Content table
Worried low AMH will wreck your chances of conceiving? Well, I’ve got good news.
Having low AMH doesn’t affect your ability to get pregnant. As long as you’re ovulating – there is the possibility of pregnancy. After all, one healthy egg is all it takes.
That said, if your AMH is low, it does mean your time is running out. That’s because AMH is a marker of your ovarian reserve, or how many eggs you have left.
So, if you’re waiting to start (or grow) your family and discover your AMH is low – it may be time to take action.
Read on to learn more about what AMH is, what causes it, and how it affects your fertility.
What is Anti-Müllerian Hormone (AMH)?
Anti-Müllerian hormone, or AMH, is a hormone made by ovarian follicles. Follicles are tiny fluid-filled sacs that house an immature egg.
Every month, follicle-stimulating hormone (FSH) prompts a batch of follicles to grow. The healthiest, biggest follicle goes on to become the ‘dominant follicle.’
This egg is released during ovulation – while the other follicles die off.
Your AMH level helps gauge how many follicles are developing each cycle. Research shows this can also help predict your ovarian reserve, or how many eggs remain.
In general, the higher your AMH level, the more eggs you have left.
If your AMH is low, it means your egg supply is running low too. This is known as diminished ovarian reserve. It happens as a natural part of aging. But for some women, it may sneak up earlier than expected.
Why is AMH Important?
Since AMH offers clues about the number of eggs that remain, it can be invaluable if you’re trying to conceive.
All women are born with a finite number of eggs (roughly two million). By the time you reach puberty, around 400,000 eggs remain. And with each menstrual cycle, your egg supply shrinks further.
This can pose a problem for some, since many couples are waiting longer to start families.
If your AMH levels are on the lower side it can influence your family planning. It may spur you to start trying to conceive naturally – or freeze your eggs for when the time is right.
Research shows AMH can also help predict the onset of menopause and the end of your reproductive years.
On average, most women enter menopause around their early 50s. But some women experience premature menopause and lose their eggs earlier than expected.
Your AMH levels give you a snapshot of your egg status right now. But it can’t pinpoint how quickly your egg supply will decline in the future. That rate varies from person to person.
It also can’t tell you anything about the quality of eggs left – which is also a crucial part of fertility.
What Happens if AMH is Low?
If your AMH is low and you want to conceive, you may want to try sooner rather than later.
While low AMH doesn’t make it more difficult to get pregnant, it does shorten your reproductive window. So if you want to have a baby and have been waiting – low AMH may be the nudge you need to get to it!
So how do you know if your AMH is low?
In general, AMH levels between 1.0 to 3.0 ng/mL are considered normal. Anything under 1.0 ng/mL is considered low. But since it’s natural for AMH to decline with age, it’s far more nuanced than that.
The American Journal of Obstetrics and Gynecology analyzed current AMH research. From that analysis, they created age-specific AMH guidelines. Here’s what they came up with:
So, let’s say you’re 35 years old and your AMH is 1.3 ng/mL. While that’s within the 1.0- 3.0 ng/mL range, it’s low for your age group. This suggests your eggs are declining faster than what’s expected for your age.
But keep in mind, AMH levels fluctuate slightly throughout your menstrual cycle. So, it’s possible to get a ‘low AMH’ one day and then fall into the normal range another day.
In addition, some women may have abnormally high levels of AMH.
For example, many women with polycystic ovary syndrome (PCOS) have high AMH levels. PCOS is a hormonal imbalance that causes problems with ovulation due to high levels of androgens.
This just goes to show that AMH levels are only one piece of your overall fertility.
What AMH Is Too Low for IVF?
Research shows AMH can predict how well you respond to in vitro fertilization and how many eggs will be retrieved.
Since IVF can be emotionally and financially grueling, many use AMH levels to determine whether it’ll be worth it.
Some studies show women with AMH levels under 0.7 ng/mL may be poor responders to ovarian hyperstimulation.
That said, other research shows that women with very low levels of AMH (under 0.5 ng/mL) still have a decent chance of pregnancy. But those chances get slimmer with age.
The chart below will show you what I mean.
Pregnancy rates for women with low AMH undergoing IVF
Causes of Low AMH
As mentioned, AMH naturally declines with age. But besides age, there are some other factors that can lead to low AMH.
Genetics
Some genetic disorders are linked with lower AMH levels. This includes the Fragile-X mutation and Turner syndrome, a rare chromosomal disorder that only affects women.
Smoking
There is evidence that smoking may decrease AMH levels. The good news is, this effect is reversible, as it only pertains to active smokers. Former smokers showed no drop in AMH. That said, there is currently no research on the effects of vaping on AMH levels.
Alcohol
Research suggests that those who binge drink frequently can have a lower ovarian reserve. It was observed that people who binge drank twice a week had a 21% lower AMH level than those who had never touched alcohol. And the ones binging had a 26% lower AMH level compared to current drinkers who weren’t bingers.
Medications
Some medications are linked with low AMH levels. For one, women who take birth control pills tend to have lower AMH levels than those that don’t. Luckily, AMH typically rebounds after oral contraception ends.
Another medication that may lower AMH is metformin, which is used to treat patients with type-2 diabetes. One study found that metformin reduced AMH levels in PCOS patients, but only in those who were overweight (BMI over 25).
Endometriosis
Endometriosis is a condition where uterine tissue goes rogue and grows outside the uterus. Research shows that women with endometriosis often have lower levels of AMH. The whys are unclear. But some believe it’s because the condition causes inflammation, which damages follicles.
Cancer treatment
Cancer treatments such as chemotherapy can be rough on the entire body, including the ovaries. Because of this, AMH levels are often much lower after chemotherapy treatment.
Autoimmune disease
Some autoimmune diseases are linked with low AMH levels. This includes rheumatoid arthritis and Hashimoto’s thyroiditis.
Diet
Need another reason to ditch fast food? It may affect your AMH. One study found that people who eat more fast foods or foods high in saturated fats have lower AMH levels.
Symptoms of Low AMH
There aren’t any telltale low AMH symptoms. But there are a few general signs that can point to low AMH:
- Shorter menstrual cycles. One study found that women under 30 who had lower AMH levels had significantly shorter cycles than those with normal AMH.
- Irregular cycles. As egg supply wanes and menopause approaches, menstrual cycles may become unpredictable.
- Cessation of periods. Skipping periods is another sign of diminished ovarian reserve.
Keep in mind, these signs can be due to a myriad of reasons including hormonal imbalance, birth control, and lifestyle factors. And some women have low AMH with no signs at all.
If you’re concerned your AMH is low, testing is the only way to know for sure.
How to Check AMH?
You can check your AMH levels via a blood test. Many fertility specialists order AMH tests to assess ovarian reserve before starting fertility treatment. But you can always request an AMH test if your doctor doesn’t suggest it.
There are even at-home tests to check AMH. While these tests are convenient, AMH levels are not one-size-fits-all. Having a doctor or fertility specialist interpret your AMH test results is crucial.
Are There Ways to Increase AMH?
There’s no cure-all for low AMH. Remember, it’s normal for AMH to decrease with age.
But what can you do if you find your AMH is lower for your age than you’d expect? Research suggests some medical and lifestyle factors may prevent AMH levels from dropping too quickly.
Treat underlying imbalances. If your hormones are off, it can create a cascade of fertility problems, including low AMH.
For example, one study found that patients with Hashimoto’s thyroiditis who took LT4 supplementation increased their AMH levels.
Exercise. Research shows that women who are physically active have higher AMH levels for their age than women who are sedentary.
Eat a healthy diet . As mentioned, diets high in fast foods and saturated fats are linked with lower AMH levels. So, steer clear of them and eat wholesome, nutritious foods such as fruits, veggies, legumes, and whole grains.
Dairy products. There is evidence that consuming dairy products may slow the decline in AMH.
Antioxidants. Research shows that certain antioxidants such as selenium and vitamin E may increase AMH levels.
Summing it Up
- Anti-Mullerian hormone (AMH) is produced by developing follicles.
- AMH is a marker of a woman’s ovarian reserve, or the number of eggs left.
- The lower your AMH is the fewer eggs that remain.
- AMH decreases naturally with age. But the rate of decline will vary among women.
- When your AMH level is low compared to others your age, it’s known as low ovarian reserve.
- AMH is often used to predict the number of eggs retrieved via in vitro fertilization. It also helps predict how well patients will respond to IVF treatment.
- It’s also used to predict the onset of menopause.
- Besides age, other causes of low AMH include genetics, smoking, alcohol, diet, and birth control pills.
Was this article helpful?
- Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications
- Unifying theory of adult resting follicle recruitment and fetal oocyte arrest – ScienceDirect
- Anti-Müllerian hormone (AMH) as a good predictor of time of menopause – PMC
- Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age | Geriatrics | JAMA
- Anti-Mullerian Hormone (AMH) Test: Purpose, Levels & Results
- Ovarian reserve testing: a user’s guide
- A systematic review of tests predicting ovarian reserve and IVF outcome
- The Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients with Different Subgroups – PMC
- Serum anti-Müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles–implications for individualization of therapy
- Anti-Müllerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology
- IVF results in patients with very low serum AMH are significantly affected by chronological age
- Genetic associations with diminished ovarian reserve: a systematic review of the literature – PMC
- AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic
- The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years
- https://pubmed.ncbi.nlm.nih.gov/23069740/
- Serum anti-müllerian hormone levels (AMH) decrease after metformin administration in women with both lean and overweight polycystic ovary syndrome (PCOS) – Fertility and Sterility
- The effect of endometriosis on the antimüllerian hormone level in the infertile population – PMC
- The Clinical Value and Interpretation of Anti-Müllerian Hormone in Women With Cancer – PMC
- Decline of ovarian function in patients with rheumatoid arthritis: serum anti-Müllerian hormone levels in a longitudinal cohort | RMD Open
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656199/
- Levothyroxine supplementation improves serum anti-Müllerian hormone levels in infertile patients with Hashimoto’s thyroiditis
- The Effect of Moderate Physical Activity on Ovarian Reserve Markers in Reproductive Age Women Below and Above 30 Years – PMC
- Do dietary intakes influence the rate of decline in anti-Mullerian hormone among eumenorrheic women? A population-based prospective investigation
- The effect of selenium and vitamin E supplementation on anti-Mullerian hormone and antral follicle count in infertile women with occult premature ovarian insufficiency: A randomized controlled clinical trial
+2K others have already subscribed
+2K subscribers
