Low AMH

What is AMH Test? AMH or Anti-Müllerian Hormone is an indicator of ovarian reserve in women. It is secreted by the Granulosa cells of the antral follicles, and then it is released in the follicular fluid and blood vessels. Follicles are the sacs which contain the immature eggs. A blood test is done to check for the AMH value, which gives us an insight of ovarian responsiveness that is how many eggs are left in the ovaries. The AMH value will help to determine how urgently a woman needs to seek treatment and how she will respond to it.

What is Low AMH?

AMH decreases with age because as a woman ages, her ovarian reserve gets depleted as well. And depleted ovarian reserve might lead to fertility issues. Critically low values would also indicate a reduced response to ART. So, during preliminary investigations, if a woman’s AMH value is found to be low, she must consider getting treatment without further delay.

Low AMH means that the woman’s ovarian reserve is rapidly declining, and she should seek fertility treatment immediately if she’s trying to have a baby.

The reference range for AMH value should be within 2.20 – 6.80 ng/mL. The range can vary from laboratory to laboratory depending on the types of equipment and testing methods. However, the age of the patient plays a significant role in predicting the outcome as low AMH always do not predict low ART success in women under 35 years of age. Also, other laboratory parameters like imaging techniques and clinical findings should be considered.

Does Low AMH levels Affect Fertility?

Low AMH level is not the cause of infertility, and it only indicates that there is a low ovarian reserve. That means that the number of eggs developing in the ovaries are limited, and the chance of a mature good quality egg releasing every month and getting fertilised decreases. Also, with age, the quality of eggs gets affected. So, the chances of early miscarriages due to abnormalities in the egg increases. Early pregnancy losses account for 85%.

Symptoms of Low AMH

There are no specific low AMH symptoms that suggest that a woman may have a low AMH. But if a woman has irregular periods or has premature menopause, then she can get herself tested for AMH through a blood test.

Causes of Low AMH

AMH level is determined by the number of follicles that develop in the ovaries. But while considering the reason for low AMH, the age of the woman plays a significant role. Ovarian reserve tends to decline when a woman is in her mid-30’s and becomes even lower in a woman who is 40 years and above.

Some of the Low AMH causes include:

  • Age
  • Hormonal imbalance
  • Inherited genetic causes
  • Endometriosis
  • Cancer treatment
  • Autoimmune attack on the ovaries
  • Other environmental causes

Treatment of Low AMH

There is no low AMH treatment, but there are ways through which a woman can improve her AMH before considering ART as an option, so that quantity and quality of eggs improve before IVF treatment.

The natural low AMH fertility treatment options to improve AMH values may be suggested so that it might increase the ovarian response during stimulation.

Some of the low AMH natural treatments are:

  • Regular exercise and yoga
  • Acupuncture
  • Having a balanced diet
  • Taking DHEA supplements. DHEA (Dehydroepiandrosterone) is a hormone that can improve the quantity and quality of eggs.

Some other Low AMH levels treatment options for conceiving a baby include:

IVF with Low AMH levels – The chances of a successful pregnancy will depend on a woman’s ovarian reserve, and for them, IVF is a potential option which can make optimal use of the limited eggs left in their ovaries. Provided the matured egg retrieved in a specific IVF cycle should be of good quality. If the AMH level is low with an abnormally raised FSH levels, then it is an indication that the ovaries are not growing the right quantity and good quality eggs, which would mean poor fertility outcome. But with proper treatment that is if a woman maintains a healthy lifestyle, takes DHEA supplement and with an appropriately designed ovarian stimulation protocol women have been able to conceive successfully through IVF.

IVF with Donor egg – And for women who have very limited eggs or no eggs at all, and where ovarian stimulation to retrieve good quality eggs have failed, then they should consider IVF with a donor egg

Low AMH Success Stories – Medicover Fertility

I was trying to have a baby for a year but was unable to conceive. After a year of continued trials, we started looking for fertility experts to help us diagnose the cause and find a treatment. One of our friends suggested us to consult Medicover Fertility. After consulting the doctor, we got to know that I had Low AMH issues, and so low with ovarian reserve. But the doctor assured us that there’s nothing to worry about. She designed a stimulation protocol and treatment plans for me that actually worked. Today I’m blessed with a baby. The treatment at Medicover Fertility really does wonders.

Conclusion

AMH (Anti Mullerian Hormone) has been suggested as a marker of the quantity of the oocytes remaining in the ovaries. Having low AMH is a sign of the declining ovarian reserve. It simply means that in case of planning pregnancy, once diagnosed with Low AMH, a fertility expert should be immediately consulted.

Medicover Fertility has successfully helped many women with many infertility issues, including Low AMH, to conceive a pregnancy and become parents.

In case of planning a pregnancy with Low AMH, consult our fertility expert by calling us at +917862800700.

FAQs

Q – How to Raise AMH levels Naturally?

A – To improve AMH level, one should have a nutrient-rich diet, take DHEA & Vitamin D supplements and also take wheat germ extracts. A woman who is overweight should opt for weight loss, quit smoking. A fertility massage is also recommended to enhance the AMH level.

Q – What is Considered a Low AMH level?

A – The reference range of AMH will depend on the age of the woman. For the reproductive age group (25-35 years), the reference range is 2.20-6.80 ng/mL. A value of less than 2.20 would be considered a low AMH that means a woman has diminished ovarian reserve. And a value more than 6.80 ng/mL would mean a high AMH which is suggestive of PCOS.

Q – Can Low AMH Cause Miscarriage?

A – Yes! A low AMH can cause miscarriage because with low AMH the chances of a good quality egg releasing and getting fertilised diminishes. And with poor quality egg, the chances of early miscarriages due to abnormalities in the egg increases.

Q – Can Endometriosis cause Low AMH levels?

A – There may be effects on the ovary due to endometriosis, and ovarian endometriomas can directly affect the ovarian reserve, thus causing low AMH levels.

Q – Can Low AMH cause Infertility?

A – Low AMH is not the exact cause of infertility, but it is an indicator of ovarian reserve. Depleted ovarian reserve can lead to problems affecting pregnancy and infertility if there are lesser number of eggs or no eggs in ovarian reserve, the chance of getting pregnant decreases.

Q – What does Low AMH and High FSH mean?

A – A low AMH and high FSH would mean that both the quality and quantity of eggs formed are not good.

 

References

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0081629

https://www.sciencedirect.com/science/article/pii/S0015028211005012

https://www.sciencedirect.com/science/article/pii/S0015028210007053

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0081629