We believe in the importance of tackling myths and misinformation around fertility. That’s why our approach, product and tests have all been developed by leading fertility experts. There has been a lot of speculation about the role of AMH in fertility hormone tests. To clarify any foggy science, and debunk myths out there, fertility specialist Dr Linda Farahani tells us why it’s important to have the whole picture, and importantly what fertility tests can and can’t tell us.
All about AMH: What you need to know
The first point that is important to make – is that there’s no absolute predictor of fertility.
Fertility tests will not tell you if you are infertile. One in five couples will experience unexplained infertility, and for some of them, their fertility tests will report no problems at all.
Fertility is complex and we still have a lot to learn, however the science is developing and testing your fertility hormones can flag important issues if you’re planning to get pregnant. This includes:
- Your egg reserve, including the potential of premature ovarian insufficiency
- Whether you are ovulating regularly
- Reproductive health problems like PCOS
- Thyroid problems that can significantly impact your ability to conceive
- Whether you are likely to hit the menopause before or after the average
- Your potential response to IVF drugs
- Your general hormone health – eg. whether prolactin is causing irregular cycles
There is a lot of misinformation about the value of these tests, and what hormones you should and shouldn’t test. In this blog I set out the facts about the role of AMH in fertility. AMH can also give you information around polycystic ovary syndrome (PCOS). If you’re interested in learning more, check out our blog on PCOS and pregnancy.
What is AMH?
You are born with a certain number of eggs that decline over time. Your eggs live in little fluid-filled sacs called follicles that are in your ovaries. AMH is a hormone released by these follicles, so this hormone reflects the number of eggs you have. This is often known as your egg reserve.
What are normal AMH levels at certain ages?
As we get older, it is totally normal for our AMH levels to decline. When testing AMH you are looking to see whether you fall under the ‘normal’ level of AMH for your age group.
As a general guideline, the following levels (in nanograms per milliliter) represent the lower limit of serum AMH values by age:
- 45 years old: 0.5 ng/mL
- 40 years old: 1 ng/mL
- 35 years old: 1.5 ng/ mL
- 30 years old: 2.5 ng/mL
- 25 years old: 3.0 ng/mL
These are conservative estimate, but it’s important to remember that everyone is different and unique and can vary based on numerous factors. That’s why it’s always important to discuss your results with a doctor if you are concerned.
What can you learn from AMH in fertility tests
- High AMH levels can indicate PCOS, so if you know this you can take proactive steps with your doctor to balance your hormones and make a plan.
- Taken in context of your FSH, it’s a good indicator of your egg reserve and fertility potential. This can help you to plan when you start trying to conceive.
- Whether you’re likely to experience an early menopause (see research study here). Therefore, if you know you’re likely to hit menopause early than average and you want children, you can plan ahead.
- Whether you’re likely to have a good response to IVF drugs. If your AMH is less than [5], some fertility clinics will not offer IVF.
Why you shouldn’t test AMH on it’s own
It’s important to not test AMH on it’s own. In fact, you need to look at your fertility hormones in context. Fertility hormones are complex, and you can’t derive conclusions from looking at one of them in isolation. This is why we test a panel of six fertility hormones.
It’s particularly important to look at your AMH in the context of a hormone called FSH. FSH is released by the pituitary gland in the brain. FSH tells the ovary to develop a follicle (and, by extension, an egg) every month and also stimulates the follicles to produce oestrogen. If FSH is within normal range, this indicates that the pituitary gland and ovaries are working normally, and that you have a good number of eggs. This hormone rises when there are fewer eggs because the body needs to “work harder” to ovulate.
Just looking at AMH in fertility tests, or just FSH, means you miss important flags.
For example, you could have normal FSH but a high or low AMH, or normal AMH with high or low FSH. Testing only one of these hormones could mean the test fails to pick up the potential for PCOS or reduced ovarian reserve, or indicate how you might respond to IVF drugs.
Why your egg reserve is not indicative of your ability to get pregnant naturally
It’s important to remember that having your levels of AMH and FSH are not indicative of your ability to get pregnant naturally. Your AMH and FSH are indicative of your egg reserve, but even if your results indicate a low egg reserve as long as you are ovulating each month you still have the potential to conceive naturally. This has been confirmed in research studies.
Though AMH isn’t an indication of your ability to get pregnant naturally, it does offer a lot of valuable information about your hormone health, in context of other hormones.
Can I increase my AMH levels?
As declining AMH is linked to age, it’s hard to guarantee whether you will be able to increase your levels. However, some women find that adapting their lifestyle can help to get their AMh back to a more optimum level. This can often be really important for people who have been denied IVF due to their AMH levels. Here are some lifestyle factors to consider if you are keen to improve your AMH levels.
- Maintain a Healthy Weight: Studies have indicated that obesity could be linked to low AMH levels. Maintaining a healthy weight through a balanced diet and regular exercise may help boost AMH levels.
- Quit Smoking: Smoking is not great for any aspect of our fertility and it has been shown to reduce AMH levels, so quitting smoking is definitely something you should do if your levels are low.
- Eat a nutritious diet: Eating a diet full of fruits, vegetables, nuts, grains and protein is important for all areas of our fertility. Whilst there is limited research in to which foods specifically could help to improve AMH levels, there is a small study that indicated that eating dairy could help to slow down the decline of AMH levels in regularly menstruating women.
We hope this answers your questions about the role of AMH in fertility testing. Please reach out to our fertility experts if you have any other questions! We’re here to educate you on the options available to you.
If you would like to learn about your on AMH levels, our at-home hormone test analyses:
- Anti mullerian hormone (AMH)
- Follicle stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Prolactin (P)
- Thyroxine (T4)
- Thyroid stimulating hormone (TSH)
You can learn more and order your test here.
