It’s crucial that women know the fundamentals of female fertility before we discuss what an AMH test entails.
About 1-2 million eggs, which are kept in follicles in the ovaries, are already present in women at birth, making them completely egg-free for the rest of their lives. Usually, a woman’s remaining eggs have decreased by half by the time she first reaches adolescence. After that, the quantity of eggs continues to decline each month, albeit more slowly. The body of a woman continuously enlists a collection of tiny ovarian follicles, each of which contains an immature egg, starting with the first menstrual cycle. There will typically be one of these tiny follicles that has the capacity to react to hormones and develop sufficiently to ovulate an egg.
A woman typically releases one egg each month from a single follicle, however numerous might grow throughout each cycle. Follicles that do not develop and deliver an egg will disintegrate; a condition known as atresia. An estimated 99 percent of ovarian follicles disintegrate before ever maturing enough to deliver an egg. This procedure is repeated each month. Because the dissolving follicles do not grow back, the total number of eggs that are accessible each month decreases.
Women must be aware of their fertility and what the available tests and treatments can and cannot accomplish for them because we know that fertility lowers with age.
What is AMH?
OBGYNs and fertility specialists may do a lab test known as AMH, or anti-mullerian hormone, to evaluate a woman’s ovarian reserve or egg count. The tiny follicles in a woman’s ovaries create this hormone. AMH is a tool for measuring the number of oocytes.
Your body’s production of AMH is correlated with the quantity of ovarian follicles that are still growing, which is correlated with the number of eggs still present. The association between primordial follicles (not yet forming and in a resting condition) and the developing follicles explains the relationship between the number of developing follicles and the number of eggs still present in the ovaries. Only a part of the pool of primordial follicles are in development. The number of primordial follicles recruited to begin development decreases as the pool of these follicles does.
When compared to others your age, if your AMH is high, you probably have more eggs and a wider window for conception (the years between your first period and menopause). You probably have a reduced egg count and perhaps a smaller reproductive window if your AMH is low compared to other persons your age.
How Does AMH Levels Affect Fertility?
The amount of “activity” in your ovaries can be determined by your AMH levels. The number of potential eggs you naturally possess starts to decline as you get older. As a result, fewer preantral follicles are created, which results in a drop in the amount of AMH released. A reduced pool of possible eggs may be indicated by low AMH levels.
Low AMH levels are more of an indicator that the pool of possible eggs is depleting than they are a cause or an indication of infertility. The likelihood that an egg will develop, be released, and be fertilised diminishes as the number of possible eggs in the ovaries increases.
Your ovaries will be stimulated throughout fertility therapy in an effort to encourage these preantral follicles to develop further and generate an egg. This is done so that we can potentially collect more eggs rather than only 1-2 every month by stimulating growth.
What Does a Low AMH Level Indicate?
Low levels of AMH may be a sign that your ovaries are developing fewer preantral follicles. The less follicles there are, the fewer there are that can be stimulated for assisted contraception, therefore this is crucial. However, you shouldn’t fret because having low levels of AMH does not always mean that you are not ovulating every month or that you cannot become pregnant naturally or with IVF. Because we can only stimulate preantral follicles that are already present, knowing whether you have high or low AMH levels helps us determine how effective stimulation and IVF could be.
The number of follicles in your ovaries may be decreasing, which can result in low AMH levels. Age, as follicular reserves typically decrease with time, is one of the main causes causing a reduced number of follicles in your ovaries and ultimately low AMH levels. However, other causes such as chemotherapy, hereditary genetics, smoking, or environmental factors can also result in low AMH levels. However, having low AMH levels does not always indicate that you are infertile and unable to conceive.
What Exactly Is an AMH Test?
Any point of your menstrual cycle is suitable for an AMH test, a quick blood test. An ultrasound scan of the ovaries to seek for those little follicles and corroborate the facts. To ensure that you receive the greatest reproductive care and have a good outcome, we advise all women receiving fertility therapy to get an AMH test.
Treatment of Low AMH Levels: How to Raise AMH Levels
Little can be done to raise AMH levels because AMH naturally declines with ageing as the ovaries start to wind down their egg production. There is not much solid proof that certain diets or substances might temporarily increase or maximise AMH production.
Can fertility treatments help you conceive if you have low AMH?
Yes, fertility treatments can boost a person’s chances of becoming pregnant, but having low AMH levels does not automatically indicate that you require one. If you have a regular cycle, becoming pregnant naturally is very feasible (and likely!).
Having said that, you can speak with your healthcare practitioner about potential treatment choices if you have low AMH and wish to wait a while before having children, you intend to have additional children in the future, or you have irregular cycles (which can make getting pregnant more challenging):
You can preserve eggs now so you can utilise them in the future by freezing them. Additionally, because frozen eggs don’t deteriorate over time, their quality will remain same. Egg freezing can provide you additional alternatives in the road when AMH drops if it is something you can afford to do now, whether or not you have low AMH. Remember that if your AMH is low, you might only harvest and freeze a smaller number of eggs, and your doctor could suggest performing numerous rounds of egg retrieval and freezing.
An egg is fertilised in a lab setting using in-vitro fertilisation (IVF), which subsequently involves transferring the developed embryo into the uterus. The initial phase of an IVF cycle—which, incidentally, is the same initial step in the egg freezing procedure—may yield more eggs in persons with greater levels of AMH, but it may take longer cycles for people with lower levels of AMH to obtain the same number of eggs. The likelihood that you will have a healthy embryo to transfer increases with the number of eggs you harvest.
When should you have your AMH levels tested?
Whether or not you’re attempting to get pregnant right now, checking your AMH levels can help you be proactive in the future when it comes to your fertility journey:
- If you desire knowledge about your reproductive window or possible results for egg freezing and IVF but aren’t actively attempting to conceive.
Knowing your AMH before you’re ready to have children will help you make better future plans so that you can have children when you’re ready.
- If you’re actively trying to get pregnant and want to plan out your schedule for having more children in the future and better understand where your reproductive health is at currently.
Bring the results of your AMH test to your doctor to discuss your choices for treatment if you are actively trying to conceive but have not yet been successful.
Whether or not you’re actively trying to conceive right now, it’s always a good idea to discuss your goals and preferred timing with your healthcare professional if you know you want to have children.
How Can We Help?
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