While planning for a pregnancy, various factors like fertile window, ovarian conditions, egg and sperm health, and hormones play a role in conception. One such hormone of significance is AMH or Anti-Müllerian Hormone.
Firstly, what is AMH?
Anti-Müllerian Hormone (AMH) is a marker of ovarian reserve. Both high and low AMH can influence fertility, but the effect depends on age, egg quality, and whether pregnancy happens naturally or through IVF.
It is also known as MIS – Mullerian Inhibiting Substance, it is an essential hormone for male and female genital development during the foetal stage.
AMH is produced in the testicles by men. With concern to males, it is of no clinical importance.
In women, AMH is produced in the ovarian follicles. It helps in the growth and maturation of ovarian follicles.
AMH Testing – All You Need to Know
AMH test is a blood test. A blood sample is taken and processed to test for AMH levels. AMH testing can be done at any point of time in the month as AMH levels do not change with the menstrual cycle.
Although measuring AMH levels indicates female reproductive health issues like PCOD, AMH is essentially employed as a biomarker for measuring ovarian reserve. It is used to estimate the approximate number of eggs remaining in the ovaries.
- AMH testing helps in decision-making for women considering freezing their eggs.
- Lack of menstrual cycle (amenorrhea) in teenage girls can be diagnosed by monitoring AMH levels.
- Predicts the beginning of menopause.
Normal AMH Levels in Women
Here’s what you must watch out for when you receive the results after your blood test and understand what they mean:
| AMH Level (ng/ml) | Meaning | Fertility Implication |
| Below 1.0 | Low AMH | Reduced ovarian reserve and harder to conceive naturally. |
| 1.0 – 3.5 | Normal AMH | Good ovarian reserve with better natural fertility chances. |
| Above 4.0 | High AMH | Often linked with PCOS and may cause irregular ovulation. |
How Do AMH Levels Change with Age?
AMH levels are evaluated based on the age group of the woman. During adolescence, AMH levels start increasing and peak at the age of 25. AMH levels decline naturally in every woman with increasing age.
| Age (Years) | Average AMH Level (ng/mL) |
| 25 | 3.0 ng/mL |
| 30 | 2.5 ng/mL |
| 35 | 1.5 ng/mL |
| 40 | 1.0 ng/mL |
| 45 | 0.5 ng/mL |
AMH levels affect the chances of pregnancy. Any woman in the fertile age group of 25 – 30 years old and with an AMH reading of 2.5 ng/mL to 3.5 ng/mL has a better chance of having a pregnancy than older women and women with lower AMH levels.
High AMH Levels: Causes and Effects
High AMH levels are caused due to the following factors:
- Polycystic Ovary Syndrome (PCOS) is the most common cause, where multiple small follicles in the ovaries release excess AMH.
- Ovarian hyperstimulation is sometimes seen during fertility treatments when the ovaries produce more follicles than usual.
- Certain ovarian tumors like granulosa cell tumors can increase AMH levels.
- In some women, naturally higher follicle activity may cause high AMH levels without any underlying disorder.
Although, high AMH levels are associated with a good ovarian reserve and the presence of several eggs, it does not signify the quality of the eggs.
AMH levels can’t be used to evaluate the quality of eggs. Increased AMH levels don’t necessarily lead to good chances of pregnancy. Any AMH reading above 4.0 ng/mL is abnormally high and is a matter of concern.
- Abnormally high AMH levels face irregular ovulation, but with proper treatment such as ovulation induction, IVF, or lifestyle modifications, pregnancy is still possible.
- High AMH levels are also characteristic of certain cancers of the female reproductive system like ovarian cancer, and granulosa cell tumours.
Low AMH Levels: Causes and Effects
Low AMH levels indicate a low or decreased number of eggs in the ovaries. Fewer number of eggs means there is a low chance of getting pregnant naturally. Here are a few reasons for low AMH levels:
- Age: As the number of eggs decreases with the increasing age, the AMH levels too start to drop drastically and reduces the chances of getting pregnant.
- Diet: Following a diet that includes processed sugars and fats affects the egg quality and impacts AMH levels along with other reproductive issues. Vitamin deficiency such as Vitamin D deficiency also affects fertility and AMH levels.
- Stress: It is a leading cause of infertility among women. A healthy and peaceful state of mind is essential for women who are trying for a pregnancy. Managing stress has improves AMH levels and conception chances.
- Medical Issues: It can impact the reproductive system and affect AMH levels. Hormonal imbalances due to sedentary lifestyle and stress lead to decreased AMH levels. Women with a genetic history of cancer, ovarian disorders, and early menopause are at a high risk of having low AMH levels.
AMH levels below 1.0 ng/mL is a red flag and here’s what can happen:
- Women with low AMH may produce fewer eggs during IVF stimulation cycles.
- Persistently low AMH can be a sign of ovarian aging and earlier menopause.
- Fewer eggs available for preservation makes egg freezing very difficult.
- IVF and IUI success rates may be impacted if egg quality and quantity are both low.
- In severe cases, women may need to consider donor eggs to achieve pregnancy.
High v/s Low AMH Levels
Let’s do a quick comparison to understand what high and low AMH levels mean:
| AMH Level Range | What It Means | Implication for Pregnancy |
| Low AMH (<1.0 ng/ml) | Fewer eggs, diminished ovarian reserve | Natural conception chances are lower, but IVF or assisted methods may help |
| High AMH (>4.0 ng/ml) | Often linked with PCOS, more follicles but irregular ovulation | Pregnancy is possible; IVF may need careful monitoring to avoid overstimulation |
What Is the Importance of AMH levels in IVF?
IVF is not only about the quality of eggs, but also about the number of eggs that can be retrieved for fertilization. During the IVF process, AMH levels are assessed to get a clear picture of the egg number and the ovarian age of a woman.
It reveals how well you are likely to respond to the fertility medications that are used to stimulate the ovaries to produce multiple mature eggs. It also helps in deciding the treatment course along with an estimation of the chances of having a pregnancy.
Lifestyle Changes to Improve and Maintain AMH Levels
Here are a few tips you might want to consider improving and maintaining your AMH levels:
- Maintain a healthy body weight.
- Limit coffee, alcohol, and tobacco intake.
- Eat antioxidant-rich foods like berries, leafy greens, and nuts.
- Consider supplements like Vitamin D, CoQ10, or omega-3 (after medical advice).
- Manage stress.
- Consider taking fertility supplements (Under a doctor’s supervision).
- Reduced intake of refined products.
Take away
AMH levels alone don’t decide your fertility status. Other associated reproductive factors such as uterine status, tubal health, sperm factors, and underlying medical conditions also contribute to conception.
On the optimistic side it is safe to say that even with fewer chances of conceiving, one can still get pregnant with a low egg count or low levels of AMH.
At Oasis Fertility, we offer advanced diagnostic tests and personalized fertility treatments for women. If you are concerned about your AMH levels or fertility, call us at 1800-3001-1000 or connect with our experts through live chat for guidance and support.