What is the Anti-Mullerian Hormone (AMH)?

The anti-mullerian hormone (AMH) plays a key role in determining a baby’s gender organs and their proper development in the womb. The cells inside the follicles of the ovaries produce this hormone. Follicles are tiny fluid-filled sacs in the ovary that contain and release eggs. 

What is the Anti-Mullerian Hormone (AMH)?  

If you’re waiting to get pregnant, you may hear your doctor mention the anti-mullerian hormone. This hormone plays a key role in the development of your baby’s gender organs while in the womb.  

The hormone surrounds growing eggs in your ovaries. The more follicles you have, the more AMH is secreted. So, AMH levels correspond to the number of eggs you have or your ovarian reserve. Higher AMH levels mean more eggs and a higher ovarian reserve. Lower AMH levels mean fewer eggs and a lower ovarian reserve. 

How do High & Low AMH Levels Affect Fertility?  

AMH levels can be an indicator of how ‘active’ your ovaries are. As you age, the natural pool of potential eggs you have in store begins to decrease and as this happens there will be fewer preantral follicles produced, which means less AMH will be released. A low AMH level reading can be indicative of a smaller pool of potential eggs. 

A low AMH level is a sign that the reserve of potential eggs is low. When there are fewer potential eggs in the ovaries, the chance of pregnancy is therefore lower. 

Connection between AMH and IVF  

Wondering why is your IVF treatment specialist is talking about AMH levels? An anti mullerian hormone test, which is a blood test, gives the doctor an idea of the number of eggs in your ovaries. This will allow your IVF process to be tailored to your needs. 

AMH and Egg Retrieval  

There is a direct relationship between AMH levels and the number of eggs that can be retrieved during the IVF process for freezing. While higher AMH levels indicate more eggs can be retrieved, there are several other factors that determine the number and quality of eggs, including your age, overall health, and family history. 

AMH, IVF, and Age  

AMH levels tend to decline with age. This means the ovarian reserve for women in their 20s is higher than for those in their 30s or 40s. Here are some estimates: 

• 25 years: 3.0 ng/mL.  
• 30 years: 2.5 ng/mL. 
• 35 years: 1.5 ng/ mL. 
• 40 years: 1 ng/mL. 
• 45 years: 0.5 ng/mL. 

Since higher AMH levels indicate more eggs, this improves the chances of success of the IVF treatment. This means the IVF process works better for women in their 30s than for those in their 40s.  

One thing to note here is that AMH levels being abnormally high is also not a good sign. In fact, it indicates the possibility of polycystic ovary syndrome (PCOS). 

How does Nutrition have an impact on AMH levels?  

What you eat has a significant impact on your body, including the AMH levels. Here are a few tips for those who have low AMH levels: 

• A diet that is rich in antioxidants can help to make your AMH level high. Antioxidants are found in foods like berries, green leafy vegetables, and nuts. 
• Protein is essential for growth: If you’re a vegetarian, ensure you have sufficient quantities of lentils (daal) and cottage cheese (paneer). If you’re not a vegetarian, add eggs, fish and lean meat to your daily diet. 
• Healthy fats are a must for women with low AMH levels. Omega-3 fatty acids are found in fish, avocado, and nuts. 
• Avoid processed foods as these typically cause a spike in your sugar levels. They also have too much unhealthy fats. 
• Whole grains can also help to make your high AMH levels high. 

Here are some other foods that help improve your AMH levels: 

• Avocado: Improves egg health 
• Ginger: Reduces inflammation of reproductive organs 
• Berries: Protects the egg from free radicals 
• Sesame seeds: High in zinc and improves egg health 
• Zinc: Improves reproductive health 
• Oats/Banana/Eggs: High in vitamin B6 

Vitamin D & AMH  

Vitamin D regulates AMH levels in vitro, both directly through the AMH promoter and indirectly by controlling the number of granulosa cells and AMH signaling in the culture of the ovarian follicles. 

Foods such as milk and dairy products, fish, soybean, and eggs help increase the levels of Vitamin D in the body. 

A person should have 10-15 minutes of exposure to direct sunlight to produce Vitamin D naturally. 

How are AMH Levels Diagnosed?  

An anti-mullerian hormone test measures the amount of AMH in a blood sample. Once the blood sample is sent to the lab, it may take a couple of days to get the results. The IVF treatment specialist may wish to check the AMH levels of your partner as well. 

When Do You Need an Anti-Mullerian Hormone Test? 

A test to know the anti mullerian hormone levels is typically done for one of the following reasons: 

• If you are above 35 years and planning to conceive, your doctor may suggest this test to check your ovarian reserve. 
• When considering IVF or IUI treatment, the anti-mullerian hormone test can indicate the changes of getting pregnant, as low AMH levels indicate fewer eggs in the ovaries.  
• Women taking strong medication, undergoing chemotherapy or have had an ovarian surgery may get this test done to determine impact on fertility. 
• Abnormally high AMH levels indicate PCOS. 

Conclusion 

AMH is secreted by cells inside the follicles of your ovaries. A higher AMH level indicates more eggs in the ovaries, increasing the chances of success of IVF treatment. The normal AMH levels vary with age and depend on various other factors like overall health and family history. 

FAQs 

Can low AMH levels be improved or increased? 

You can improve your AMH levels by: 

• Eating a healthy and balanced diet 
• Adding antioxidants like berries and green leafy veggies to your diet 
• Making efforts to keep stress low 
• Quitting smoking 
• Avoiding alcohol 
• Taking vitamin supplements 

Are low AMH levels reversible with treatment? 

AMH levels decline naturally with age, which is why low AMH levels cannot be completely reversed. IVF treatment can help to slow down the process.