In an eggshell...
- AMH testing can help identify your ovarian reserve, a.k.a, how many eggs you have left.
- AMH levels vary with age. Don’t worry, the lab will consider this.
- An AMH test helps your clinic tailor the egg freezing protocol to you.
You may have heard of anti-mullerian hormone (AMH), and that it’s tested during egg freezing. Some women also choose to measure their AMH levels to check their fertility.
Your AMH will give you a good idea of how many eggs you have in your ovaries. This can be helpful if you’re looking to freeze your eggs but can cause unnecessary stress if you’re trying to conceive naturally. You only need one good egg to be released each month, after all!
In this article, we’ll discuss what the test is, why it’s important to measure AMH when freezing your eggs, and what the results mean.
What Is Anti-Mullerian Hormone?
Anti-mullerian hormone (AMH) is made in your reproductive parts. In men, that’s the testicles. In women, it’s produced by the ovaries.
As a young girl, your AMH levels would have been low. But once you reach puberty, AMH starts to increase.1
AMH is involved in follicle production. If you’ve not heard of them, follicles are fluid filled sacs that each contain an egg.
Why Do You Need to Test for Anti-Mullerian Hormone?
AMH can be a good indicator of how well your ovaries are working. By measuring it, you can learn:
How many eggs there are in your ovaries
Also known as ovarian reserve, the amount of AMH is related to the number of eggs in your ovaries.2 Yes, the number of eggs does tend to decrease as you get older. But the lab will take this into account when measuring how many eggs you have left.
How well you’ll respond to ovarian stimulation
To freeze your eggs (or even to do IVF), you’ll need to stimulate your ovaries using artificial hormones. Normally, your body matures and releases just one egg a month. But to collect your eggs, your ovaries will need to mature a lot more.
Your AMH levels suggest how well your ovaries will respond to these hormones.2 This will help your clinic decide how long you should take the hormones for.
Whether you’re close to the menopause
AMH levels drop leading up to menopause as the number of eggs drops. Tests can help find out if you’re having early menopause, but they won’t be able to tell you when you’ll reach menopause.
If there’s a problem with your ovaries
Abnormal AMH test results can help to diagnose issues with your ovaries, including some types of ovarian cancer. Polycystic ovary syndrome (PCOS), a hormonal issue that may cause infertility, can also be detected.2 If your doctor is worried, they’ll usually investigate with scans and other tests, too.
What Happens During an AMH Test?
An anti-mullerian hormone test is a blood test. As you might expect, the process is the same as with other blood tests. Your clinic should contact you to discuss the results.
Do I Need to Prepare for an AMH Test?
No, there’s nothing special to do before an AMH test. It doesn’t need to be done at a particular time in your cycle.
Just make sure you’re hydrated to make it easier to take your blood.
How is AMH interpreted?
As AMH decreases with age, the normal range changes for women in different age groups.
There’s not one standardised set of numbers used. Values vary between clinics, laboratories, and countries. For clinic-specific values, contact our partner clinics directly.
We’ve included some widely-used AMH values to give you an idea of “normal”.3
Age Range AMH (pmol/L)
20 – 24 years 8.7 – 83.6
25 – 29 years 6.4 – 70.3
30 – 34 years 4.1 – 58.0
35 – 39 years 1.1 – 53.5
40 – 44 years 0.2 – 39.1
45 – 50 years 0.1 – 19.3
What Does Low/High Anti-Mullerian Hormone Mean?
You might know what the normal range looks like for your age group. But what if you’re outside this range?
Low and high AMH levels can be caused by a few things. High levels can just mean you’re very fertile and have a lot of eggs. Or they can be due to an issue causing your ovaries to produce too much AMH. PCOS is the most common example.2
Low levels can be caused by age, your genes, environmental factors, and bad habits like smoking.4
Now you’ve heard what causes your anti-mullerian hormone level to fall outside the normal range. Let’s talk about what low and high AMH levels can mean in practical terms.
Fertility
A low AMH level doesn’t mean you’re infertile. Low AMH just means fewer eggs. It doesn’t measure egg quality.2
If you’re trying to get pregnant naturally, the number of eggs matters less. If one good-quality egg is released every month, your chances of success are higher.
For egg freezing, the number matters more. You’re hoping to freeze a good number of eggs as some might get damaged during freezing and thawing. Women who’ve only frozen a few eggs still go on to have successful pregnancies, though!
At the opposite end of the scale, high AMH doesn’t necessarily mean you’re very fertile. It can be a sign of fertility issues like PCOS or, rarely, ovarian cancer. Your doctor will discuss this with you in more detail.
Ovarian Stimulation
Clinics measure AMH to get an idea of how you’ll respond to ovarian stimulation.
Low levels suggest you may need a longer ovarian stimulation protocol. Essentially, you’re likely to be more successful with egg freezing if you take the hormones for longer before egg extraction.
High levels suggest you’re more likely to respond too well to the hormones. This can put you at an increased risk of ovarian hyperstimulation syndrome (OHSS).5 Your clinic may decide taking the hormones for a shorter time is better for you. They may also monitor you more closely.
Number of Egg Freezing Cycles
Low AMH suggests that, even with stimulation, you’ll probably only be able to extract a few eggs with each egg freezing cycle. This means you might need more egg freezing cycles to freeze a good number of eggs.
What Can’t an AMH Test Tell You?
AMH testing can help guide your egg freezing experience. It can help your clinic tailor the protocol to your individual needs. But there are a lot of misconceptions around what you can learn from AMH testing.
An anti-mullerian hormone test can’t tell you:
When you’ll go through the menopause
There’s currently no accurate way to predict this, including AMH testing. AMH testing can tell you if you’re going through early menopause, though.6
How likely you are to conceive naturally
You only release one egg a month during a normal cycle. Lots of things affect whether it’s fertilised, but the number of eggs in your ovaries doesn’t.
The quality of your eggs
AMH levels are linked to the number of eggs, not the quality.
That you’re infertile
AMH testing doesn’t pick up lots of fertility issues. It’s not a direct measurement of your fertility, just the number of eggs in your ovaries.
Frequently Asked Questions
Hopefully, you’re now a bit better informed about AMH testing. If you want to know more, we’ve answered some of the most frequently asked questions below.
How can I increase my AMH levels?
If your low AMH levels are caused by lifestyle factors, like smoking, stopping can improve your AMH levels.4
There’s some evidence that vitamin D supplementation can increase AMH. But it probably just increases the hormone levels, rather than increasing the number eggs.7
Unfortunately, there’s no clear evidence that one thing significantly increases AMH levels.
How accurate is an AMH test about fertility?
As we previously mentioned, AMH tests don’t tell you everything about your fertility. But they’re good for providing information on the number of eggs you have. Antral follicle count (AFC) testing can give even more information about ovarian reserve, and how well you’ll respond to ovarian stimulation.
If you’re worried about your fertility or suspect something is wrong, contact your doctor directly. They can organise the tests and scans required.
Do at home AMH tests work?
At-home AMH tests are convenient. However, these tests still require a blood sample, which is usually taken by pricking the finger. It can sometimes be difficult to get enough blood at home.
The sample is then sent to a lab for analysis, and the results are provided. You should follow up with a healthcare provider to discuss the test results. If you’re not already seeing a specialist, book a free specialist consultation through Amilis.
Some clinics might ask you to do a repeat test for egg freezing, as not all clinics accept at-home test kits.
Does the contraceptive pill interfere with AMH testing?
Yes, the contraceptive pill can reduce your AMH. Usually, levels return to normal a few months after stopping taking the pill.8
Hopefully, you’re now more confident about AMH testing and what the results mean. Thinking about getting your anti-mullerian hormone levels tested? Book a consultation through Amilis here.
