Is it possible to get pregnant with high AMH levels?

Author: Dr. V Ramya, Consultant & Fertility Specialist

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?

Also known as MIS – Mullerian Inhibiting Substance, it is an essential hormone for male and female genital development during the fetal 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.

Uses of AMH testing

· Although measuring AMH levels can shed light on a range of 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.

· It also helps in predicting the outcome of fertility treatments like IVF and IUI.

· Predicts the beginning of menopause.

What are the normal AMH levels?

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. Hence low levels of AMH indicate low egg reserve and vice versa.

Standard levels are variable. Below are general ranges for AMH levels.

· Average: Between 1.0 ng/mL to 4.0 ng/mL (approximately).

· Low: Under 1.0 ng/mL

· Extremely low: Below 0.4 ng/mL

AMH levels as per age groups:

Below are the approximate minimum levels for each respective age group.

· 25 years old: 3.0 ng/mL.

· 30 years old: 2.5 ng/mL.

· 35 years old: 1.5 ng/ mL.

· 40 years old: 1 ng/mL.

· 45 years old: 0.5 ng/mL.

AMH levels and pregnancy:

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.

Is high AMH a good thing?

Although, high AMH levels are associated with a good ovarian reserve and the presence of a large number of eggs, it does not signify the quality of the eggs which is also an important factor that plays a role in conceiving and the outcome of a fertility treatment. 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 indicate polycystic ovary syndrome (PCOS) a hormonal condition characterized by the presence of fluid-filled sacs in the ovaries which trigger high production of AMH.

In the case of egg freezing, high AMH levels can make you more susceptible to developing ovarian hyperstimulation syndrome (OHSS).

High AMH levels are also characteristic of certain cancers of the female reproductive system like ovarian cancer, and granulosa cell tumors.

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 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.