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!
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.
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.
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.
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.
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