AMH levels and its testing is considered to be a biomarker for a woman’s ovarian reserve. On the contrary, AMH levels don’t indicate a woman’s ability or not to conceive an off-spring within a time frame.
In a blood test, AMH levels can act as an indicator of the potential number of follicles inside the ovaries. Yet, AMH levels don’t represent the quality of eggs.
The base of the relationship between one’s AMH levels and fertility is that a woman’s fertility declines as she ages. This correlates with the decline in AMH levels too.
AMH level test indicates the counting of eggs remaining rather than the quality of those eggs. AMH level test is actually a “screening test” but it is often viewed as the “fertility test”. Hence, a low AMH levels test result does not signify that the women are not fertile. It is just a screening test to study and treat a fertility problem.
So, AMH level alone should not be the source to understand fertility as fertility also depends on the quality of the eggs which is not gauged by the AMH level test.
Ideal AMH levels for different age groups.
Age Ideal AMH level
<24 months <4.7 ng/mL
24 months – 12 years <8.8 ng/mL
13 – 45 years 0.9 – 9.5 ng/mL
>45 years <1.0 ng/mL
Now, let’s delve into interpretation of AMH levels.
Interpretation AMH levels
High levels (Testing for PCOS is advisable) >5.0 ng/ml
High levels (Ideal for IVF treatment) 3.5 – 5.0 ng/ml
Optimal levels 1.0 – 3.5 ng/ml
Low levels (Assisted reproduction is viable) 0.3 – 0.7 ng/ml
Very low levels <0.3 ng/ml
Note: The scale is general and intended for women only.
AMH levels are indicative of the oocyte count. A typical normal AMH Level for a fertile woman is 1.0-3.5 ng/ml, under 1.0 ng/ml is viewed as low and AMH Blood level above 3.5 ng/ml is considered as high.
AMH test may prove useful if you are a woman who is facing difficulty to conceive. This test might help you know what are your chances of getting pregnant in case you are looking for any assurance. It can also help you make the decision to go for fertility treatments because if you are already consulting a fertility specialist then he/she may use the AMH test to conclude whether you will respond poor or well to treatment like IVF (In Vitro Fertilization).
Also, you may need an AMH test if you show the symptoms of PCOS (Polycystic Ovary Syndrome). Moreover, an AMH test may be needed if you are being treated for ovarian cancer as it may help you know if your treatment is working.
AMH i.e. Anti-Mullerian Hormone is a test that indicates about a woman’s ovarian reserve as it is on the day. Higher AMH values (greater than 1 ng/mL) usually signals that a woman has a normal ovarian reserve and lower levels (less than 1 ng/mL) may signify that a woman has diminished ovarian reserve (DOR). AMH levels results help you decide when you try to conceive by telling you the chances to conceive. A higher level of AMH signifies higher chances and more time before you try to get pregnant. But it may also mean that you are suffering from PCOS(Polycystic Ovary Syndrome).
A low level of AMH signifies that you may have a low chance of getting pregnant. It may also mean that you are starting menopause. Low levels of AMH are common in women after menopause and young females. The AMH level test can tell whether the treatment is working or not in the women who are being treated for ovarian cancer. As we know that the fertility in women declines with the increasing ages, so, correspondingly the AMH levels also start decreasing as women age.
AMH levels are vital data to be taken into consideration when a woman is opting for egg freezing. Women with AMH levels between 1.0 ng/ml to 4.0 ng/ml are in the optimal range for egg freezing. It is advisable if they’re actively trying to conceive.
On the flip side, women with AMH levels under 1.0 ng/ml are prone to increased risk of infertility. However, it doesn’t rule out the chances of bearing an offspring, but the time frame is narrowed down. And women with lower AMH levels should consider freezing as soon as possible.
The number of eggs being extracted for freezing also depends on the woman’s AMH levels. For a woman whose AMH levels are less than 1.0 ng/ml, fewer eggs will be extracted to freeze.
Furthermore, for women with high AMH levels, generally over 4.0 ng/ml, risk of ovarian hyperstimulation syndrome (OHSS) is pretty high. This will require a personal diagnosis for assessing the safe number of eggs to be extracted for freezing.
Usually, individuals aren’t asked to get their blood test for AMH levels alone. It is often coupled with Sonohystogram (SHG) or Hysterosalpingogram (HSG). These tests compile into a comprehensive fertility test.
These are done using ultrasound scanners to evaluate the individual’s uterus, fallopian tubes to identify or diagnose any issue.
Furthermore, women not only undergo AMH levels test but also other tests to evaluate their ovarian reserve.
FSH blood test evaluates the count of Follicle Stimulating hormone. In general, if FSH levels are high, it is an indication of poor ovarian reserves. Getting an FSH blood test not only indicates the health of an individual’s ovarian reserves, but it also helps in deciding for the usage of IVF treatment or other assisted reproduction methods.
Antral Follicle Count (AFC) test — an ultrasound-based test which measures the quantity of egg-containing follicles present in the ovaries.
These two tests are generally advocated alongside AMH levels test to gauge a woman’s ovarian reserve.
AMH levels test is a mild blood test. The best thing is AMH levels of a woman can be tested at any point of time in her menstrual cycle. There are no harsh pre-requisites for the test like fasting.
The nurse or doctor would use a needle and draw a small blood sample. This is further sent to testing and usually, the results will be provided within 48-72 hours.
When a woman is planning to conceive, AMH test coupled with her age will be taken into full consideration. This will be processed and the doctor will prescribe a course of action for the conceiving of an offspring.
In the case of low AMH levels, doctors generally look at IVF treatment and other assisted reproduction methods.
Let’s understand the fact that elevated levels of AMH have generally been treated as a signal for the presence of Polycystic ovarian syndrome (PCOS). The increase in cyst formation and follicles at the development stage is why AMH levels are high and correlate with the presence of PCOS.
The menstrual disturbance caused by PCOS and its increase coincided with the elevated levels of AMH. Reference: A research paper published at PubMed Central of the National Institute of Health (NIH) (Ali Abbara, Pei, Maria et. al, 2019)1.
PCOS, in short, is a leading cause of reduced fertility amongst women. Hence, testing for PCOS will be advisable when high AMH levels are noticed.
The presence of PCOS in women with high AMH levels is a correlation. So, to truly understand the woman and her affecting from PCOS, a comprehensive ultra-sound scan is advisable. The antra follicle count (AFC) will further determine the presence of PCOS.
Women suffering from PCOS need not worry about their potential to bear offsprings. In general, women with PCOS react well to IVF treatments. Yet, the risk of Ovarian Hyperstimulation Syndrome (OHSS) amongst women with high AMH levels means mild stimulation treatment or natural IVF protocols can suffice.
Short answer – Yes.
Even after many studies and research, the scope of getting pregnant for women was unaffected by their Anti-Mullerian hormone (AMH) levels. The AMH test which evaluates the ovarian reserve in a woman has often been used as a potential gauge for fertility and birth prospects.
However, a study (Steiner AZ, Pritchard D, Stanczyk FZ, 2017)2 published in the Journal of the American Medical Association (JAMA) with 981 volunteers proved otherwise. It showed a trivial correlation to diminishing ovarian reserves and fertility potential.
In short, women having low AMH levels too can get pregnant. Yet, the time frame of pregnancy, within 6 cycles or 12 cycles has been left as food for thought.
AMH levels aren’t the only deciding factor for the success of in-vitro fertilization. We also need to know that AMH levels are a quantitative indicator of an ovarian reserve and not a qualitative one. Concerning low AMH levels, age is a major factor and outmatches the dependency on how low the AMH levels are.
To bring IVF into the picture, the combination of age and AMH levels substantiate the potential for reproduction. According to research in the Middle East Fertility Society Journal (Zaghloul, Y.I., Amin, Y.M., Mansour, R.T., 2020)3 AMH levels under 0.5ng/ml are considered to be less than desirable. However, even they have the potential for bearing off-springs with assisted reproduction – IVF. Yet, in the same age group, normal AMH levels resulted in higher pregnancy potential than low AMH levels.
In short, women enjoyed successful outcomes from IVF treatments as their AMH levels increased. 1.0 ng/ml to 4.0 ng/ml can be considered to be the sweet spot for the highest rates of success of IVF treatments.
AMH is a hormone released by the ovaries, and its levels are indicative of the oocyte count. A typical oocyte count for a fertile woman is 1.0-4.0ng/ml, under 1.0ng/ml is considered low and considered as a diminished ovarian reserve. Women with a very low AMH level (0.5ng/ml) can have a chance of getting pregnant, although there is a risk of cycle cancellation but should not exclude a couple from IVF.
An AMH level of 2.5ng/ml to 4ng/ml is considered to be normal for women around the age of 35.
Pointers to note:
Diet can have a profound bearing on a woman’s ovarian reserve and AMH levels. Some types of food like iron, fibre, proteins, high-fat diary are a must for a woman to boost fertility levels. In a similar vein, red meat, processed food, fast food with any kind of processed sugar will have an adverse effect on the woman’s fertility levels.
And one non-negotiable part of your diet will be water. Increasing your water intake will improve your AMH levels and also your health, in general.
We have put forth a list of food items that will help you increase AMH levels, in turn, enhance the health of the ovaries and eggs.
AMH level blood tests and the associated costs depend on lots of variables. For example, the location, access to testing facilities, quality, convenience etc.
In India, an AMH level blood test can be priced anywhere in the range of ₹ 800 to ₹ 3000.
High AMH levels also don’t necessarily have medications or measures to be naturally decreased.
There are no sure shot ways to increase AMH levels naturally. However, there are a few measures which can help enhance the quality and quantity of eggs.
Apart from all this, an interesting way that has shown correlation to increased AMH levels is the consumption of Bone marrow soup.