What is AMH in fertility health?

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Anti-Mullerian Hormone (AMH) functions as a glycoprotein hormone that has a vital role in the formation and operation of the reproductive system. It is synthesized by the granulosa cells located in ovarian follicles and plays a role in controlling the development and advancement of eggs within the ovaries. AMH is frequently employed as a biological indicator to evaluate a woman's ovarian reserve, which indicates the quantity of viable eggs remaining in the ovaries.

This hormone is present in females right from birth and diminishes gradually, with concentrations generally decreasing, notably as a woman nears the menopausal phase.

It's crucial to bear in mind that while AMH levels offer valuable information about a woman's potential fertility (the number of eggs present), they do not determine egg quality, which is another pivotal factor influencing the likelihood of successful conception and healthy pregnancy.

Additionally, AMH levels are just a single aspect of the broader fertility context, and a comprehensive assessment of a woman's reproductive health such as egg quality, condition of fallopian tubes and uterus should be taken into account to initiate the best possible treatment suited for them.

Dr. Sandeep Talwar, Fertility Specialist, at Nova IVF Fertility, Vasant Vihar, shared his insights on the topic.

Females possess all the eggs they will ever have in their lifetime, around 1-2 million at birth. Starting from their first menstrual cycle onward, the body enlists a set of follicles, each containing a small immature egg, that can potentially respond to hormones, develop, and be released through ovulation. Generally, a woman releases a single egg each month. Any eggs not chosen for ovulation dissolve, and this process repeats.

The AMH test is a valuable diagnostic tool indicating the size of one's ovarian reserve. Generally, higher AMH levels suggest a greater egg count and a higher chance of becoming pregnant. However, higher levels of AMH also shed light on the possibility of a PCOS presence in an individual. On the other hand, low AMH levels indicate issues in one's conceiving journey and signals to not delay the process.

Normal AMH levels typically range from 1 to 3.5 ng/ml. An AMH level above 2 ng/ml is considered favourable, while levels below 1 ng/ml are considered low. Very low levels fall below 0.3 ng/ml. Individuals with polycystic ovaries often have AMH levels exceeding 3.5 ng/ml. AMH levels decline with age, with younger women usually having levels above 3.5 ng/ml and those over 40 having levels below 1 ng/ml.

It's crucial to emphasize that while AMH levels provide valuable insights into fertility, they represent only a single facet of the broader picture. Other critical factors, including the quality of eggs, the openness of the fallopian tubes, the health of the uterus, and the quality of the male partner's sperm, all contribute significantly to the likelihood of successful conception.

Various factors lead to low AMH levels, and some of these factors are outlined below:

Age: The most prevalent reason for low AMH levels is advancing age. As women grow older, their ovarian reserve naturally diminishes, leading to decreased levels of AMH. This decline becomes more pronounced as women approach menopause.

Genetics: Inherited traits can also influence ovarian reserve. Some women might inherit a smaller ovarian reserve from their mothers, resulting in lower AMH levels even at a younger age.

Medical Treatments: Certain medical treatments, such as chemotherapy or endometriosis, potentially impact ovarian reserve and lead to diminished AMH levels.

Surgical Interventions: Ovarian surgery, like the removal of ovarian cysts or treatments for conditions like endometriosis, can potentially impact ovarian reserve and lead to decreased AMH levels.

Autoimmune Disorders: Autoimmune conditions like lupus or rheumatoid arthritis can have negative effects on ovarian function, contributing to lower AMH levels.

Environmental Factors: Exposure to environmental toxins or chemicals can have adverse effects on the ovarian reserve, resulting in reduced AMH levels.

Low AMH levels could indicate a diminished ovarian reserve, which might make conception more challenging. It's important to recognize that every person's fertility journey is unique, and some women with low AMH levels can still achieve pregnancy either naturally or through fertility treatments.

While it's not feasible to drastically increase AMH levels or reverse the natural decline in ovarian reserve, there are a few measures that women can consider to promote overall fertility and enhance egg quality:

Lifestyle Changes: Cultivating a healthy lifestyle can contribute to overall fertility, even in cases of low AMH levels. This encompasses maintaining a well-balanced diet, engaging in regular physical activity, managing stress effectively, and avoiding detrimental substances like tobacco and excessive alcohol.

Supplements: Some supplements, like Coenzyme Q10 (CoQ10) and dehydroepiandrosterone (DHEA), have been proposed as potential aids in enhancing egg quality among women with low AMH levels.

Minimize Exposure to Environmental Toxins: Certain environmental toxins, including those found in cigarette smoke and certain plastics, can adversely affect fertility. Taking measures to limit exposure to these toxins can help support overall fertility and contribute to better egg quality.

Consuming Impryl: Impryl offers a balanced form of support for the body's metabolic processes, potentially enhancing the quality of the follicles produced. According to a study, Impryl consumption among older women resulted in a 40% increase in AMH levels, with several patients achieving pregnancy while taking Impryl during the trial.