Low anti-Müllerian hormone: an indicator of our fertility?

AMH, or anti-Müllerian hormone, is a hormone produced by cells within the follicles of the ovaries.

The role of AMH in women is to protect growing follicles from premature maturation, by opposing the effects of FSH. [3] In the absence of AMH, primordial follicles are recruited at a faster rate than normal.

The majority of studies report a peak in AMH in women between the ages of 16 and 25, followed by a progressive decline in concentration until the menopause [4]. This decrease reflects the gradual loss of the primordial follicle pool and the decline in fertility.

AMH hormone: a fertility indicator?

AMH hormone testing is used to assess the ovarian reserve of a woman, that is to say her available egg supply. This test is normally prescribed as part of an infertility assessment.

The higher the concentration of anti-Müllerian hormone, the greater a woman's chances of becoming pregnant.

A high AMH value generally indicates a significant number of follicles in the process of maturing and, consequently, a good ovarian reserve.

This test can therefore be used to estimate a woman's chances of ovulating naturally and to estimate how many eggs could be retrieved in the event of ovarian stimulation.

Depending on the results, this measurement may help inform the decision to bring forward a maternity project, freeze eggs, or consider egg donation.

It should be noted that AMH is not the only indicator of ovarian reserve. An ultrasound is generally also performed between the third and fifth day of the menstrual cycle to count the antral follicles in each ovary (follicles that have already developed); along with a measurement of follicle-stimulating hormone (FSH), which triggers follicle maturation, and oestradiol.

AMH hormone testing: how do the values vary?

Measuring anti-Müllerian hormone involves a simple blood test that does not require fasting. The result is then compared against values established as "standard" for one's age.

The concentrations of this hormone do not change during the menstrual cycle, which means the test can be carried out at any point in the cycle [5].

AMH concentrations may, however, vary according to ethnicity. [6]

Spanish researchers followed 10,443 women aged between 20 and 45. It was found that each average decrease of 0.2 ng/ml in AMH levels increased ovarian age by 1 year [7].

What are the limitations of AMH hormone testing?

AMH is often nicknamed the Anxiety Making Hormone (instead of Anti-Müllerian Hormone) because, whilst it is an indicator of ovarian reserve, it is not an indicator of the ability to conceive or of how one responds to IVF.

You may have a normal AMH level and still have difficulty becoming pregnant. The possible causes of infertility are numerous.

And women with PCOS often have a high AMH due to the many follicles developing, even though they are experiencing difficulties conceiving…

A large study of 181 women was unable to demonstrate a significant link between AMH levels and the chances of becoming pregnant [8]. So if your level is low, it does not mean you will never be able to conceive naturally!

And of course, it is important to remember that hormone levels are only a reflection of your inner physiology at a given moment. They do not define you!

If you would like an indication of your fertility, you can have your AMH hormone level tested.

Do not forget that this test is only an indicator of ovarian reserve, it is not an indicator of the ability to conceive or of how one responds to IVF.

It is possible to have a normal AMH level and still have difficulty conceiving, and a low level does not mean you will never conceive naturally!

Furthermore, sperm quality also counts and has a major impact! Having him carry out a male fertility test, such as a semen analysis, is also useful. 

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