infographic.

In this context, it is important to emphasise that some women have low ovarian reserve regardless being young, biologically speaking. These cases are usually associated with an unhealthy lifestyle, genetic factors or specific medical reasons, such as undergoing chemotherapy treatments, having undergone ovarian surgery, or being diagnosed with certain conditions (early menopause, endometriosis, autoimmune diseases, etc.).

Can I get pregnant if my AMH is low?

In any of the scenarios stated previously, it is important to know that the experience, resources, and expertise of IVF-Life professionals have enabled hundreds of patients with low ovarian reserve to achieve pregnancy, so your case will not be any different.

Even though the prognosis of IVF treatment in a woman that presents low ovarian reserve may be less favourable, due to the low response of stimulation, our reproductive medicine experts have specific and personalised protocols to address your particular case.

For instance, having low ovarian reserve does not imply poorer egg quality. Therefore, in IVF-Life we avoid conducting massive ovarian stimulation that could potentially “stress out” those eggs that could be functional.

Properly calculating the dose of gonadotropins that each patient should administer is essential in making your success our priority, just as providing the most promising treatment. These may include ovarian rejuvenation techniques or egg donation.

While many women and couples perceive egg donation treatments as a last choice due to the stigma surrounding them and the genetic grief that is sometimes experienced, at IVF-Life we encourage you to see it as a powerful decision made by patients, like yourself, who are seeking pregnancy.

Whatever your story may be, in our fertility clinics in Alicante, Donosti and Madrid, we want to hear it.We want to listen to you, address your concerns and be part of the successful outcome we will experience together.