One of the first steps in a fertility workup is to measure markers that indicate how many eggs you have. One of those markers is anti-mullerian hormone (AMH). What does AMH tell you about your fertility? Here’s what you need to know.
What is anti-mullerian hormone (AMH)?
Anti-mullerian hormone is a hormone secreted by the supportive cells surrounding the eggs in your ovaries. The more eggs available, the higher the amount of AMH produced.
How do you test AMH?
Testing AMH is as simple as rolling up your sleeve for a blood test. Your doctor can test AMH at any point in your menstrual cycle since the measurement remains relatively stable throughout that cycle.
What do AMH levels tell you about your fertility?
The number of eggs in a woman's ovaries is referred to as "ovarian reserve," and AMH level is one data point that your doctor can use to get a sense of yours. In general, as women age, their ovarian reserve diminishes and AMH levels decrease until menopause occurs.
Having low AMH doesn’t necessarily mean that you won’t be able to get pregnant though. It just suggests that you may have a bit less time to work with in terms of trying to conceive. Measuring it can also help inform fertility treatment options.
What is a normal AMH level?
There are age-specific averages for AMH levels, but in general, an AMH level more than 1.0 nanograms per milliliter (ng/mL) is considered "normal."
What is a low AMH level?
AMH levels under 1.0 ng/mL are usually considered low, suggesting a somewhat depleted supply of eggs. AMH levels less than 0.1 ng/mL may indicate a woman is starting menopause.
Can you still get pregnant with low AMH?
Yes! Many women with low level AMH levels get pregnant naturally. It's just one number your doctor will check during a fertility workup among many others.
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Can you improve your egg quality or your anti-mullerian hormone level?
A number of supplements, like antioxidant coEnzyme Q-10 (CoQ1O) and DHEA, have been touted as a possible way to boost ovarian reserve, but there’s no reliable science to back up those claims.
Some have suggested that there may be a relationship between adequate levels of vitamin D and a higher AMH level, but again, there’s no data confirming that taking vitamin D supplements increases AMH levels or improves egg quality.
Causes of low AMH
There are a few possible causes of low AMH, including:
- Age. Your age is the primary reason for low AMH. As you get older, your ovarian reserve — and your AMH levels — naturally decline.
- Your genetic profile. Your DNA could be a factor for why your body is depleting eggs at a faster rate than the average woman your age.
- Certain medical conditions. Women with chronic illnesses like endometriosis may have lower ovarian reserve. Some autoimmune conditions, including autoimmune thyroid disease, may also factor in.
- Surgery for ovarian cysts or endometriosis can also sometimes cause low AMH.
- A history of radiation or chemotherapy may lead to a low AMH and early menopause.
At your preconception checkup, your doctor may recommend a blood test to measure AMH and other markers such as follicle-stimulating hormone (FSH) and estradiol. That, along with other factors, will help piece together a picture of a woman's fertility.
Keep in mind that your AMH level and other fertility tests won't tell the whole story with 100 percent accuracy. If you have any concerns, talk to your doctor, and if necessary establish a plan to work with a fertility specialist if you are having difficulty conceiving.
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