If you’ve ever had an AMH test and wondered how it actually relates to the health of your fertility and egg quality then you’re not alone. Anti-Mullerian Hormone (AMH) is produced by developing ovarian follicles and can be measured in the blood once a girl passes puberty.
This test can be useful in predicting the potential for a woman to get pregnant, especially as she progresses through her 30’s and even 40s, indicating how much time she may have left to conceive. However, although levels are expected to decline in relation to getting older, results can be confusing and disheartening if they are interpreted as “outside the normal range”.
As a woman ages her amount of follicles decreases. The levels of AMH being produced by developing follicles are said to reflect the pool of remaining ‘dormant’ follicles or egg supply. Therefore, as AMH can reflect the remaining follicles a woman potentially has to conceive with, it can also indicate how much time a woman may have left to get pregnant.
This doesn’t necessarily reflect egg quality, more the potential number of remaining eggs.
AMH levels are consistently stable, not being significantly affected by monthly hormone changes and therefore a test can be taken at any point in the menstrual cycle. Due to this, it is considered to be a more reliable indicator than other hormones such as FSH (Follicular Stimulating Hormone) which is tested on day 3 of the menstrual cycle and can vary due to other factors.
Women with low AMH are thought to have a lower response to IVF, because if fewer eggs mature then there are less eggs to choose from when selecting the best ones to use. It is important to remember that results do not only indicate the potential chances of success, but they can also help to guide the dosages of the stimulating drugs used within the assisted fertility cycle, helping with the response rate and therefore improving the chances of getting pregnant.
High AMH levels can indicate polycystic ovary syndrome (PCOS) or even occasionally granulosa cell tumours. This is due to having many more small follicles which usually fail to mature and reach an adequate size to stop releasing AMH.
Reading AMH levels can be confusing because there are two commonly used scales. These scales are pmol/L and ng/mL. Also, within these scales, what is considered to be “normal” can vary vastly. This is due to the relatively recent usage of AMH testing and research, which at the time of writing, hasn’t gathered enough clinical data to determine an accepted standard range.
Below is a chart of the two units and their commonly found ranges.
Remember, testing AMH is just one method used to predict a woman’s remaining egg supply.
Fertility clinics can use a combination of tests as none of them are perfect and what is considered normal can vary. The ranges can differ so slightly that you can find yourself just within or outside a certain bracket. Think of it as a sliding scale between high and very low and most importantly it’s not necessarily a reflection of egg quality, more the potential eggs remaining.
Further reading on AMH
Anti-Müllerian hormone - Wikipedia
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