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AMH (anti-Mullerian hormone)

08 Jun, 2017

A frequent question is whether women with low levels of AMH (anti-Mullerian hormone) can become pregnant, regardless of their reproductive age.

The granular cells surrounding the oocytes release AMH.
AMH levels reflect the total number of oocytes available in the ovary.
Patients with low a vitamin D level may get lower AMH results.
The screening of the AMH is part of the fertility investigation and, if it is low, we also have a diagnosis of low ovarian reserve.
The blood test is the one that evaluates the ovarian reserve and can be performed at any moment of the menstrual cycle.

AMH testing is recommended for women who:

• Have family history of premature menopause;
• Have undergone surgical intervention on the ovaries;
• Are suffering from endometriosis;
• Have went through chemotherapy;
• are planning to become mothers in the near future.

Factors influencing the AMH level:

• Age;
• Tobacco consumption;
• Ovarian surgeries;
• Body mass;
• Other causes.

Timely fertility screening via AMH level is also a recommended option for younger patients (<30 years old). Sometimes, women with low AMH may even have a greater chance of getting pregnant naturally.
Of course, a 38-40 year old woman with a level of 3.0 AMH ng / ml does not have the same chances of getting pregnant as a 25 year old woman with the same AMH level.
The situation of patients of over 35 years old is somewhat more complicated. Age is an independent variable which needs to be taken into consideration.

At the same time, a low AMH level in this age group is generally associated with poor prognosis.

Is the In Vitro Fertilization procedure recommended for the treatment of low AMH?

Yes, for women over 35 it is the most modern and justified option. The chances of getting pregnant are higher.

What are the chances of IVF pregnancy for women with low AMH level?

Specialists have proven that in IVF patients with a low AMH level the chances of pregnancy are quite high. Typically, higher doses are used, in order to compensate for low ovarian reserve.
A current approach is the use of drug combinations to stimulate the patients’ reproductive system (but with the freezing of the obtained embryos) and to resort to the natural cycle.

Important! AMH levels are not affected by contraceptive pills, gonadotropin-releasing hormones or pregnancy. Also, large follicles do not release AMH, and in this case the level of AMH will decrease at the following stages of the stimulated cycles.