Assessing your fertility: how does AMH help?
AMH, or Anti-Mullerian Hormone, is a hormone produced by the granulosa cells that take care of a woman’s eggs. So the higher the quantity of eggs, more will be the granulosa cells, which implies a higher level of AMH in the blood. AMH hormone level is used to estimate a woman’s ovarian reserve, and it will differ with age and from woman to woman. Typically, AMH levels above 1ng/ml signify a normal ovarian reserve, and lower than that imply low ovarian reserve. We know that a woman’s fertility decreases with age, and hence the AMH level will also decrease with age.
How can AMH levels help check the ovarian reserve?
AMH is only produced in small ovarian follicles, and hence the level of AMH can indicate the size of the total pool of follicles which have the potential to release a mature egg. Studies show that the size of the pool of primordial follicles (follicles which are “sleeping”) heavily influences the size of the pool of growing follicles. Hence, the AMH levels can help estimate the size of the remaining egg-supplying follicles, also called the “ovarian reserve”. Women with polycystic ovarian syndrome (PCOS) have higher number of microscopic follicles, and hence have a higher level of AMH. Women close to their menopause, or with fewer number of follicles will have low levels of AMH.
What can AMH measure?
AMH is a great indicator of a woman’s ovarian reserve. It gives a picture of what your fertility profile looks today. It can also play a role in setting realistic expectations of how many eggs can be retrieved or how your follicles respond to medication should you wish to go ahead with in-vitro fertilization (IVF) treatments or egg freezing.
What can AMH not measure?
AMH is not a predictor of how easily a woman can conceive now or in the future. Research has shown that women with low levels of AMH and those with normal levels of AMH have very little difference in their pregnancy rates. So even if you get a low level of AMH, it does not signify that you cannot conceive naturally. Conversely, if you have a normal level of AMH, it does not mean it will stay at that level in the future. Your age is a major influence on your egg quantity and hence the level of AMH hormone.
AMH also does not tell anything about the quality of eggs either. Egg quality could be adversely impacted due to lifestyle choices like smoking, exposure to radiation during cancer treatments or while working or due to occupational hazards such as exposure to certain chemicals.
What can you do right now?
We, at Proactive, are big proponents of women getting educated about their fertility so they can proactively take decisions about their fertility on their own terms. Taking our fertility test will help you assess your AMH levels, along with other hormone levels, at your current stage in life. It will help you start discussions with the doctor on what you can do right now.
It is important to note that while this test will help you check your current ovarian reserve, it can in no way predict how your ovarian reserve will look in the future or at what rate it will decline.