Tag: AMH ovarian reserve

AMH (anti-Müllerian hormone) is a hormone made by the small, developing follicles in your ovaries. Measured with a simple blood test, and is a marker of your ovarian reserve or broadly, how many eggs you have left. It reflects egg quantity, not quality, and it’s one important piece of your wider fertility picture, not the whole story. If you’ve come across it while looking into your fertility, egg freezing, or “checking your egg count,” you’re in the right place. Here’s what AMH actually is, what your result can and can’t tell you. Quick facts: What is AMH? Anti-Müllerian hormone (AMH) is made by cells surrounding the small, developing follicles in your ovaries. Each of these follicles contains an immature egg. Because the number of these follicles is related to the size of your remaining egg pool, the amount of AMH in your blood can provide an indication of your ovarian reserve. Think of AMH as an indirect marker rather than an egg counter. It cannot tell you exactly how many eggs are left in your ovaries, but it can help show whether your ovarian reserve appears higher, lower or around what would be expected for your age. You’re born with all the eggs you’ll ever have, as we age, both our egg quality and quantity declines. As the pool shrinks, so does your AMH, which is what makes it such a useful window into where your reserve sits for your age. What is a normal AMH level for my age? There is no single normal AMH level that applies at every age. AMH naturally declines as you get older. A level that might be considered relatively low for someone in their 20s could be entirely expected for someone in their early 40s. That means the most useful question is not if you levels are good or bad, but more about how your levels compare with what is expected for someone your age? Broadly, AMH is higher in your twenties and declines through your thirties, with a steeper drop from the mid-thirties onwards, though there’s wide natural variation, and some people have a lower reserve earlier than expected. AMH results are also assay-specific. Different labs use different testing platforms, and because there’s no single international standard for calibrating AMH, a number from one lab can’t be directly compared to a number from another. This is why a result is only meaningful when it’s read against the reference range of the exact lab that ran it. At Hertility, AMH is interpreted using age-stratified reference ranges, so your result is compared with the expected range for people of a similar age rather than against one universal cut-off. Your result should also be interpreted alongside factors such as your cycle history, symptoms, hormonal contraception, medical history and fertility goals. How does AMH change with age? AMH is generally highest earlier in reproductive life and decreases as the ovarian follicle pool declines with age. There is, however, a lot of variation between individuals. Two people of exactly the same age can have quite different AMH levels without either necessarily having a reproductive health problem. This is why age matters so much when interpreting AMH. AMH also shouldn’t be confused with egg quality. Although both egg number and egg quality decline with age AMH measures the follicle pool. It does not tell us whether the eggs within that pool are chromosomally healthy. What does a low AMH level mean? A low AMH result means your ovarian reserve appears lower than expected for your age. It does not mean that you cannot get pregnant. This distinction is really important. AMH is much better at predicting how your ovaries may respond to fertility medication than it is at predicting whether you will conceive naturally. Current NICE guidance specifically says AMH should not be used to predict the chance of pregnancy through spontaneous conception. Instead, AMH or an antral follicle count (AFC) can be used to predict ovarian response when planning assisted conception. So if your AMH is low, it may mean that fewer eggs would be expected to develop during an IVF or egg-freezing stimulation cycle. Depending on your age and plans for pregnancy, it may also be useful information when thinking about fertility timelines. But it does not tell us whether the eggs you have are healthy, whether you are ovulating, whether your fallopian tubes are open, whether there are any issues affecting your uterus or, where relevant, whether sperm factors could affect conception. Does low AMH mean I can’t get pregnant? Many people with low AMH conceive naturally and without difficulty, particularly when they are younger and their egg quality is high. What low AMH does mean is: It tells you that your egg quantity is lower than average for your age. If your AMH is very low, particularly if you are under 40 and also have irregular or absent periods or symptoms associated with early menopause, your doctor may want to investigate further for conditions such as premature or primary ovarian insufficiency (POI). AMH alone, however, does not diagnose POI. Does high AMH mean I am fertile and won’t have problems conceiving? A high AMH level usually means there are more small follicles in the ovaries than expected for your age. It does not automatically mean you are more fertile. This is another common misconception about AMH. More follicles may mean a larger ovarian reserve, but natural fertility depends on much more than egg quantity. AMH cannot tell you about egg quality, whether you ovulate regularly, the health of your fallopian tubes or uterus, or sperm quality. Higher AMH is also commonly seen in people with PMOS, formerly known as PCOS, because the ovaries often contain a greater number of small follicles. A high AMH result therefore needs context rather than being interpreted as simply “good”. Can AMH diagnose PMOS or PCOS? AMH can contribute to a PMOS/PCOS assessment in adults, but it cannot diagnose PMOS on its own. Under current international guidance, AMH […]