My AMH is Low – Will I be able to Conceive?

When you are informed of a low AMH level, do not panic.

Instead,

  • Go for a re-test preferably to confirm the same.
  • A professional IVF clinic will definitely advise you to go for additional tests to assess your ovarian reserve in such a scenario.
  • This includes the AFC, the Antral Follicle Count Test that evaluates the number of antral follicles in the ovaries, other tests that estimates FSH levels and ovarian volume.
    Anti-Müllerian hormone (AMH) level actually indicates the egg supply available (known as the ovarian reserve) in women for conception.

                  Source: http://www.whattoexpect.com

It is very important to note that low AMH levels in women just indicate poor egg reserve and not infertility or absolutely poor egg quality.

  •  Thus, it is definitely possible to conceive naturally and through IVF as long as you have eggs in your ovaries. 
  • At the same time, assessment of AMH levels is quite useful to predict the response to some medical procedures employed to induce ovulation while employing in vitro fertilization (IVF) techniques 
  • According to standard medical guidelines on in vitro fertilization (IVF), an anti-Müllerian hormone level (AMH) of less than or equal to 0.8 ng/mL predicts a poor response, whereas a level higher than or equal to 3.6 ng/mL predicts a good response to such procedures 
  • Thus, elevated AMH levels signify better chance of success of an IVF procedure, even in
    women with advancing age
     
  • AMH level assessments are, therefore, used to fine tune and improve the process of ovulation and the choices on the number of embryo transfers during IVF 
  • AMH assessment ultimately helps to maximise the pregnancy success rates and also brings down the side effects and risks of ovarian stimulation during IVF

    Research studies have suggested that AMH levels can be improved with daily consumption of wheat germ, 100 mg per day supplementation of CoQ 10 (Coenzyme Q10) and a 10 week supplementation of 60000 IU Vitamin D3 (Calcirol) once in a week with doctor’s approval.
    Apart from AMH, AFC is another marker for the diagnosis of the ovarian egg reserve and a low AFC indicates low numbers of remaining eggs in the ovaries.

    Numerous research studies have shown that an AFC test is quite precise in predicting the outcome of an IVF cycle than other normal tests for women, especially with advancing age.
    AFC and AMH test results are usually correlated with parameters such as patients’ prior response to stimulation, age, FSH levels and ovarian volume for further evaluation and treatment options.

    To summarize,
  • Assessment of the levels of AMH alone is often misleading
  • An elevated level of AMH is common even in conditions like polycystic ovarian syndrome
  • AMH levels should be, thus, evaluated only in combination with a transvaginal scan to assess antral follicle count and other relevant tests to evaluate pregnancy related hormone levels.
  • In case of diagnosis of a poor ovarian reserve after all these evaluations, IVF is obviously the best option

                                                   AMH Levels decrease with Age
                                                Source: www.womanhealthgate.com

Research

  • Behringer RR (1994). “The in vivo roles of müllerian-inhibiting substance”. Current Topics in Developmental Biology. Current Topics in Developmental Biology. 29: 171–87.
  • Fertility: assessment and treatment for people with fertility problems. NICE clinical guideline CG156 – Issued: February 2013
  • La Marca A, Sunkara SK (2013). “Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice”. Human Reproduction Update. 20 (1): 124–40.
  • Visser JA, de Jong FH, Laven JS, Themmen AP (Jan 2006). “Anti-Müllerian hormone: a new marker for ovarian function”. Reproduction. 131 (1): 1–9.
  • Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, Kramer P, Fauser BC, Themmen AP (Feb 2004). “Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment”. Molecular Human Reproduction. 10 (2): 77–83.

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