What is AMH and what can AMH testing tell me?
- Anti-Müllerian Hormone (AMH) is a hormone produced by the follicles in our ovaries.
- It is produced by the follicles that house our eggs, so testing our AMH levels can help to determine the number of eggs we have left—our ovarian reserve.
- Along with our ovarian reserve, our AMH levels naturally decline with age after our mid 20s.
- High AMH levels and low AMH levels can both impact our fertility.
- Taking an AMH blood test is the least invasive way to accurately determine whether your AMH levels are normal for your age.
Anti-Müllerian Hormone (AMH) is an important hormone when it comes to our fertility.
Produced by the follicles that house our eggs, our AMH levels can give us a insight into your reproductive health because it is reflective of your ovarian reserve (egg count) and whether fertility treatments like egg freezing or IVF might be right for us.
But as always, getting the straight-talking info we need on our hormones can be hard, and many of us are left asking questions like ‘what is a good AMH level for my age’? And, ‘what are the symptoms of low AMH’?
Luckily, we’ve got you covered. Here’s everything you need to know about AMH and the importance of AMH testing.
First up, what is AMH?
AMH is a reproductive hormone made by the small sacs (called follicles) in our ovaries that hold our eggs before they are released each month during ovulation.
Unlike your menstrual hormones which are cyclical, meaning their levels fluctuate throughout the month, your AMH levels stay relatively stable throughout your menstrual cycle.
Since they are made by the follicles, your AMH levels are a reflection of how many eggs you might have left, known as your ovarian reserve.
You’re born with all the eggs you will ever have. Throughout your lifetime as you age your egg quality and quality will decline—right up until menopause when all your eggs are gone.
AMH levels by age
If you’re wondering ‘what is a normal AMH level for my age?’, you’re not alone.
AMH levels will steadily decrease year after year from your mid 20s onwards, as your ovarian reserve declines. After your mid 30s, the AMH decline becomes much more rapid and completely drops off as you near menopause (usually between 45 and 55 years old).
Although the overall levels of our AMH by age is a general downward trend, each person has an individual rate of decline depending on genetics, lifestyle, medication and underlying conditions—therefore some people will be blessed with an abundance of eggs for longer.
To read more about the impact of age on fertility, you can do so here.
So what is a good AMH level?
The higher your AMH the better, right? Well… not exactly. Like all of our hormones, too much or too little can cause us problems.
High AMH levels
In general, higher AMH levels indicate larger numbers of ovarian follicles and therefore a larger ovarian reserve.
Some underlying reproductive health conditions like polycystic ovaries or PCOS (polycystic ovary syndrome) are associated with high AMH levels too, which can cause symptoms such as irregular periods or no periods at all which can affect your fertility.
Low AMH levels
On the flip side, low AMH levels can indicate lower numbers of remaining follicles and therefore, a smaller ovarian reserve. Very low AMH levels are often seen in premature ovarian insufficiency (POI), which is a condition where menopause occurs before the age of 40.
Similarly, some autoimmune conditions, like Crohn’s disease and rheumatoid arthritis (RA), can cause low AMH levels too. Ovarian surgery can also carry a risk of low AMH levels afterwards.
Some lifestyle factors have also been linked to low AMH levels – smoking, obesity, and poor diet and nutrition—specifically insufficient Vitamin D levels. Symptoms of low AMH levels include irregular menstrual cycles and difficulty getting pregnant.
How do I know if I have normal AMH levels?
Should I do an AMH test?
In short, yes.
Doing an AMH blood test can give you an accurate insight into your current AMH levels, and give you an insight into your reproductive health because it is reflective of your ovarian reserve (egg count).
Your AMH levels can also be used as an indication of whether you have polycystic ovaries, however, it can not currently be used to diagnose PCOS based on current guidelines.
Understanding your AMH levels and ovarian reserve can also help to determine if you would be suitable for certain fertility treatments like IVF or egg freezing.
During fertility treatment, AMH levels are often tested to help determine the doses of medication and are to predict the outcomes of the egg collection process. You can read more about IVF here.
Investigation of AMH levels is often done in combination with an Antral follicle count (AFC), which is an internal ultrasound scan where the number of small follicles seen on the ovary is counted.
You can take an at-home AMH test with a Hertility Hormone and Fertility test, alongside up to 9 other hormones such as oestrogen, testosterone and thyroid-stimulating hormone. Check your AMH levels by age, and get results in as little as 10 days.
Although AMH levels give us insight into the number of follicles in your ovarian reserve, it does not provide any insight into the quality of the eggs. AMH levels alone can not be used to determine someone’s chance to conceive because conception is dependent on many other factors, including if ovulation is happening, the condition of the fallopian tubes and uterus and the quality of the partner’s sperm.
How to increase AMH levels?
Unfortunately, you can’t stop your AMH from declining with age. That being said, there are some lifestyle and diet changes that can improve your fertility, check our article on fertility nutrition and lifestyle tips here.
What should I do if I have low AMH levels?
If you’ve done an AMH blood test and your results have come back out of range for your age, you can have your AMH test results explained by one of our fertility advisors or specialist doctors.
Monitoring your AMH levels twice a year with an at-home blood test, or more than twice a year is also recommended if you have low AMH levels and are actively trying to conceive, or wanting to do so soon.
Additionally, if you’re worried about your future fertility but not ready to have kids yet, you may want to consider egg freezing. Or, if you have low AMH levels and are struggling with conceiving, IVF treatment could be a good option for you. Again, you can chat through any fertility treatments with our team of doctors and fertility advisors.
What is a good AMH level to get pregnant or to have IVF?
Successfully getting pregnant is not entirely dependent on your AMH levels and ovarian reserve. Other factors can affect fertility such as the quality of your eggs, the quality of sperm from your partner, whether you are normally ovulating and whether you have structural issues with your reproductive organs which might obstruct a pregnancy. There is, therefore, no evidence of a good AMH level to increase the likelihood of pregnancy, however it is known that getting pregnant is less likely or can take longer when AMH levels are low (read your Hertility results report to check if your AMH level is low for your age).
The success of IVF treatment is also dependent on many different factors. However, there is evidence that an AMH level lower than 5.4 pmol/L will lead to a poorer response to fertility medications. This is why some NHS IVF clinics will not accept patients who have an AMH level lower than this threshold.
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Oh, S. R., Choe, S. Y., & Cho, Y. J. (2019). Clinical application of serum anti-Müllerian hormone in women. Clinical and experimental reproductive medicine, 46(2), 50–59. https://doi.org/10.5653/cerm.2019.46.2.50