- AMH is a useful yet unique bio-marker for predicting the time of menopause.
- It is present in the reproductive tissues of both males and females, but generally, the levels are measured in females.
- It gives a good and reliable parameter in the assessment of ovarian reserve.
- A study revealed 54% of females in the age group 30-35 had extremely low AMH levels.
- The primary use of AMH determination has been assessing ovarian reserve in the diagnostic tests of infertility and premature ovarian failure.
What is AMH?
Anti-Mullerian Hormone (AMH) is a glycoprotein hormone produced by small follicle cells of an ovary. The test determines how many eggs you have left in your ovary.
Despite that, you do not get an idea about the quality of the eggs; it only tells you the number of eggs laid in your ovary.
As, by puberty, your body has about 100,000 oocytes (a cell in an ovary), but with time these oocytes start diminishing, and once you reach the age of 40 years, there are no eggs.
Therefore, this AMH level provides a view if you are likely to enter the pre-menopause or not.
What are the adequate levels of AMH?
The level of AMH varies with age, and it is also normal to have fluctuations in the AMH level within a short period.
Although, the values are:
- AMH Levels between 1 – 3.5 ng/ml – Normal
- AMH level above 2ng/ml- Good value
- AMH level less than 1ng/ml- Low
- AMH level less than 0.3ng/ml- Very low.
- AMH Level > 3.5 Ng/ml- High
What does low AMH mean?
The AMH level in a woman can provide information about eggs present in the ovary. The more eggs you have, the greater your AMH levels are, and as low as eggs you have, the levels of AMH slow down.
The level of AMH is low naturally with advanced age. Still, even if you have a low AMH level at a younger age, you risk premature ovarian failure and a decreased chance of conceiving naturally.
What are the causes of Low AMH?
The natural cause of low AMH levels can be age or gender in males and females.
But there are some other conditions as well that lead to the decrease in AMH level.
The common low AMH causes are;
It is a painful disorder of the reproductive system. A condition in which the tissues generally found inside your uterus (womb) grows outside the uterus is called endometriosis. In this case, the inflammation and scar tissue damage the ovaries and fallopian tubes, resulting in low levels of AMH.
Changes in genes, i.e., a positive history of low AMH in families, can also affect your level of AMH.
Polycystic ovary syndrome (PCOS)
PCOS is the most common female reproductive disorder. In this, your ovary produced an abnormal amount of male sex hormone androgens. The number of small cysts formed in the ovaries can affect your AMH levels.
In this disease, your immune system attacks your healthy cells and thus damages the healthy egg cells, which lowers the AMH level.
If one is having active cancer and undergoing chemotherapy, it increases the risk of damaging healthy follicles of the ovary, leading to a low number of AMH.
Some lifestyle factors can also affect the level of AMH in your body, like excessive smoking, environmental pollution, obesity, vitamin D deficiency, etc.
What are the symptoms of low AMH?
As there are not many specific symptoms of low AMH found in a woman, general symptoms may include:
- Reduction in menstrual bleeding
- Irregular menstrual periods
- Permanent stopping of the menstrual cycle
What are the risk factors affecting low AMH?
A low AMH level can reduce a woman’s chance of having a baby, and it also plays a vital role during fertility treatment like IVF.
So here are some risk factors of which you need to be aware:
- Adnexal surgery: A woman having surgery involving any reproductive organ or organs next to the uterus may increase the risk of low AMH.
- Intense exercise: Having strenuous exercise with high intensity or power can affect your reproductive system. This can lead to low AMH levels in your blood.
- Sleep quality: If you cannot sleep well or have a regular disturbance in sleep, it can affect your hormonal level. This can lead to a low level of AMH also.
- Younger age at Menarche: Menarche is the first menstrual cycle or monthly period in a woman. Early menstrual periods can affect your AMH level as there is an early reduction in eggs in your ovaries.
How can you determine your AMH level?
As there are no specific symptoms of low AMH, the blood test is the best way to diagnose low AMH.
AMH Blood Test: An Anti-Mullerian Hormone Test can measure Anti-Mullerian Hormone (AMH) levels in the blood. This test is done to check a woman’s ability to produce eggs that are fertilized for pregnancy. An AMH blood test has several other aims:
- AMH Blood Test can be used to determine the reason for early menopause (permanent stoppage of the menstrual cycle).
- The test can also be used to discover the reason for abnormal menstruation in women even at a young age.
- It majorly helps in the diagnosis of Polycystic ovary syndrome PCOS.
- The test is also helpful in diagnosing some ovarian cancers.
Other tests- Basal Antral Follicle count is used to evaluate the counting of follicle cells during a transvaginal ultrasound, and it measures the remaining egg supply in the woman’s ovary.
What are the complications of low AMH?
The low AMH level can indicate infertility problems and a recession in the ovarian range can have problems with infertility.
Some major common complications that can affect low AMH levels are:
A low level of AMH can increase the chances of infertility in women. However, this may not be considered a cause but can indicate a decrease in the ovarian reserve rate. As fewer developing eggs remain in ovaries, the chance of mature egg cells may decrease and lead to infertility problems.
As with the decreasing rate of AMH, the quality of eggs may change in different ways. These changes in genes can lead to having an abnormal pregnancy.
In some cases, the low level of AMH can be a cause of having miscarriages.
Lower correspondence to fertility medications:
A low AMH level is sometimes why you don’t respond to fertility medications.
What are the treatments for low AMH levels?
If you are an older woman and don’t want to have a child, then the low level of AMH is not a concern for you, and you don’t need treatment.
But if you are a young woman and want to have a child, then there is a need to treat the low level of AMH.
The low AMH treatment includes:
IVF with low AMH level
A good ovarian reserve increases the possibility of a successful pregnancy. Still, in the case of low AMH, i.e., low ovarian reserve, IVF is a hope to get pregnant.
With our fertility experts at Crysta IVF, we can ensure best IVF treatment in Delhi as per your condition, along with suitable tests and counseling.
Moreover, low AMH does not mean low-quality eggs; it means a lower quantity which doesn’t matter when going through Assisted Reproductive Technologies (ART).
IVF with Donor Eggs
If the AMH level is very low and no eggs are left, and the IVF is not successful at retrieving good quality eggs, another option is to use donor eggs in IVF.
In this case, low AMH treatment is done by the good-quality egg of the stranger being used to carry out the IVF procedure.
The use of vitamins, supplementation, and some lifestyle modification may help in increasing the outcome of treatment.
Some lifestyle changes like adopting a nutrient-dense diet with high protein content. Regular daily exercise of the body with physical and emotional mental health can improve the level of AMH. Also, avoid smoking and alcohol.
Related Blog: IVF With Low AMH? Possible Or Not!
The determination of AMH level is a good yet unique bio-marker to rule out the number of eggs present in the ovary, which is essential for conceiving. If the level of AMH is low, it may increase the risk of infertility and requires proper treatment by fertility experts.