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AMH Fertility

What is AMH?

Quite simply, AMH is a reflection of your ovarian reserve.
By definition, Anti-Mullerian hormone (AMH) is a hormone that is produced predominantly by granulosa cells of preantral follicles within the ovary.
These ‘preantral’ follicles are the smallest, earliest stages of growth and development of the follicle or egg.
If you have low AMH, it means that you have low ovarian reserve – in other words, fewer growing follicles. But it doesn’t mean you are not able to conceive naturally!

How do AMH levels relate to your Fertility?

In healthy women, AMH level increases until early adulthood, peaks at 25 years of age, and then slowly declines until after menopause (at which time there are no more growing follicles).
According to research, “Among women aged 30-44, without a history of infertility who had been trying to conceive for 3 months or less…..findings do not support the use of AMH levels to assess natural fertility with these characteristics”. So even though your AMH levels naturally start to decrease with age, you should still be able to conceive. The issue is that there are fewer follicles to recruit, so it might become more difficult the older you get.

Is AMH important for IVF treatment?

If you have been trying unsuccessfully to conceive for at least 12 months, your doctor or fertility specialist will organise for you to have your AMH levels checked.
These levels are an indicator of your pregnancy treatment outcome.
If you are undergoing IVF, your specialist would need to work out if you have enough eggs for a successful outcome, and also how well your ovaries will respond to being stimulated with medication.
In these cases, women with low AMH levels might need their stimulation medication adjusted accordingly. And women with high AMH levels, as in PCOS, would need to be very carefully monitored.

What factors other than age could cause low AMH levels?

  • Smoking – affects ovarian function as well as the quality of the eggs.
  • Endocrine Disruptors – Environmental toxins affect ovarian function and quality of the eggs in a similar way to smoking.
  • BMI – Obesity as well as being underweight are both problematic for ovarian function and therefore AMH.
  • Current contraceptive use – this will decrease AMH levels. So it’s pointless testing for AMH during contraceptive use. Best to wait until 3 months to do the AMH test.
  • Low Vitamin D levels – chronically low level of vitamin D has been known to compromise AMH.
  • Premature Ovarian Insufficiency
  • Ovarian surgery
  • Genetic factors

Are AMH levels changeable in some women?

Yes! Your AMH levels can change during various times during your cycle, and under certain conditions. So it isn’t a static number.
There are many avenues I use in my practice to help women improve their health status and hence their AMH levels.

Is there anything that can help improve AMH levels?

Even though there are no medical options available for improving AMH status, Naturopathically there are many.
As a Naturopathic Fertility Practitioner, I consider AMH levels as just one part of a much bigger picture when making my overall assessment of each patient.
I need to consider many factors when giving advice and making my treatment decisions.

Some examples of my natural approach to improving your AMH levels:

  • During the consultation I would explain my ‘4 Steps to Fertility’ Protocol.
    This includes advice on a good ‘fertility improvement’ diet as well as lifestyle factors such as exercise, relaxation and avoidance of endocrine disrupting chemicals.
    The advice I give is fully back by research and studies that are known to improve fertility as well as AMH levels.
  • I might also suggest certain supplements such as Vitamin D, Iron, Zinc etc. ( if your levels don’t fall into my optimal fertility values range).
  • I often prescribe antioxidants and fish oil, as these are known to be beneficial.
  • Appropriate Herbal medicines are extremely important for to addressing hormonal imbalance which usually influence your overall fertility as well as your AMH levels.

I hope I have given you a better understanding of AMH and how I approach it from a Naturopathic perspective.

Joanne Lipinski Fertility Naturopath Melbourne

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