What Is AMH?
A Guide to AMH Testing: Why It Matters and What It Can Mean for Your Fertility
There are many different tests involved in fertility treatments, which brings us to today’s topic: What is AMH, and why does it matter? AMH is a hormone related to egg production, and it can provide useful information to both the IVF and egg donation process.
AMH stands for anti-Müllerian hormone, which is a hormone produced by cells linked to the follicles in your ovaries. Follicles are the little fluid-filled sacs in which eggs grow before being released into the ovaries during your period. Each ovarian follicle has a cell which produces AMH. Women are born with approximately one million microscopic egg follicles, but that number decreases with age. By puberty, most women have around 400,000 egg follicles. By age 37, only 25,000 follicles remain.
What Does AMH Mean for Ovarian Reserves?
Since each ovarian follicle produces AMH, it means that AMH can be used to estimate your ovarian reserve, or how many eggs you have left. A higher than normal result suggests there are many eggs left. A lower than normal result suggests that there are fewer eggs left. As your ovarian reserve gets smaller with age, so do your AMH levels, so “normal” levels change depending on age.
Testing is especially useful for people who are already considering IVF as a fertility treatment. In general, AMH can help estimate how well you will respond to ovarian stimulation, and how many eggs you can expect to retrieve during an IVF cycle.
It’s important to note that testing only provides information about the quantity of remaining eggs. It does not reveal anything about the quality of those eggs. In general, egg quality diminishes over time, dropping off sharply by age 40.
What Does AMH Mean for Egg Donation?
If you are planning to use a donor egg, your fertility clinic may test your donor’s AMH levels. As with IVF, looking at a donor’s test results can suggest how many eggs to expect during the retrieval. Again, it’s important to remember that these results cannot say anything about egg quality. However, egg donors are required to be healthy individuals within the age window of peak egg quality (20-29 years old).
What Else Can AMH Tell Us?
These levels can also provide information about women with polycystic ovarian syndrome (PCOS) and with certain types of ovarian cancer. Women with PCOS often have very high levels of AMH, and AMH testing can be used to support a diagnosis of PCOS when combined with other symptoms and testing. AMH testing is also used for patients with certain types of ovarian cancer to monitor treatment success.
I’m Young, Healthy, and Want Kids Someday. Should I Get My AMH Tested?
The American College of Obstetrics and Gynecology (ACOG) currently does not recommend testing for women who are not seeking fertility care. This is because AMH levels can vary widely, even in young women, and there aren’t yet any universally accepted standards for what constitutes “normal” levels at different ages. Lower levels in women under 35 have not been connected to lower chances of pregnancy. Testing has been proven to be a useful measure of how a woman may respond to ovarian stimulation (either as an IVF patient or egg donor), but that’s as far as it goes for now.
