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Anti-Mullerian Hormone (AMH) – one of the most important indicators of a woman’s reproductive health. AMH is produced by ovarian follicles and helps assess the ovarian reserve, i.e., the number of eggs remaining in the ovaries.
What does AMH level indicate?
- Reproductive potential of the female body
- Likelihood of successful fertilization
- Whether you should hurry with pregnancy planning
- What to expect from ovarian response to stimulation during IVF
When should you take the AMH test?
- When planning a pregnancy, to learn about your ovarian reserve
- At ages 24-28, to understand your individual egg reserve
- If pregnancy planning is delayed for some time, to assess your future fertility potential
- Before starting an IVF program, ovulation stimulation, to calculate ovarian reserve and dosage of stimulants
- If there are signs of early menopause or if there were cases of early menstruation cessation in the family
What are the norms according to age?
📍 20-25 years: 3.0-6.0 ng/ml (high ovarian reserve)
📍 26-30 years: 2.5-5.5 ng/ml
📍 31-35 years: 1.5-4.5 ng/ml
📍 36-40 years: 1.2-3.0 ng/ml
📍 41-45 years: 0.6-1.5 ng/ml (significantly reduced ovarian reserve)
📍 45+ years: <0.5 ng/ml (sign of approaching menopause)
It is highly recommended that AMH level is above 1.1 ng/ml when planning pregnancy.
What affects AMH levels?
- Age (levels decrease with time)
- Genetic predisposition (if there were cases of early menopause in the family)
- Ovarian surgeries (endometriotic, dermoid cysts) reduce follicle reserve
- Autoimmune diseases (AIT, rheumatoid arthritis, lupus)
- Polycystic Ovary Syndrome (PCOS) – high AMH due to a large number of immature follicles
- Oncological treatment: the impact of chemotherapy and radiotherapy (thus, before undergoing such treatments, it is very important to assess the possibility of preserving eggs or embryos for future child planning)
- Chronic stress, poor nutrition, smoking (causes impaired blood flow to ovarian tissue, accumulation of free radicals that negatively affect egg quality and quantity)
Why does Anti-Mullerian Hormone decrease with age?
A woman is born with a certain reserve of eggs, and over her lifetime, this number gradually decreases. Up to 35 years, the decline in reserve happens relatively slowly, after 35-38 years, it accelerates significantly, and after 45 years, the ovarian reserve may be exhausted. Reproductive specialists worldwide are increasingly noting cases of egg reserves not matching a young reproductive age, meaning that even at a young age, egg reserves can be significantly reduced or completely depleted.
How does AMH affect pregnancy planning?
AMH level helps determine the optimal time for conception. Women with low Anti-Mullerian Hormone are advised not to delay pregnancy or to consider fertility preservation options, such as egg freezing (the “delayed motherhood” program).
What to do with low AMH?
- Undergo additional examinations to assess the chances of natural conception
- Consult with a reproductive specialist to choose the optimal fertility preservation strategy
- Consider preserving eggs or embryos (cryopreservation) for the future
- Use assisted reproductive technologies (IVF, donor eggs) if necessary
Important facts:
- AMH is not affected by the menstrual cycle phase, so it can be tested on any day
- High Anti-Mullerian Hormone is often observed in women with polycystic ovary syndrome (PCOS)
- Low Anti-Mullerian Hormone can be the first signal of approaching menopause, even if the menstrual cycle is still regular
5 most common questions about Anti-Mullerian Hormone
- Does lifestyle affect AMH levels?
- Yes, a healthy lifestyle, balanced nutrition, and avoiding harmful habits and stress can positively affect overall reproductive health, but it is not possible to artificially increase AMH levels.
- Does low AMH mean complete infertility?
- No, a low Anti-Mullerian Hormone level reduces the chances of natural conception, but modern reproductive technologies can help.
- Is AMH an indicator of egg quality?
- No, AMH shows only the quantity of eggs, not their quality. The quality depends on a woman’s reproductive age and overall health condition.
- Can AMH be tested while on hormonal contraceptives?
- Yes, but the results may be somewhat lowered, so the doctor may recommend discontinuing contraceptives for 2 months before the test.
- Can AMH levels be increased?
- Unfortunately, it is not possible to increase Anti-Mullerian Hormone levels since they reflect the natural egg reserve. However, reproductive health can be supported through proper nutrition, avoiding harmful habits, and managing stress levels.
Can the level of Anti-Mullerian Hormone be increased?
No, AMH level reflects the number of follicles in the ovaries, and it is not possible to significantly increase it. However, reproductive health can be supported through:
- Taking vitamins B9 (as metafolin, methylfolate) and B12 (methylcobalamin), D, E (tocopherol), omega-3, and coenzyme Q10 (ubiquinol)
- Leading an active lifestyle, reducing stress levels, and quitting smoking
- Consulting a reproductive specialist on reproductive strategies with low AMH levels
What are the most useful nutraceuticals for low Anti-Mullerian Hormone?
- Vitamin B9 (as metafolin, methylfolate) and B12 (methylcobalamin) – very important for egg quality
- Coenzyme Q10 (as ubiquinol) – helps improve egg quality
- Omega-3 fatty acids (EPA:DHA in a 2:1 or 3:1 ratio) with natural vitamin E (wheat germ oil) – support overall ovarian health
- Myo-inositol and D-chiro-inositol in a 40:1 ratio (this ratio matches the natural balance of inositols in follicular fluid) – can improve ovulation, especially in PCOS
- L-arginine and L-citrulline – amino acids that improve ovarian blood circulation
- Resveratrol (as trans-resveratrol) – a powerful antioxidant that can slow down cell aging
- Magnesium and zinc (in chelated form, i.e., bound to amino acids, which improves absorption). These minerals are essential for the normal functioning of the reproductive system. Best forms: Magnesium bisglycinate, zinc bisglycinate, zinc monomethionine
- Vitamin D (cholecalciferol in fat-soluble form) – helps maintain hormonal balance
Remember: AMH level is just one of the fertility indicators. It should be assessed along with other factors. If you have questions, contact the reproductive specialist at our clinic – we will help find the best solution for your health and motherhood! 💙
