What does Low AMH Mean?
Anti Mullerian Hormone or AMH is a hormone which is released by developing ovarian follicles – Developing ovarian follicle is the sac which contains immature eggs (ooctyes).
Anti Mullerian Hormone or AMH gives us an idea about the number of eggs left in the ovaries. This is known as the ovarian reserve. Therefore Anti Mullerian Hormone or AMH is a blood test of ovarian reserve which gives us an idea about the chances to get pregnant. It can be normal, low or high.
Low AMH means that the ovarian reserve is on the lower side.
Is AMH the only test needed to determine ovarian reserve ?
No. Apart from Anti Mullerian Hormone or AMH Estimation, Age, Antral Follicle Count on Ultrasound (also known as AFC), hormones like FSH, Estradiol level, response to previous stimulation are also markers of ovarian reserve.
While estimating ovarian reserve, a combination of these will be advised by your fertility specialist.
What is the normal value of AMH ?
Anti Mullerian Hormone or AMH estimation is done by a Blood Test which can be done at any time of the menstrual cycle.
Different labs use different units so while comparing results, one should ensure that the values are in the same units.
The commonly used values are:
- High (Often PCOS) : Over 4 ng/ml
- Normal : 1.5 – 4.0 ng/ml
- Low Normal : 1.0 – 1.5 ng/ml
- Low : 0.5 – 1.0 ng/ml
- Very Low : Less than 0.5 ng/ml
Can I become pregnant with Low AMH?
Anti Mullerian Hormone or AMH naturally decreases as the age increases. This indicates that with an increase in age, the ovarian reserve reduces.
Don’t worry if your AMH values are low. There are chances that you will conceive on your own without any assistance, but these chances are less than other females of the same age group.
There are many treatment options available which you should discuss with your fertility specialist. Initially if age and response to stimulation are satisfactory, IUI can be tried. If not successful, Natural IVF and Modified natural stimulation IVF may be considered.
Do I need Donor eggs if I have low AMH?
Low Anti Mullerian Hormone or AMH does not necessarily mean egg donation.
If one can get own oocytes or eggs with minimal stimulation, that should always be attempted first.
Oocyte or Embryo pooling is often considered for patients who are willing to try multiple treatment cycles in case of Low AMH.
However, if one cannot get good quality ooctyes, taking oocytes or eggs from oocyte donor may be considered.
Is there any medication to improve AMH Value?
No medicine / injection can increase Anti Mullerian Hormone or AMH. It is a value that will reduce as the age increases.
What is the treatment for Low AMH?
This means that those who wish to conceive should not waste time and act proactively.
Visit your fertility specialist and discuss options. These options may range from simple timed intercourse to IVF or ICSI depending on co-existing factors.
For those who are not married, have not decided their partner, or wish to be single parents, oocyte cryopreservation or egg freezing should be discussed.