What is AMH?
AMH, which stands for anti-mullerian hormone, is a hormone that is secreted by the reproductive tissues of both male and female bodies. It is also called the Mullerian Inhibiting Substance (MIS).
In male foetuses, high levels of this hormone contribute to the development of the male reproductive organs, whereas in the case of female foetuses, low levels of the hormone are responsible for developing the female reproductive organs.
The antral follicles in the ovary, each of which has the potential to produce a mature egg, secrete an increased amount of the hormone adrenocorticotropic hormone (AMH) at the onset of puberty in females, which increases the overall level of AMH.
Significance of AMH testing
A straightforward blood test can be carried out whenever a patient chooses during their menstrual cycle.
The primary purpose of the test is to evaluate a female’s capacity to produce eggs capable of being fertilised and resulting in a pregnancy.
There is a correlation between the levels of AMH in the blood and the total number of eggs her body could produce. This concept is referred to as ovarian reserve. The levels of AMH in a woman’s blood and her ovarian reserve tend to fall as she ages.
This is also the case with testosterone levels. A woman with a high level of AMH has a greater chance of having a healthy pregnancy than a woman with low levels of the hormone.
What does a high AMH level Simply?
When measured in the blood, the levels of the hormone AMH should be between 2.2 and 3.9 ng/ml to indicate optimum fertility.
Values above four indicate a higher range and could be considered pathological in some contexts. Two conditions can cause AMH levels to rise above the normal range:
- Polycystic Ovarian Syndrome (PCOS): This condition is characterised by irregular menstrual cycles, subfertility, obesity, excessive facial hair growth, and varying degrees of insulin resistance. PCOS is caused by an imbalance in the hormones that regulate ovulation.
- Certain ovarian tumours, such as granulosa cell tumours: Monitoring AMH levels in patients with these types of cancer helps determine how well they respond to treatment.
Fertility Treatment for High AMH Levels & PCOS
Even though the AMH test is not a test that can definitively diagnose PCOS, it is an extremely helpful instrument that can support its diagnosis when combined with other criteria such as delayed ovulation, ultrasound evidence of polycystic ovaries, and clinical features such as hirsutism, acne, obesity, and so on.
In women with PCOS, the AMH levels are invariably higher than what is considered normal. These women have an abnormally high number of antral follicles, which disrupts the normal menstrual function, which in turn causes irregular menstrual cycles, an arrest in the maturation of eggs, and, as a result, infertility.
These women frequently require the assistance of various assisted reproductive techniques to achieve a healthy pregnancy.
Importance of high AMH levels in IVF
If your levels of AMH are high, you will have more antral follicles and a higher yield of oocytes when your ovaries are stimulated. This can, in turn, result in the formation of more embryos.
It is important to remember that AMH is only a marker of the number of eggs, not their quality. The quality of the eggs is a more important factor in the formation of high-quality embryos and, ultimately, a healthy pregnancy. This is an essential point to keep in mind in this context.
A woman undergoing treatment for having a high AMH level may also have the option of freezing any extra embryos created during a single IVF cycle for use later. This is an additional benefit of having a high AMH level.
There is a correlation between having high levels of AMH and having a low rate of cancellation, a higher rate of retrieval of eggs, a higher rate of live births, and an increased likelihood of cryopreservation.
Couples should not be dissuaded from trying in vitro fertilisation (IVF) solely based on low AMH levels because live birth rates were found to be reasonable. Thus it is always better to check with the IVF doctor for further steps.
Frequently Asked Questions
No. If your periods are consistent, you will produce one egg monthly even if you don’t get pregnant. Your chances of becoming pregnant will be comparable to those of a woman of the same age with a high AMH.
The fact that a woman’s ovary will mature and ovulate one egg every month, regardless of the amount of AMH present in her body, explains this phenomenon. Egg and embryo freezing should be considered for postponement.
Several treatments use the fact that your ovary can release multiple eggs during the same treatment month.
In humans, the ovary naturally (and almost always) releases a single egg at ovulation; however, in other species, such as cats, dogs, and mice, the ovary releases multiple eggs simultaneously.
Predicting ovarian response and optimizing fertility drug dosage are essential for IVF success. Your AMH levels can predict the number of eggs likely to mature due to ovarian stimulation during a single IVF cycle.
Everything hinges on the objectives you have set for yourself in life. There is no need for concern if you have finished having children and have no interest in having any more.
Suppose you begin menopause at an earlier age. In that case, your fertility therapist can provide you with the appropriate hormone replacement therapy, and the fact that you do not have eggs is not abnormal. It happens to every woman who lives past the age when she can have children.