What Is AMH? And Why Is It Important for IVF Success?

When you're navigating the journey of infertility treatments like IVF, understanding your body’s reproductive health is crucial. One important marker that fertility specialists rely on is AMH-Anti-Müllerian Hormone. But what exactly is AMH, and why does it play a critical role in the success of IVF? Let’s dive into a better understanding of this hormone and its significance in fertility treatments.

What Is AMH?

Anti-Müllerian Hormone (AMH) is a hormone produced by the cells in the ovaries that helps regulate the development of eggs. AMH is considered a marker of ovarian reserve, which refers to the number and quality of eggs a woman has remaining in her ovaries.

• Ovarian Reserve: Your ovarian reserve doesn’t just tell you how many eggs are left, but also gives an idea of how well those eggs will respond to fertility treatments.

• Production of AMH: The hormone is produced by the granulosa cells in the ovaries, specifically in the small follicles, which are the early stages of egg development.

AMH as a Marker of Ovarian Reserve

The term “ovarian reserve” refers to the number of eggs a woman has left in her ovaries, as well as the potential quality of those eggs. Since women are born with a fixed number of eggs, this reserve naturally decreases with age. By measuring AMH levels in the blood, fertility specialists can estimate how many eggs are still available.

• A higher AMH level generally suggests a larger supply of eggs.

• A lower AMH level may indicate a reduced egg count and possibly a diminished response to fertility treatments.

However, it’s important to note that AMH doesn’t predict the exact timing of menopause or guarantee pregnancy outcomes—it simply gives insight into the current state of the ovaries.

Read Also: IVF Increase Chances of Pregnancy

How and Where AMH Is Produced?

AMH is produced in the granulosa cells of early-developing follicles called pre-antral and small antral follicles. These are the follicles that are just beginning their growth phase and are not yet ready for ovulation. As these follicles mature, AMH production decreases.

This production pattern makes AMH unique:

• It reflects the number of growing follicles available each cycle.

• It remains relatively stable throughout the menstrual cycle, unlike hormones like estrogen or FSH, which fluctuate.

• It can be tested on any day of the cycle, offering flexibility in fertility assessments.

Why AMH Matters for IVF Success?

AMH levels can give doctors valuable insights into your fertility potential and guide treatment decisions during IVF. Here's why AMH is crucial:

1. Indicates Ovarian Reserve

AMH levels directly correlate with the quantity of eggs remaining in your ovaries. A higher AMH generally indicates a larger number of eggs available for fertilisation, while a lower AMH suggests a reduced ovarian reserve, meaning fewer eggs and potentially a more challenging fertility journey.

• Higher AMH: Women with high AMH levels usually have a larger ovarian reserve and may respond better to ovarian stimulation during IVF, increasing the chances of retrieving multiple viable eggs.

• Low AMH: A low AMH doesn’t mean you can’t have children; it simply indicates fewer eggs are available for IVF. However, you may respond less well to stimulatory drugs, making IVF more challenging. But don’t worry—advancements in IVF have helped women with low AMH successfully conceive.

2. Predicts IVF Response

AMH levels are often used as a guide to help fertility specialists predict how a woman will respond to IVF treatment. If your AMH is on the lower end, the doctor may recommend using a higher dose of fertility drugs or consider other fertility treatments tailored to your specific needs. In contrast, higher AMH levels may indicate that fewer drugs are required for ovarian stimulation.

3. Assess the Effectiveness of Ovarian Stimulation

During an IVF cycle, ovaries are stimulated to produce multiple eggs. AMH levels can help predict how well the ovaries will respond to these stimulation protocols, thereby impacting the number of eggs retrieved. Having a reliable number of eggs increases the likelihood of successful fertilization and embryo development.

4. Guides Decisions on Egg Freezing

For women who are considering fertility preservation (like egg freezing), knowing your AMH levels can help determine the best time to freeze eggs and how many eggs you might be able to retrieve in a given cycle. Women with lower AMH may choose to freeze eggs earlier in life when their ovarian reserve is still higher.

5. Helps Personalise IVF Treatment Plans

In IVF, one-size-fits-all treatments don’t work. A low AMH may prompt the use of different stimulation protocols or the consideration of egg donors, while high AMH levels could indicate the need for close monitoring to avoid over-responding to ovarian stimulation, a condition called Ovarian Hyperstimulation Syndrome (OHSS).

Read Also: Signs and Symptoms of Infertility in Women

How Is AMH Tested?

AMH testing is simple and is typically done through a blood test. The results are measured in ng/ml (nanograms per millilitre), and levels are interpreted as follows:

• High AMH (Above 3.0 ng/ml): Generally indicates a good ovarian reserve, though it could also be associated with conditions like polycystic ovary syndrome (PCOS), which can affect fertility.

• Normal AMH (1.0–3.0 ng/ml): Suggests a normal ovarian reserve, with a reasonable chance of success during IVF.

• Low AMH (Below 1.0 ng/ml): Indicates a lower ovarian reserve, which may affect IVF success rates but doesn’t rule out the possibility of conception.

It’s important to note that AMH is just one part of the fertility picture. Factors such as age, overall health, and lifestyle also play a significant role in determining fertility potential and IVF outcomes.

Consult a Fertility Specialist

If you’ve been struggling with infertility or are considering IVF, AMH levels are an essential part of your fertility assessment. Consulting with an experienced fertility specialist like Dr. Bindu Garg can help interpret your AMH results in the context of your situation and guide you through treatment options.

Whether your AMH levels are high or low, IVF can still offer hope. With the right approach and support, many women successfully conceive, even with challenges like low ovarian reserve.