You are currently viewing Low Anti-Mullerian Hormone (AMH): Symptoms, Causes, Treatment

The journey to parenthood is a profound and often challenging path, influenced by various factors that can impact fertility. One crucial player in this complicated reproductive symphony is the anti-Mullerian hormone (AMH). As medical experts, we understand the importance of the Anti-Mullerian Hormone (AMH) test in determining female fertility. In this article, we will explore the specifics of AMH, shedding light on the causes, symptoms, and treatments associated with both low and high AMH levels. Understanding how to interpret and manage AMH levels can be crucial for those navigating fertility concerns. From exploring ways to boost AMH levels naturally to delving into the complexities of AMH tests, we aim to provide comprehensive insights to empower individuals on their fertility journey. Whether you’re seeking to increase AMH levels, identify symptoms, or comprehend the significance of AMH testing, this article serves as a guide to navigating the multifaceted landscape of reproductive health.

What is the Anti-Mullerian Hormone (AMH) Test?

The Anti Mullerian Hormone (AMH) test is a blood test that measures the level of AMH in a woman’s blood. AMH is a hormone that is produced by the ovarian follicles hence the level of AMH in a woman’s blood can indicate the number of eggs in her ovaries, which is also known as her ovarian reserve.

What is Normal Anti-Mullerian Hormone (AHM) Levels?

The normal range for AMH level is 1.0 – 4.0 ng/ml for women of reproductive age.

What is the Anti-Mullerian Hormone Test Cost in India?

The cost of the Anti-Mullerian Hormone (AMH) test in India may vary depending on several factors such as the location of the laboratory, the type of test (ELISA, RIA, or CLIA), and whether the test is conducted as part of a fertility assessment package or separately. Generally, the cost of the AMH test in India ranges from INR 500 to INR 4000 (approximately $7 to $55 USD).

AMH & Infertility

How are Anti-Mullerian Hormones and Female Fertility Connected?

The level of AMH in a woman’s blood is an indicator of her ovarian reserve, which is the number of eggs remaining in her ovaries. The higher the level of AMH, the greater the number of eggs remaining and the higher the likelihood of fertility. On the other hand, a low level of AMH may indicate a lower ovarian reserve and a decreased likelihood of fertility.

What are Anti-Mullerian Hormone Levels or Anti-Mullerian Hormone Range by age?

The AMH level can vary based on a woman’s age. In general, the Anti-Mullerian Hormone Levels can decrease when a woman ages. Here is a general guideline for the Anti Mullerian Hormone Range by age:

(Note: These are considered Anti-Mullerian Hormone Normal Level)

  • Under 30 years old: 2.0 – 6.8 ng/ml
  • 30-34 years old: 1.6 – 6.4 ng/ml
  • 35-39 years old: 0.9 – 5.1 ng/ml
  • 40-44 years old: 0.2 – 4.0 ng/ml

Approximately 14.5% of women under 35 and 50.5% of women over 35 had low AMH levels (<1.1 ng/ml). Additionally, 5.6% of women under 35 and 23.6% of women over 35 had an AFC of ≤5. In this study, 55.7% of women with low AMH and 50.7% with low AFC were under 35 years old. The median AMH levels were 4.23 ng/mL in women aged 20 to 25, 3.48 ng/mL in women aged 26 to 30, 2.43 ng/mL in women aged 31 to 35, 1.28 ng/mL in women aged 36 to 40, and 0.52 ng/mL in women aged 40 to 44. Each age group had a median AFC of 20, 18, 14, 10, and 6, respectively.

National Center for Biotechnology

What causes low AMH levels?

Low Anti Mullerian Hormone causes can be attributed to various factors that affect the overall ovarian reserve and reproductive potential of women. Several factors can contribute to low AMH levels, including age, ovarian surgery, chemotherapy, and endometriosis.

1. Age:

One of the most significant factors that can cause low AMH levels is age. As women age, their ovarian reserve declines, which can lead to decreased production of AMH. This decline in ovarian reserve is a natural phenomenon that occurs as women approach their 30s and 40s. However, women over 35 years of age are more likely to have lower levels of AMH, which may affect their ability to conceive. So, in short Anti Mullerian Hormone & Fertility are interlinked.

2. Ovarian Surgery:

Another factor that can lead to low AMH levels is ovarian surgery. Removal of an ovary or ovarian cysts can impact the ovarian reserve and reduce AMH levels.

Low AMH Causes

3. Chemotherapy:

Similarly, chemotherapy drugs used to treat cancer can damage the ovaries and cause a decline in AMH production, leading to decreased ovarian reserve and fertility potential.

4. Endometriosis:

Endometriosis is another medical condition that can cause low AMH levels in women. Endometriosis is a condition in which the tissue that lines the uterus grows outside of it and can damage the ovaries, leading to reduced ovarian reserve and lower AMH levels.

5. PCOS:

Women with Polycystic Ovary Syndrome (PCOS) may have higher levels of AMH due to an increased number of ovarian follicles. However, despite higher AMH levels, women with PCOS may still experience decreased oocyte quality and reduced fertility potential.

Symptoms of Low AMH

Low AMH levels do not cause any specific symptoms, but anti-Mullerian hormone and fertility can be interlinked. Women with low AMH levels may have difficulty conceiving or may have an increased risk of miscarriage.

How to Increase Anti-Mullerian Hormone (AMH) Levels?

There are several ways how to increase anti-Mullerian hormone, These are:

  • Natural supplements: Certain anti-oxidants and natural supplements like DHEA, CoQ10and vitamin D have shown the potential to increase AMH levels in some women.
  • Diet and lifestyle changes: A diet rich in antioxidants, healthy fats, and protein can improve overall reproductive health and potentially increase Anti Mullerian Hormone. Regular exercise can also improve ovarian function and lead to increased AMH levels. Stress management techniques such as meditation and yoga can help reduce stress levels and improve overall reproductive health.
  • Platelet-rich plasma- Platelet-rich plasma or PRP is made from women’s blood and is rich in growth factors and it is injected inside the woman’s ovaries. Within a span of a few weeks, it increases the ovarian reserve thus increasing AMH.
Low AMH Fertility Treatment

 Best Low Anti-Mullerian Hormone (AMH) Treatment

The best treatment for low AMH depends on the individual and the underlying cause. Some options include:

  • Fertility treatments: various fertility treatments may help women with low AMH levels conceive, induction of ovulation and ovarian stimulation using hormonal injections are done for the same.
  • Donor eggs: In some cases with very low AMH, where ovarian reserve and antral follicular count is extremely low using donor eggs may be the best option.
  • Lifestyle changes: Eating a healthy diet, exercising regularly, and managing stress levels can help improve overall reproductive health and may increase AMH levels.

Conclusion:

Understanding the causes and symptoms of low AMH, as well as ways to increase AMH levels and the best treatments for low AMH, can help women make informed decisions about their reproductive health. If you have concerns about your AMH levels, consult with a medical professional to determine the best course of action for your individual needs and need for future fertility.

FAQs:

What levels of AMH indicate infertility?

Generally, AMH levels of less than 1 ng/ml are indicative of a low ovarian reserve, which may lead to infertility. However, it is essential to note that infertility is a complex issue and that AMH levels alone cannot predict fertility outcomes. Low AMH values need to be correlated with antral follicular count on ultrasound.

Who should undergo the AMH Test?

The AMH test is usually recommended for women who are having difficulty getting pregnant and are getting evaluated for infertility or for those who are considering assisted reproductive technologies such as in vitro fertilization (IVF).

Can the AMH test be wrong?

While the AMH test is considered to be a reliable indicator of ovarian reserve, it is not 100% accurate. Factors such as age, hormonal medications, and certain medical conditions can affect AMH levels, leading to false results. Additionally, AMH levels may vary among different testing methods and laboratories.

What is a good AMH level to get pregnant?

Women with AMH levels of 1-2 ng/ml or higher are considered to have a good ovarian reserve. However, as mentioned earlier, infertility is a complex issue, and AMH levels alone cannot predict fertility outcomes.

What causes low AMH levels?

Low AMH levels can be caused by factors such as advanced age, genetic predisposition, certain medical conditions, or a history of ovarian surgery or chemotherapy, all of which contribute to diminished ovarian reserve. Lifestyle factors, like smoking and excessive stress, can also play a role in reducing AMH levels.

Dr Atishay Jain

Dr. Atishay Jain is an Obstetrician and Gynecologist, fertility specialist and advanced Gynae Laparoscopic Surgeon with an experience of performing more than 1000 advanced laparoscopic surgeries. He is the co-director of Asian Institute of infertility management and Asian women’s center.