Thinking about starting IVF? One thing to consider is your AMH level for IVF: Read on to learn more about AMH. 

 

By OBGYN and fertility expert Dr. Kenosha Gleaton

Tests, hormones, medications, appointments...there's already a lot to think about when you’re preparing for fertility treatments. But what is AMH, and does it really factor into IVF success? Let’s talk about it.

What is AMH

AMH (short for anti-müllerian hormone) is a hormone released by cells in the ovary during a woman’s reproductive years. Your AMH level is often a good indicator of ovarian reserve, or how many eggs you have left. A gradual increase in AMH levels occurs in girls from birth until about age 25, where maximum levels are observed. In adult women, AMH levels gradually decline as the primordial follicle pool declines with age, becoming undetectable at menopause.

Why AMH matters

Research shows that AMH levels correlate with the number of oocytes (eggs) retrieved after stimulation and can help predict ovarian response for those undergoing IVF. This tells us that AMH has some association with predicting live birth after IVF, but it’s ability to accurately predict live birth is somewhat poor.

AMH can also tell us when to expect menopause. Research shows that AMH is very low or undetectable approximately five years before menopause.

While AMH levels can be helpful for drawing some conclusions, it should be noted that AMH is not the only test for fertility and does not determine your chances of conceiving. Multiple studies show that AMH does not correlate with how likely you are to get pregnant, as conceiving depends on many other factors, including egg quality, the quality of the ovaries, sperm quality, or the health of the womb. The best way to prepare for a baby is to maintain overall health, such as taking fertility supplements for pregnancy as part of your daily routine. 

Fertility treatments and AMH

AMH can be especially useful for women going through fertility testing and treatments as it is often the earliest indicator of ovarian function. While AMH does not tell us everything we need to know, it can help predict someone’s response to fertility treatment. To understand ovarian reserve (the reproductive potential based on number and quality of eggs), a number of screenings may be utilized, but no single test is highly reliable for predicting pregnancy potential. In addition to AMH, your doctor will likely perform a variety of tests to look at numerous markers, including day 3 FSH (follicle stimulating hormone), day 3 estradiol, antral follicle count, and more. 

How often should AMH be tested?

There is no uniform timeline for how often AMH levels should be tested, but we do have a general idea. A team of doctors studied women undergoing IVF and performed repeat testing of AMH levels to determine how often significant changes occurred. The study concluded that quarterly AMH level assessments (≤1 per three months) may be beneficial for patients seeking fertility treatments for conveying additional diagnostic and potential prognostic assessments. For more information on what causes low AMH and ways to increase AMH, visit our website

Shop the Women's Fertility Test Bundle

How to interpret AMH results

General guidelines for AMH values and IVF are as follows:

  • AMH <0.5 ng/mL: This indicates a woman has fewer eggs than most. This result predicts difficulty in IVF getting more than three follicles to grow, which in turn reduces the chance for pregnancy with IVF 
  • AMH <1.0 ng/mL: Suggests a limited egg supply, and a short window of opportunity to conceive
  • AMH >1.0 ng/mL but <3.5 ng/mL: Suggests a good response to IVF stimulation
  • AMH >3.5 ng/mL: Indicates an ample egg supply, and suggests caution should be exercised in order to avoid ovarian hyperstimulation syndrome (OHSS). OHSS is a condition that may occur in response to excess hormones, sometimes due to medications used while undergoing fertility treatments. 

To summarize, the best response to IVF stimulation is typically seen in women with an AMH level in the 1.0-3.5 ng/mL range, but as previously mentioned, AMH levels do not indicate the quality of eggs, sperm, or the ovaries. These levels only give an idea of how many eggs are in the ovary and how many may be retrieved for those undergoing IVF.

What does “good” mean anyway? 

In general, a typical AMH level for a woman of reproductive age is between 1.0–4.0 ng/ml. For every woman, AMH levels will decrease with age, and there’s not much any of us can do about that, so it’s best not to stress about your level! It’s also important to note that there is no international standard for AMH levels, so interpretation of your results can vary depending on the test and the lab. The best thing you can do when trying to conceive is maintain good overall health. Try the Prenatal Daily Packets for doctor-formulated prenatal nutrition. 

AMH is just one measurement your doctor looks at to assess overall ovarian reserve, and multiple studies show that AMH doesn’t correlate with how likely you are to get pregnant. For example, AMH doesn’t reflect egg, sperm, or ovarian quality, which all play an important role in fertility. Bottom line, there really isn’t a “good” AMH level to hope for, because there is so much more that goes into fertility than one test. We at Natalist are committed to supporting you with the most evidence-based information to help you make informed decisions on your pregnancy journey.

Take-aways

  • AMH is a hormone released from the ovaries that can predict about how many eggs you have left
  • Research shows that AMH levels correlate with the number of eggs retrieved after stimulation and can help predict ovarian response for those undergoing IVF
  • AMH does not correlate with how likely you are to get pregnant, as conceiving depends on many other factors that AMH does not account for, including egg quality, the quality of the ovaries, male fertility, or the health of the womb
  • The best response to IVF stimulation is typically seen in women with an AMH level in the 1.0-3.5 ng/mL range
  • AMH levels decrease with age, and there isn’t much we can do about it, so try not to stress over your AMH levels and focus on maintaining overall health when TTC

 

Featured Image by Petr Ganaj