AMH Test: Understanding Anti-Mullerian Hormone and Its Role

The Anti-Mullerian Hormone (AMH) test is a blood test that measures the level of AMH, a hormone secreted by the reproductive tissues in both males and females. The AMH test plays a crucial role in evaluating a person’s fertility potential, particularly for women, as it provides insights into the ovarian reserve — the number and quality of eggs remaining in the ovaries. For men, AMH is essential for normal reproductive development, but its role in females is more focused on fertility assessment.

This article will explore what AMH is, how it functions in both men and women, why it is measured, and how the AMH test can help with fertility assessments, diagnosis, and treatment decisions.

What is AMH?

Anti-Müllerian Hormone (AMH) is a glycoprotein hormone secreted by the Sertoli cells in the testes in males and by the granulosa cells of the ovaries in females. AMH plays different roles in each sex and varies significantly in its levels based on age, reproductive health, and other factors.

AMH in Males:

In males, AMH is secreted by the Sertoli cells of the testes, starting during embryonic development. During this phase, the secretion of AMH is responsible for the regression of the Müllerian duct, a structure that, in females, would eventually develop into the uterus, fallopian tubes, and upper part of the vagina. The secretion of AMH is crucial for the normal male reproductive development and is present throughout a man’s life, gradually decreasing after puberty.

AMH in Females:

In females, AMH plays a significant role in the development of ovarian follicles — the structures that contain egg cells. From birth until puberty, AMH levels are very low in females. However, after puberty, AMH levels rise and peak in the early reproductive years before gradually declining with age. By menopause, AMH is undetectable or extremely low, reflecting the natural decline in ovarian reserve.

What Does the AMH Test Measure?

The AMH test measures the concentration of AMH in the blood, providing important information about ovarian reserve. In women, AMH levels correlate with the number of remaining eggs in the ovaries, which can help assess fertility. High levels of AMH typically indicate a higher ovarian reserve, while lower levels may suggest a reduced number of eggs.

In men, AMH levels are generally stable and are used primarily in assessing male reproductive development. For females, the AMH test is commonly used to evaluate fertility potential, assess reproductive health, and assist with treatment decisions, particularly in cases of infertility or when undergoing fertility treatments like IVF.

Why Do I Need an AMH Test?

For Women Trying to Conceive:

The AMH test is a crucial tool for women who are struggling to conceive, as it helps estimate the ovarian reserve and the chances of successful pregnancy. The test can give insights into how many eggs a woman has left and how well she might respond to fertility treatments such as IVF.

• High AMH Levels: Elevated AMH levels may indicate a higher number of eggs in the ovaries. This can be beneficial when undergoing fertility treatments like IVF, as it suggests that there are more eggs available for retrieval. However, high AMH levels can also indicate a risk of ovarian hyperstimulation syndrome (OHSS), a condition where the ovaries become overstimulated during IVF.

• Low AMH Levels: Low AMH levels can suggest a lower ovarian reserve, which may make it more difficult to conceive naturally or through IVF. Women with low AMH may respond less effectively to ovarian stimulation during IVF.

For Diagnosing Polycystic Ovary Syndrome (PCOS):

The AMH test is commonly used to help diagnose PCOS, a hormonal disorder that is a common cause of infertility. Women with PCOS typically have higher AMH levels because they have more small, immature follicles in the ovaries. Elevated AMH levels in combination with other symptoms, such as irregular periods and excess hair growth, can indicate PCOS.

For Women Undergoing Cancer Treatment:

Women who are about to undergo cancer treatments such as chemotherapy or radiation may want to test their AMH levels. These treatments can damage the ovaries, causing early menopause or fertility problems. By testing AMH levels, women can assess their ovarian reserve before starting treatment and may consider options like egg freezing to preserve fertility.

For Monitoring Response to IVF Treatment:

In women undergoing IVF, the AMH test can help fertility specialists determine the best ovarian stimulation protocol. If AMH levels are high, the doctor may use lower doses of medication. Conversely, women with low AMH levels may require higher doses to stimulate egg production.

How is the AMH Test Performed?

The AMH test is a simple blood test that is typically done on day 2 or 3 of a woman’s menstrual cycle for accurate results. The blood sample is taken and sent to a laboratory, where the AMH levels are measured. Unlike other fertility-related tests that are time-sensitive, the AMH test can be done at any time during a woman’s menstrual cycle.

Interpreting AMH Test Results

AMH levels vary significantly depending on the age and reproductive health of the individual. Here’s what different AMH levels may indicate:

• High AMH (more than 4.0 ng/mL): May indicate polycystic ovary syndrome (PCOS), where women have a higher number of small follicles in the ovaries. High AMH may also suggest a good ovarian reserve, but could be associated with a higher risk of ovarian hyperstimulation during IVF.

• Normal AMH (1.0 – 4.0 ng/mL): Indicates a healthy ovarian reserve. This is typically the optimal range for women undergoing fertility treatments like IVF.

• Low AMH (less than 1.0 ng/mL): Suggests reduced ovarian reserve and may indicate that the woman has fewer eggs remaining. Women with low AMH levels may experience difficulty in conceiving and may need to pursue assisted reproduction options like IVF or egg donation.

• Very Low AMH (less than 0.5 ng/mL): Indicates a significantly reduced ovarian reserve. In such cases, assisted reproductive treatments may be less effective, and egg donation may be considered.

What Does AMH Test Results Mean for Fertility Treatment?

AMH and IVF Response:

The AMH test is an important predictor of how a woman will respond to ovarian stimulation during IVF. Women with high AMH levels generally respond well to standard ovarian stimulation protocols. Conversely, women with low AMH may require higher doses of fertility drugs to stimulate the ovaries and retrieve eggs.

Egg Freezing:

Women who wish to delay childbearing may opt for egg freezing. The AMH test can help determine whether a woman is a good candidate for egg freezing by assessing her ovarian reserve. If AMH levels are low, egg freezing may still be possible, but success rates may be lower.

What Can Affect AMH Levels?

Several factors can influence AMH levels, including:

• Age: AMH levels naturally decline with age, typically starting after age 30. This decline accelerates in the late 30s and early 40s.

• Ovarian Surgery: Surgical procedures on the ovaries, such as cyst removal or ovarian tissue biopsies, can reduce the ovarian reserve and lower AMH levels.

• Chemotherapy or Radiation: Cancer treatments that target the ovaries can reduce AMH levels and impair fertility.

• Polycystic Ovary Syndrome (PCOS): Women with PCOS often have higher-than-normal AMH levels due to the higher number of follicles present in the ovaries.

• Genetics: Family history and genetic factors can play a significant role in ovarian reserve and AMH levels.

Frequently Asked Questions (FAQs)

1. How accurate is the AMH test?

The AMH test is highly accurate and provides reliable information about ovarian reserve. However, it’s essential to use the results alongside other tests and evaluations for a comprehensive fertility assessment.

2. Can I take the AMH test at any time in my menstrual cycle?

Yes, unlike other fertility tests, the AMH test can be done at any time during your menstrual cycle. The results will still be valid regardless of your cycle phase.

3. What happens if my AMH levels are low?

Low AMH levels indicate a reduced ovarian reserve, but this doesn’t mean you cannot conceive. However, it may suggest that conception could take longer or that fertility treatments like IVF or egg donation may be necessary.

4. Can AMH levels increase?

AMH levels generally do not increase over time. However, maintaining a healthy lifestyle, avoiding smoking, and managing stress may help preserve ovarian reserve and slow the decline of AMH levels.

5. Does a high AMH level mean I have PCOS?

Not necessarily. While high AMH levels are a common indicator of PCOS, it is not the only diagnostic factor. Your fertility specialist will evaluate your AMH levels in conjunction with other symptoms to determine if PCOS is present.

6. Can the AMH test diagnose menopause?

The AMH test can help predict when menopause might occur by assessing ovarian reserve. As a woman nears menopause, AMH levels drop significantly, signaling a reduced ability to conceive naturally.

Get Expert Advice 

If you're concerned about your fertility or considering options like IVF, egg freezing, or investigating PCOS, the AMH test is a crucial first step. Contact Sakalli IVF today to schedule an AMH test and consult with our fertility specialists to understand your options. Our team is committed to providing personalized care and helping you make informed decisions about your reproductive health.