Curious to know current egg supply “waiting in the wings?” Research suggests that AMH is a reliable biomarker serving as an indicator for the quantity of eggs in the ovaries 1. Additionally, it could also help initiate discussions with your doctor about different fertility treatments (IVF) and insights on Polycystic ovarian syndrome (PCOS). However, one must keep in mind that no single test can confirm infertility or the ability to get pregnant. 

What Is Anti Mullerian Hormone?

Anti Mullerian Hormone (AMH) is a glycoprotein hormone produced by the granulosa cells found inside little sacs called the ovarian follicles. Our eggs are held in these tiny follicles present inside the ovaries. Since AMH is released from these follicles, it is a reliable indicator of your egg count (ovarian reserve).

Role Of Anti Mullerian Hormone 

1. Ovarian Reserve Testing - AMH, An Early, Anytime And Reliable Indicator:

Fact:  

It’s no secret that your egg reserve is not a renewable source. Women are born with ~1 million potential eggs (in the form of ovarian follicles), but that’s all the eggs they’ll ever have in their lifetime. Unlike blood cells that regenerate, our bodies aren’t able to make more eggs. 

Imagine the ovarian reserve is like a bank that doesn’t accept deposits though we’re withdrawing from it each month. Your ovarian reserve is an indicator of the number of eggs left in your body. 

AMH levels in the blood is a promising screening test for your ovarian reserve that can help doctors estimate the number of follicles inside the ovaries.2

Implication: 

If your results indicate an average or below average egg count, you can consult your doctor/fertility specialist and plan ahead. You may consider Egg Freezing as a potential option to preserve your fertility in case you wish to postpone motherhood so that the most viable eggs may be extracted for future fertilization and implantation, for when you are truly ready. 

Having said that, testing AMH has limitations too; it is only an estimate of the number of eggs a woman has (and does not give information on the quality of eggs) and should not be used as a definitive test to assess the likelihood of you becoming pregnant.

2. Understanding The Outcomes Of Fertility Preservation & Fertility Treatments:

Fact: 

Ovarian reserve testing is offered to women prior to initiating egg freezing cycles as it provides information regarding expected oocyte (eggs) yield per stimulated cycle.2, 3 This will also help you understand how much your ovaries will have to be stimulated to collect eggs in any given treatment cycle. Using smart algorithms, namely the Brigham Calculator and Nomogram, we can predict the number of oocytes (eggs) that can be retrieved in controlled ovulation stimulation using two data points - your age, and AMH levels. 

Furthermore, At LifeCell we provide insights on the probability of live birth through fertility treatments should you opt for egg freezing in the future.  

Implication: 

In the event your results indicate normal levels of AMH, you may choose to preserve your fertility for later (Planned Egg Freezing) or you may consult a Fertility Specialist to plan your pregnancy and family plans accordingly.

3. Understanding Polycystic Ovary Syndrome (PCOS)

Fact:

About 4-20% of the women of reproductive age are found to be affected by PCOS worldwide 4. It is a hormone imbalance that often results in irregular periods or lack of ovulation (release of eggs during menstruation). Generally, women suffering from PCOS are more likely to experience higher production of AMH in their bodies coupled with high levels of Testosterone. This is because women with PCOS have more immature follicles (‘cysts’) in their ovaries which tend to produce more AMH. 

Reminder: While testing AMH is not an official part of the Rotterdam criteria,5 a high number of immature follicles is third on the list for diagnosing PCOS. 

Implication: 

Should your test results indicate that you are likely to have PCOS, consulting your doctor and initiating mild treatment coupled with certain lifestyle changes can help you manage PCOS effectively and efficiently. 

When Can I Do An AMH Test? 

A big advantage of AMH is that levels do not fluctuate mostly during the menstrual cycle (cycle-day independent)2. So, the test can be taken at any point during your cycle.

What Can Differing AMH Levels Tell You?

1. Normal AMH Levels 

Should your results suggest normal levels in comparison to females of the same age, you can get an insight into the number of eggs likely retrievable during a fertility treatment cycle which is helpful information for someone opting for planned oocyte cryopreservation/egg freezing or someone undergoing IVF or about to initiate the same. It is important to remember that every individual is unique - egg count and AMH levels may decline at different rates. 

Since AMH declines with age, the normal levels vary for women between the age groups of 18-14 as follows:

2. High AMH Levels

High AMH levels are indicators of rich ovarian reserves. This does not mean that women with high levels of AMH are more likely to get pregnant. There are other underlying factors that constitute the fertility quotient which need to be considered. On the other hand, high AMH levels coupled with high levels of testosterone and related symptoms may indicate the risk of Polycystic Ovary Syndrome.  

3. Low AMH levels

As AMH is an indicator of the quantity of eggs produced by the ovaries, low AMH levels may be a subtle hint that the clock is ticking on your reproductive years when compared to your female peers of the same age category having normal AMH levels. It may also indicate a fast depletion of your ovarian reserve, meaning you are more likely to hit menopause earlier than expected.

Where Can I Get My AMH Levels Tested?

Curious to know more about your AMH levels and how you can manage your fertility better? We  have got you covered.  

Order your OvaScore kit today and learn all about your reproductive hormones from the comfort and privacy of your home.

References 

  1. https://www.yourhormones.info/hormones/anti-mullerian-hormone/  
  2. https://pubmed.ncbi.nlm.nih.gov/25585505/ 
  3. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/ajo.13028 
  4. https://pubmed.ncbi.nlm.nih.gov/33627974/ 
  5. https://pubmed.ncbi.nlm.nih.gov/28119448/ 

References