Do you know when a baby girl is born, she has almost 2 million eggs in her ovaries? These eggs decrease and reach four lakh eggs when she hits puberty and it decreases with every menstrual cycle. Isn’t it an interesting fact that we just told you?
The egg sacs in the ovaries are in the resting stage known as primordial follicles or sleeping follicles. Every month 4 to 5 eggs grow and mature out of the total eggs and are known as antral follicles. These antral follicles develop an AMH hormone that supports the eggs.
Anti-Mullerian Hormone (AMH) is a very important hormone that tells us about the ovarian reserve or the number of eggs in the ovaries to date. An AMH test tells us about the number of eggs in the ovaries but doesn’t give any information about the quality of the eggs. That is why we consider AMH as a quantitative test and not a qualitative test.
The second thing to remember is that AMH is a simple blood test that can be done in any lab. Also, AMH is not interred-menstrual variation and hence it can be done on any date of the month.
Now, what are the levels or values of AMH?
There are different levels or values of AMH that is shown in the report. Normally the AMH level is between 1 to 3 nanogram per ml. If this AMH level is above 3, especially 4, then this report can show polycystic ovary or PCOS. If this AMH level is below 1, we consider it a low normal value, and if this level is below 0.7; we consider it a very low value.
Now the question arises: Can you become pregnant with low AMH levels?
Yes. As we just understood that the AMH test tells us about our ovarian reserves. Even if the AMH level is less, you can still become pregnant as you just need a single egg to become pregnant. If all the other factors are normal, you can become pregnant with even low AMH levels.
You need to keep one thing in mind that is you can naturally conceive even with the low AMH levels, but you may face some problems, too. The second thing is to know that your reproductive window is low, so you have less time to become pregnant. This happens because your eggs are decreasing in number. With low AMH levels, try to plan your pregnancy as soon as possible.
Are there any symptoms of Low AMH levels?
Usually, in most people, there are no symptoms of low AMH levels, but some people can experience irregular periods. Some people may face fertility problems, after which a test is done that shows low AMH levels.
The next thing is that after you know that your AMH levels are low, you can confirm it through ultrasound. By doing an ultrasound, your doctor can see the count of Antral follicle count inside the ovaries. The doctor can see the count of small follicles and then you can compare it with your AMH levels.
There is another uncommon test which is an FSH test or Follicle-stimulating hormone test. This FSH gets secreted from the brain and acts upon the ovaries to develop follicles. If the level of FSH is above 10, that means your brain is making FSH in high amounts to act upon ovaries.
But as there are less accuracy and more variations in this test, it is not done nowadays.
What are the causes of low AMH?
The first cause of low AMH is inherited genetic causes. This means if you have a family history of early menopause, you can also have the same issue. In this situation, your genes or DNA are responsible for low AMH.
Another important cause of low AMH is aging. We already learned that AMH levels decrease with age. These AMH levels are highest when you are around 25 to 30 years old. These levels get decreasing with age and when you reach your 40s the AMH levels are about 0.9. So it is important to understand that with the increasing age, the chances of pregnancy decreases.
Other causes of low AMH can be any past surgeries or any ovarian disease like endometriosis, dermoid cyst, etc, by which you can have low ovarian reserve or low AMH.
The last but important cause of low AMH can be smoking. Smoking decreases the ovarian reserve at a very fast pace. It is important to quit smoking while planning for pregnancy as it has many side effects.
Can we increase AMH levels?
Unfortunately, we can not increase our ovarian reserve or AMH level because it is something that gets fixed at the time of birth. So, there is no drug, medicine, or treatment can that increase the AMH levels to a high number. But up to some extent, we can increase AMH levels by some medicine like DHA. Your doctor may suggest you vitamin d supplements if he finds vitamin deficiency in you.
One thing to remember is that you can not increase your AMH levels to the levels you want. It is something natural.
What to do if you have low AMH?
Now if you have low AMH and you are young, you can consult a fertility expert. Try to plan your pregnancy as soon as possible. But if you are above 30, decide that you may take the help of advanced techniques like IVF to get pregnant. If you are young and married, and you don’t wish to plan your pregnancy, you can use some advanced methods like egg freezing.
Sometimes some women with low AMH levels may need an egg donor to get pregnant. But if someone eagerly wishes to get pregnant with her own egg, then we can use Ovarian rejuvenation techniques in which we insert PRP material in ovaries and use them. This ovarian technique is an expensive treatment and its result is still controversial.
At last, remember that low AMH shows your ovarian reserve and not your fertility potential. Low AMH may show that you have less time to plan a pregnancy, but it doesn’t mean that you can not conceive naturally. If you have low AMH, consult your doctor as soon as possible so that you don’t miss out the important chances of getting pregnant before it becomes too late.
AMH Hormone and Values
|Too High||> 6ng/ml|
|Normal low||0.7-0.9 ng/ml|
|Very Low||< 0.3ng/ml|