There’s lots of talk out there about a hormone called Anti-Mullerian Hormone or AMH.
Understanding what AMH is can be as tricky as can getting your head around your cycle, especially when there are so many different voices putting forward conflicting messages online and elsewhere.
This week, LetsGetChecked wants to tell you everything you need to know about AMH so you can better understand your cycle and overall health.
Whether you are simply curious about your hormonal health or you are hoping to start a family, AMH is a one of the most prominent hormones to understand when you are going down this path.
This week, LetsGetChecked tells you everything you need to know about you AMH levels, what they can mean and how to test them if you are worried about certain signs and symptoms.
- What Is AMH?
- How Does Your Body Produce AMH And Eggs?
- What Is A Normal AMH Level?
- What Else Can AMH Explain When It Comes To Your Health?
- Should You Test Your AMH?
What Is AMH?
AMH stands for Anti-Mullerian Hormone. Anti Mullerian Hormone is a glycoprotein hormone that is produced by granulosa cells in the ovaries.
Okay, so that's a medical definition and sounds confusing. Let's break it down.
Follicles are produced in your ovaries, as follicles develop into eggs that are transported through the fallopian tubes, they secrete anti-mullerian hormone.
Women are born with millions of eggs "in reserve". A baby girl starts her life with two million tiny follicles in her ovaries, these ovaries produce and secrete AMH. This is why AMH is a good teller of how how many eggs you have "in reserve." The more follicles you have, the more eggs and AMH you will be capable of producing.
The number of eggs you have continuously decreases in quality and quantity as you age. Anti-Mullerian hormone may be indicative of how many eggs you have left for a viable pregnancy, it is important to note that AMH will not tell you how good the quality of your eggs are, it measures the quantity.
In normal circumstances, a woman will carry these eggs for the rest of her life. There is no way of slowing down the depletion of eggs, as they lower with each cycle, and there is no way of increasing the number of eggs in your ovaries naturally.
There is nothing to be worried about here, however, being aware of and understanding your hormones can drastically help you to understand your body and overall health.
The amount of AMH in your blood will tell you:
- How many eggs you have left.
- How likely you are to respond to IVF treatment.
- What stage of the reproductive cycle you are in.
The amount of AMH in your blood will not tell you:
- The quality of your eggs.
- When you are likely to get pregnant.
How Does Your Body Produce AMH And Eggs?
Your body produces AMH during the production of your ovarian follicles. Ovarian follicles are responsible for the secretion of essential hormones that are released during the menstrual cycles as well as the nourishment of the oocyte ahead of ovulation.
When it comes to thinking about your eggs including how many your produce and how many you lose each month, it would seem like perfect sense to think "I lose one egg because only one egg will be fertilized if it fuses with sperm."
This is actually not the case. Each month you lose a little over 1,000 eggs. Do not panic. This is perfectly normal and healthy.
The one egg you're thinking about is the lucky candidate that has made it through a period known as folliculogenesis. Let's go through these stages to understand how AMH and your eggs are connected.
Folliculogenesis refers to the maturation of the ovarian follicle. The ovarian follicle is packed with cells that produce the immature egg which will later be later released from the ovary in a process known as ovulation.
Before ovulation, the immature egg sits in the fluid filled sacs until they are mature enough to go through the process of ovulation. Eggs that are viable for this process will exist in four stages.
Primordial follicles are small and flat, dormant cells that are covered in one thin layer of protective cells.
When a primordial follicle is stimulated, it develops into a primary follicle. Follicles in the primary stage begin dividing which allows for the continued growth of cells in the ovaries.
Preantral follicles are also commonly known as secondary follicles. At this point they have two or more layers of granulosa cells surrounding them with the continued division of cells. This cell growth supports the growth of the follicles into an ovum or egg.
Antral follicles or secondary follicles are capable of growing as large as follicle-stimulating hormone allows. Antral follicles are mature ovarian follicles that hold and nourish the immature egg which will later burst through the ovary wall and travel through the fallopian tube.
This might all seem a bit "out-there" but it is the release of these follicles that allows for the production of progesterone and estrogen, both of which control the timing and symptoms of your period and menstrual cycle overall. Next let's move onto the all important question of where your AMH levels should be depending on your age.
"Normal AMH levels may be dependent on your age, medical conditions and fertility status and can vary on a case by case basis. Do not panic if you see that your AMH levels are outside the range as documented in the diagram below.
What Is A Normal AMH Level?
Hormones are commonly measured in Nanograms per Milliliter because relatively, they circulate in the blood in tiny amounts. Hormones are measured in laboratories through blood samples.
Normal AMH levels are solely dependant on your age because as described, our number follicles and developing eggs are responsible for the amount of circulating AMH in our blood.
What is also important to note is that while girls are born with approximately 2,000,000 eggs, this number will have depleted to 400,000 by the time a girl reaches puberty. From the a girl's first period, she will begin to lose about 1000 eggs a month. Therefore it is no surprise that AMH levels will also begin to lower as you get older.
This is why often times, the onset of the menopause can also be predicted through using AMH testing.
- This diagram illustrates normal ranges for AMH per age group.
Again, it is important to note that AMH testing will not offer you insight into the quality of the eggs in your ovarian reserve. To measure the quality of your eggs, you will need to undergo an ultrasound.
In that vein, it is also important to note that you may have a low AMH reading but it doesn't necessarily mean you will not be able to get pregnant. It only takes one egg and one sperm to fuse for a healthy pregnancy. You should see AMH then as a good indicator of where you are in your reproductive years.
According to Ava, after 3 months of trying to conceive, you have an 18% chance of getting pregnant at the age of 25, this drops to 12% at the age of 35 and 7% at the age of 40. An older age and lowered AMH equates to a lower chances of successful conception.
AMH doesn't just impact reproduction, it is also indicative of other conditions that may explain irregular or painful periods.
What Else Can AMH Explain When It Comes To Your Health?
It is important to know that AMH levels and their meaning are dependent on a number of variables, most importantly, your age. Universally, AMH levels can be indicative of a number of conditions.
Low AMH is generally sign of:
- Low Ovarian Reserve
- Premature Ovarian Failure (POF)
- Crohn’s disease
- Autoimmune thyroid disease
Irregular AMH is generally a sign of:
High AMH is generally a sign of:
- Polycystic Ovary Syndrome (PCOS)
Should You Test Your AMH?
Yes! You should test your AMH levels. High AMH in younger women indicates that your may have polycystic ovary syndrome (PCOS), irregular AMH in older women may indicate that you are experiencing the menopause and low AMH in those of a child-bearing age can indicate a number of fertility issues including Diminished Ovarian Reserve (DOR). AMH testing will also tell you if you are likely to respond to IVF treatment.
You should take an AMH test, also commonly known as an Ovarian Reserve Test if:
- You have symptoms of PCOS which may include acne, weightgain and the growth of hair on the face.
- You have been diagnosed with endometriosis.
- You have been diagnosed with ovarian tumours or cysts.
- You are thinking about starting a family.
- You have been told you may need to undergo IVF treatment.
- You are approaching the menopause.
- You are experiencing irregular or painful periods.
LetsGetChecked provide an AMH test which will offer you not only the results of your AMH but support and guidance from the LetsGetChecked medical team at every step of the way. To learn more about the test, visit Letsgetchecked.com where you can talk to the nursing team via live chat or via phone call.
Written by Hannah Kingston | Medically Approved by Dr. Dominic Rowley