Tests, learning acronyms, doing math – TTC can feel a whole lot like going back to school.
We’re keen to take the load off and make taking those essential tests a breeze.
So let’s jump into AMH levels and what they mean for your reproductive health.
The TTC journey can be filled with a lot of unexpected twists and turns.
One thing you may not have bargained for?
The host of new lingo and the tests to go with it – especially if you’re doing IVF.
Overwhelming, we know.
TTC and blood tests go hand-in-hand (and that’s before you become a pro at peeing on sticks).
These blood tests check for certain hormones, including follicle-stimulating hormone (FSH), estradiol, and, the leading character of this article, AMH.
The AMH level is used specifically to estimate how many eggs you have left in your ovarian reserve.
It’s also the hormone that works inside the ovarian follicles where each of your eggs lives (and grows), helping them mature and ultimately leave the nest.
Needless to say, your AMH levels are important especially if you’re TTC over 35.
To help you get a handle on what can be an overwhelming subject, we’ve enlisted embryology expert Navya Muralidhar to give you the low down all all things AMH.
Let’s talk reproductive health!
In this article: 📝
- What is AMH?
- What is AMH in fertility?
- How do you take an AMH test?
- Is AMH testing worth it?
- What are normal AMH levels by age?
What is AMH?
AMH stands for anti-mullerian hormone.
While you may have heard of it only in relation to your egg production, it forms a crucial part of the reproductive systems of all sexes.
Let’s break it down.
The “M” in AMH refers to the Mullerian ducts.
Every embryo has these ducts, but they will develop into different organs depending on the sex of the fetus.
In female fetuses, they will become the female reproductive tract.
That’s where “anti-mullerian hormone” comes in.
If a fetus has XY (male) genes, it will produce a high level of AMH to prevent the development of female sex organs.
If a fetus has XX (female) genes, only a small amount of AMH is produced, allowing the female sex organs to develop.
What is AMH in fertility?
Wait, so what does this have to do with TTC?
Interestingly, AMH steps up to the plate in a different way after women hit puberty – and that’s to help house and protect the eggs in your ovaries.
Your egg production begins and ends during your time in the uterus, meaning when you’re born, you have all the eggs you will ever have.
At one point in the womb, you would have had upwards of about 6 million immature eggs. 🤯
This drops down to around one million by the time you are born and then down to 300,000 by the time your menstrual cycle kicks in.
As you age, your number of eggs continues to decrease – as well as their quality – which has a direct impact on your fertility.
We’ll explore this further a little later on but for now, it’s important to know that only a handful of your eggs will reach their final maturation towards ovulation.
“Each month, this recruitment of eggs start in the ovary” explains Navya, “a certain number of eggs start to grow in their follicles, until only one egg matures, and emerges to be the selected ‘egg of the month’.” 🏆
So what does AMH have to do with this?
“AMH helps with the growth and development of these follicles, and is secreted by the granulosa cells of the follicles” says Navya.
As your eggs decline so will your AMH levels, making the Anti-Mullerian hormone the best indicator of how many eggs left in your ovaries.
How do you take an AMH test?
The AMH test is a blood test that is used to indicate the size of your ovarian reserve.
As you can imagine, this is huuuge info for you to have as you make decisions about your fertility journey including whether you want to try IVF.
And speaking of IVF cycles, an AMH test can be a good predictor of the eggs that can be retrieved for that particular cycle.
You know, just standard TTC stuff.
If you’re wondering when to test AMH levels, there’s some good news.
Is AMH testing worth it?
The benefits of the AMH test are not only for those who are TTC BTW.
“AMH is said to be the most sensitive indicator of a diminished ovarian reserve or impending ovarian failure” says Navya.
Yes, it seems higher levels of AMH is associated with some features of the well-known condition.
Another important use?
Testing for AMH levels may also help to get to the bottom of cases of amenorrhea – a condition where a girl’s period has not started by age of fifteen.
What are normal AMH levels by age?
Age is generally the biggest factor affecting your AMH levels.
That’s not to say there hasn’t been some other pretty convincing suggestions – namely caffeine, smoking, and the use of marijuana – but these have not been proven.
Egg count will naturally decrease slowly in your teens and twenties with AMH levels typically reaching their peak at 25.
From 35, this decline becomes more rapid followed by a sharp decrease in your early 40s with most women starting menopause with less than 1000 eggs.
This study of women between the ages of 17 and 54 revealed that high AMH levels started at about 2.91 ng/ml in younger participants and decreased to about 0.45 ng/ml in participants over 50.
And since our eggs age with us, their genetic makeup breaks down over time.
So, it’s not uncommon for eggs to lose their quality or for older women to have higher quantities of genetically abnormal ones .
You might even say contrary to popular belief (read self criticism) it’s 100% natural.
What it does mean, is that pregnancy over 35 can look quite different.
What is a good AMH level to get pregnant?
If your AMH levels are between 1.0 and 4.0 ng/ml, you’re generally within a range where it will be possible for you to get pregnant.
But it’s important to note that pregnancies also happen when very low levels of AMH are present.
This may be because, as this study suggests, AMH is not a great predictor of the quality of the egg inside the follicle.
It’s possible that even if you have low ovarian reserve, your egg quality is still high enough to give you a good chance at pregnancy.
The other side of the story is also true – a “good” AMH level is no guarantee that you will get pregnant.
The TTC journey is anything but straightforward.
What level of AMH indicates infertility?
So that you can get a gauge of the spectrum, less than 0.6ng/ml is considered low, and less than 0.3 is considered very low.
Very high levels, as in those that might indicate PCOS, are above 3.
That being said, Navya points out that “having low AMH levels is in no way a sole predictor of a low-success IVF cycle.
No one should be deprived the chance of attempting IVF cycles due to low AMH levels alone.”
What is a good AMH score?
This is all comes down to age and even then is deeply personal.
According to Cleveland Clinic, the following are considered good AMH scores for each age bracket:
- Age 25: 3.0 ng/mL
- Age 30: 2.5 ng/mL
- Age 35: 1.5 ng/ mL
- Age 40: 1 ng/mL
- Age 45: 0.5 ng/mL
These numbers are on the lower end of a good AMH score but give a clear idea of what normal AMH levels would look like for your age.
It’s worth remembering that having AMH levels on the higher end could pose a risk for Ovarian Hyperstimulation Syndrome (OHSS) or indicate PCOS.
We’re talking beyond optimum levels.
No matter what side of the spectrum you fall on – even if neatly in the middle – your doctor or Reproductive Endocrinologist will be able to walk you through the next steps needed for your unique journey.
Can I increase my AMH levels?
Unfortunately there is no way to naturally increase your AMH levels.
As much as we wish there was, there are no miracle drugs or diets that will move the needle.
But AMH levels are not the only factor at play when it comes to infertility.
Illness, addiction, stress, and some medical treatments can all play a part.
You are also only one of your team’s players in this doubles match.
Somewhere between 40 and 50% of cases of infertility come from male partners.
And then, often, we just don’t know why it’s hard to conceive.
In as many as 10% of TTC struggles, it’s not possible to identify a root cause.
What we do know is that TTC can be incredibly stressful, often affecting both your personal wellbeing and your relationships.
The bottom line is, you don’t have to do this alone.
About 12% of women between the ages of 15 and 44 have trouble getting pregnant.
So, talk to your doctor about the options available to you and reach out to your Peanut TTC community.
The conversation is happening babe! Come be part of it. 🎤
If you’d like to continue to explore the language of TTC, head over to our guide.
We’re in your corner.