Anti-Müllerian Hormone (AMH) Explained

anti-müllerian hormone amh

After sharing our fertility struggles with my OBGYN doctor, one of the first hormones she wanted to measure was my anti-müllerian hormone (AMH). If you are trying to conceive, or seeking fertility treatment, you may have heard of AMH too.

But for those that are not familiar with AMH, or what it could potentially mean, I will help explain what AMH is, how it is measured, why it is important, the role it plays in fertility treatments, and what I learned from my new doctor.

Learn more about our fertility journey here.

What is Anti-Mullerian Hormone (AMH)?

To put it in the most simplest terms, AMH is used to predict how many eggs a woman has left. This is also referred to as the woman’s ovarian reserve.

The hormone is produced by the granulosa cells in the ovarian follicles, which are small fluid-filled sacs that contain the developing egg. That said, AMH also helps regulate the development and maturation of the eggs in the ovaries.

As you can imagine, this hormone plays a critical role in fertility. As a woman ages, the levels of AMH decline, which means her ovarian reserve is decreasing with time.

How do you determine AMH levels?

Anti-müllerian hormone levels are measured through a blood test. You can request the blood test from your doctor, and once your doctor puts in the lab order, you can make an appointment at the lab closest to you. This test is usually done on a specific day of your menstrual cycle so it is important to follow protocol from your doctor.

The test itself is quick. Typically, the results are available within a couple of days. And once the results are available, the lab provides the results to your doctor for their review. Afterwards, you can expect your doctor to review the results with you.

What are the AMH levels?

AMH levels can vary depending on the laboratory that performs the test since labs may use different units of measurement. However, the below ranges are often used:

  • High: 4.0 ng/mL or higher
  • Normal: 1.0-4.0 ng/mL
  • Low: 0.7-1.0 ng/mL
  • Very Low: 0.3-0.7 ng/mL
  • Undetectable: less than 0.3 ng/mL

It is important to keep in mind that these ranges are simply guidelines and the results may vary. And speaking from personal experience, the results definitely varied for me. When I first tested my AMH levels at the local LabCorp, my AMH level came back at approximately .9 something. But after testing my AMH level at the fertility clinic because they had their own lab, my AMH level came back slightly lower than .9 something. It came back at .8 something.

Please note the above ranges may vary dependent upon your age.

Can I get pregnant with low levels of AMH?

The short answer is yes. Although, it may be more difficult, and it could take some time, it does not mean that a woman is infertile, or unable to conceive. Women with low AMH levels may still have good quality eggs that are capable of fertilization.

As you probably know, there are a number of factors to consider when evaluating a woman’s fertility such as age, underlying health conditions, quality of the eggs, and quality of the sperm.

It is a multi-dimensional subject.

The Role AMH Plays in Fertility Treatments

So why does anti-müllerian hormone level matter when it comes to fertility treatments?

In in vitro fertilization (IVF), the goal is to stimulate and retrieve as many eggs as possible from the woman’s ovaries. Because it is essentially a numbers game, the higher the number of eggs stimulated and retrieved, the better the outcome is of having fertilized eggs. (If you don’t understand the IVF process, don’t worry because I plan to write a blog post about it.)

That said, doctors feel more hopeful with normal, or higher, levels of AMH because this means there’s a good chance they will retrieve a higher number of eggs. Although, the quality of the eggs is still much more important, which I will discuss in another blog post.

In NaProTECHNOLOGY (or NaPro), the AMH level, including additional data points, are used as part of a broader approach to fertility care. This approach focuses on identifying and addressing underlying medical issues that may be affecting the woman’s ability to conceive.

That said, NaPro practitioners use a combination of tests and diagnostic tools to help identify the root causes of infertility. Their goal is to develop a treatment plan that is tailored to the woman’s individual needs. This way, it increases her chances of conceiving naturally.

What is the success rate of IVF?

The success rate of IVF can vary widely depending on a variety of factors. You have to consider the age and health of the woman, underlying causes of infertility, quality and quantity of embryos produced, and specific techniques used during the IVF process.

In general, the success rate of IVF is reported as the percentage of cycles that result in a live birth. According to the Centers for Disease Control and Prevention (CDC), the national average live birth rate per IVF cycle in the United States is around 23% for women under 35 years old, 20% for women aged 35-37, 13% for women aged 38-40, 5% for women aged 41-42, and 2% for women over 43.

However, it’s important to note that success rates can vary widely among individual fertility clinics. Other factors to consider include specific patient population and treatment protocols used by the clinic.

It’s also worth noting that success rates may be influenced by factors outside of the IVF process itself, such as lifestyle choices, underlying health conditions, and environmental factors. Women who are considering IVF should work closely with a fertility specialist to understand their individual chances of success and develop a personalized treatment plan.

What is the success rate of NaPro?

The success rate of NaPro depends on various factors including the age and health of the woman, the underlying cause of infertility, and the specific treatment plan developed by the NaPro practitioner.

Several studies have shown that NaPro can be an effective method for helping couples achieve pregnancy.

For example, a 2018 study published in the Journal of Obstetrics and Gynaecology Canada found that NaPro was associated with a live birth rate of 48.4% per couple after a median of 13 months of treatment.

Another 2017 study published in the Journal of Reproductive Medicine found that among women with infertility due to endometriosis, NaPro was associated with a pregnancy rate of 73.9% after six months of treatment. (Pretty insane, right?!?)

While IVF is a direct approach of stimulating, retrieving, and fertilizing the eggs, NaPro may take a little longer. This is because it takes time going through the various tests to help identify the root causes of infertility. Once the root causes are identified, and addressed, it sounds like there is a high chance of becoming pregnant naturally.

What I Have Learned Thus Far

If you took the time to read about our fertility journey here, you will learn that we decided to move forward with NaProTECHNOLOGY over IVF. We were so close to moving forward with IVF because that was all we knew. We had no idea there was a different approach.

And after meeting with our new NaPro doctor this week, I left feeling even more hopeful.

Let me put it to you this way –

My new doctor is in her 40s. I believe she said that she got pregnant with her first baby at 40.

And guess what?

She said her AMH levels were almost nonexistent. I did not ask what her AMH level was, but if we reference the chart above, we can guess it was under 0.7 ng/mL. Although, this is mainly attributed to her age. Remember that age matters BIG time when it comes to fertility.

Anyway, what had me on the edge of my seat was that she is almost 37 weeks pregnant with her second baby. How incredible is that?!? Utilizing the NaProTECHNOLOGY approach, she was able to pinpoint the underlying issue, and address it with medicine to help her achieve a second pregnancy.

Again, her AMH level is almost nonexistent.

I don’t know about you, but this gives me so much hope.

Another thing I have learned thus far is, most healthy couples who experience fertility issues, the woman ends up having endometriosis (or endo). Endo is a medical condition where excess tissue grows outside the uterus. There is usually pain and discomfort associated with this, but not always. The only way to diagnose this condition is if you have surgery if it doesn’t appear in an ultrasound.

On average, after the endo is removed, the chances of conceiving is between 40% and 60%. This was pretty impressive to learn!

That said, I also learned that IVF cycles sometimes fail because underlying issues are not always addressed. This part was heartbreaking to learn because fertility treatments are costly. Not to mention, IVF is not for the faint of heart. It takes an emotional and physical toll on the mind, body, and spirit.

Final Thoughts

I know this was a lot of information to digest but I hope I was able to shed light on new information. I know with certainty that I didn’t know half of the information covered here.

If you are experiencing fertility issues, please know that you are not alone. There is an abundance of resources available, whether it is in person or online. In future blog posts, I will share helpful resources.

This blog post was created with AMH in mind. As a woman with a low level of AMH, it is so easy to be consumed by this number. I know the feeling of losing hope all too well. It can be detrimental to our emotional and spiritual health if we don’t take control of our thoughts and emotions.

One last note – there is no right or wrong way of addressing your fertility issues. Whether you are considering IVF, IUI, NaPro, or nothing at all, there is no judgement here. Our bodies are so unique and the reproductive system is quite complex.

I think the most important thing you can do is research, research, research. Become aware of your options and move forward with the best protocol that makes sense for you and your family.

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