AMH stands for Anti-Müllerian hormone, which is an essential fertility hormone factor. It is produced in both male (testes) and female (ovaries) reproductive tissues. In women, AMH levels are a baseline of their fertility potential, because these levels provide specialists with information about ovarian reserve (the number of egg follicles waiting to mature).

While AMH testing – performed via a blood sample – is a routine part of infertility testing, this affordable test is also recommended for women interested in learning more about fertility preservation via egg freezing to support future family building plans.

AMH Plays an Essential Role in Fertility

While AMH does play a role in male fertility (more on that below), most fertility centers focus on their female patients’ AMH levels as a way to assess their ovarian reserves. It’s important to note that while AMH gives us an idea about egg reserves, AMH levels do not tell us anything about egg quality.

Since ovarian follicles excrete AMH, normal levels of AMH in women between the ages of 20 and 35 typically indicate healthy ovarian reserves. Lower levels of AMH can indicate lower ovarian reserves or may be a sign that a woman has a diminished ovarian reserve, or she may be experiencing early menopause. Once a woman is no longer producing eggs (typically 12 months after her last period), AMH levels drop to 0.

How AMH Levels Affect Female Fertility

There are several ways we use the results of AMH tests.

1. To get an idea of your ovarian reserves

In most cases, the main reason to perform AMH tests is to get an idea of your ovarian reserves.

• Women 35 and younger. If you are interested in fertility preservation because you don’t plan on getting pregnant before your late 30s or early 40s, we use AMH testing to determine whether you’ll have enough eggs to freeze for the future – or whether retrieving them now might negatively impact future fertility. If we see that your AMH levels are lower than normal, we’ll discuss your fertility options, which could include the decision to get pregnant sooner than originally planned or to discuss how age will affect your egg reserves going forward.
  
• Women 36 and older. If you are coming to use after struggling to get pregnant, AMH testing is part of the infertility testing protocols. These levels help to shape future fertility plans. For example, if you have healthy reserves, we may be able to take a scaled approach, working using oral fertility meds and timed intercourse to start, and then working into things like IUI or IVF from there.
  
  However, women 38 and over who have exceedingly low AMH levels may only have a single chance to retrieve an adequate number of eggs, in which case we’ll talk about moving forward with IVF. Your fertility specialist may also discuss the idea of using donor eggs if we suspect egg quality may be an issue.

2. Assess how you’ll respond to fertility medications

Your AMH levels also provide information about how your body may respond to fertility medications. We use oral or injectable fertility medications (depending on the fertility treatment) to stimulate the ovaries so they’ll produce more than one egg per cycle.

We prescribe oral fertility medications to increase your chances of conceiving at home or for IUI procedures because, when accurately dosed, oral medications only allow the production of two or three eggs per cycle. However, if you’re pursuing IVF or wanting to freeze your eggs, we like to retrieve 15 or more eggs that we’ll fertilize in our embryology lab when you’re ready to move forward.

AMH levels give us an idea of the number of eggs you have, and how your body is likely to respond to fertility medications, so that we can prescribe the most accurate dose. Remember, the ultimate goal of any fertility treatment is healthy outcomes for both mother and baby. So, one baby at a time is the goal; twins are okay, and we try to avoid triplets or higher-order multiples.

3. Diagnose perimenopause or early menopause

Because AMH levels directly correlate with egg reserves, lower levels help us diagnose perimenopause (a natural part of the aging process and common in women 43 years old or more) or premature menopause (when levels are lower than usual in women 45 years old or younger). This information leads to a more focused fertility treatment plan for women committed to using their own eggs.

4. Diagnose and monitor reproductive conditions impacting ovarian reserve

The results of AMH testing may also provide information about existing reproductive issues that cause higher-than-normal AMH levels. For example,

• Ovarian cancer. Certain types of ovarian cancer cause higher AMH levels. These tests could be the first indicator of cancer or doctors may use AMH testing to help you monitor the disease.
  
• Polycystic ovarian syndrome (PCOS). PCOS is one of the leading causes of infertility in the United States. Often, women with PCOS do not ovulate at all, or very irregularly, so AMH levels can seem high for their age as their immature ovarian follicles are on a virtual “pause.” As we mentioned above, AMH testing helps us determine fertility medication doses, and this is very true for women with PCOS who may require less medication to stimulate the release of multiple eggs.

AMH Levels Also Play a Role in Sex-Specific Embryo Selection & Male Reproductive Organs

For the most part, your fertility center uses AMH testing for female patients to learn more about their egg reserves. However, this hormone can also be used when determining a baby’s biological sex and for sex-specific embryo selection for family building.