What is AMH and AMH testing?

blood in the tube for testing in the lab

AMH, or Anti-Mullerian hormone, is a hormone that is made by granulosa cells that take care of the eggs, so the more eggs a woman has, the more of these cells she has, and the higher her AMH. If the AMH is above 21.98 pmol/l (picomole per litre) it is relatively speaking, reassuring. If the AMH level is less than 3.08 pmol/l (picomole per litre), that can be relatively more concerning.

Ultimately, AMH testing enables women to make informed decisions on their future family plans. If you’re having trouble conceiving or simply want to be more informed, it is definitely worth considering. No test is 100% accurate, but an AMH test can be a helpful way to assess your egg reserve if you are considering fertility treatment.

If you have a family history of early menopause or you suffer from an under-active thyroid, an early AMH test could help to reassure you that your egg reserve is not adversely affected. Equally, you may want to consider egg freezing if you are not ready to start a family.

What does an AMH test mean in regards to your fertility?

An AMH test is a blood test that measures your level of anti-mullerian hormone (AMH). This is a hormone given off by developing eggs in the ovary that gives an estimate for a woman’s ovarian (egg) reserve; the higher the number of developing eggs, the higher the concentration of AMH in the bloodstream.

 As a woman ages, a natural drop in AMH levels is normal. However, if a woman has polycystic ovary syndrome (PCOS), then her AMH level will likely be unusually high. This is because her ovarian “cysts” are, in fact, small ovarian follicles that failed to reach maturity, and so were never released from the ovary.

 We know that a woman’s fertility declines as she ages so typically we see AMH values also start to decline as women age.

 The value of this test is that a woman with a low AMH can choose to do something about her fertility now if she desires a family for the future.

What is a good AMH level?

Your AMH levels are considered ‘satisfactory’ if they are above 21.98 pmol/l (picomole per litre).

At any age, a score over 48 pmol/L is considered a relatively high AMH level and could be an initial indication of PCOS. Studies have shown that around 97% of women with a high AMH level of 71 pmol/L or more have PCOS.

Ovarian fertility potential (pmol/l)

  • High AMH  = 40.04 – 67.9
  • Satisfactory AMH = 21.98 – 40.03
  • Low AMH = 3.08 – 21.97
  • Very low AMH = 0.0 – 3.0

What is a good AMH level for IVF?

Your level of AMH in the blood will help determine what IVF treatment is best for you.

It is important to note that different levels of AMH will impact your IVF (In Vitro Fertilisation)  success rate.

There is hope for IVF success even if your AMH levels are low – the best treatment can be identified for you dependent on your AMH test results.

For example, if you have low AMH, then you are likely to respond better to fertility treatment which uses fewer of the conventional stimulating drugs. However, Natural IVF and Modified Natural IVF can be considered as more suitable treatment for women with low Anti-Mullerian Hormone (AMH).

Tell me more about my options for treatment if I have low AMH levels?

Natural Cycle IVF involves egg collection aligned with your natural menstrual cycle; there are no stimulation drugs or injections involved. It works in sync with your menstrual cycle to collect the egg naturally selected by your body. Specialist doctors will use advanced ultrasound technology to monitor your cycle and check blood supply to the developing follicle to monitor it’s quality.

This treatment is suitable for women who match criteria such as low ovarian or egg reserve, women with low Anti-Mullerian Hormone (AMH) or high Follicle Stimulating Hormone (FSH), women who are older but wish to try with their own eggs rather than with donor eggs.

Natural Cycle IVF is suitable for every woman who is still ovulating and wants to avoid stimulation IVF drugs or injections.

There are benefits to this treatment such as reduced side effects and emotional burden on patients caused by stimulation hormone injections, reduced risk of a rare but potentially dangerous condition called Ovarian Hyperstimulation Syndrome (OHSS) , improved quality of eggs since naturally selected eggs can potentially have fewer abnormalities, while embryos created in conventional IVF can have an increased proportion of chromosomal abnormalities.

Also, by avoiding stimulant drugs, the womb is more receptive as their is a healthier womb lining, as a result more chance of the embryo successfully implanting and leading to a healthy pregnancy.

 Modified Natural Cycle IVF is a form of Natural IVF where the treatment is carried out within your natural menstrual cycle but is modified by introducing additional medication aimed at blocking your spontaneous ovulation and supporting the growth of the naturally selected follicle. This treatment has an improved success rate compared with Natural IVF while retaining many of the benefits.

 During treatment, you will be given medication for 3-4 days to keep the follicles growing healthy and to avoid spontaneous ovulation prior to egg collection. Specialist doctors will monitor your IVF cycle and tailor your treatment to offer the best possible chance of success while protecting your safety and reducing side effects.


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