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Date issued: August 2021

Review date: August 2023

Ref: B-479

PDF:  Anti Mullerian Hormone (AMH) test final August 2021.pdf [pdf] 211KB

What is Ovarian Reserve?

• Ovarian reserve decreases with a woman’s age

• All women are born with a fixed number of eggs and this number reduces as they get older

• Women with a reduced number of eggs have a low ovarian reserve

What is AMH?

It is a marker of Ovarian Reserve

• Anti–Müllerian Hormone (AMH) is a hormone released by the small follicles in the ovary

• It gives us an idea about the number of remaining follicles and therefore eggs in the ovary

• It does not tell us about the quality of your eggs and there is a known decline in quality after the age of 35

How and when can I have my AMH tested?

• AMH assessment is done through a blood test.

• The range of AMH level remains relatively stable throughout your menstrual cycle so it can be taken at any point and will be organised by your fertility clinician.

Why am I being advised to have an AMH assessment?

• AMH tells us about the storage of eggs in your ovaries and helps us to counsel you regarding your chance of having a pregnancy and the best treatment options.

• During IVF/ICSI we use medications to stimulate your ovaries to produce eggs, we decide on the dose of your medications and your treatment protocol based on a number of things including age, diagnosis, previous treatment and AMH.

• AMH is the most reliable hormone to predict how well your ovaries will respond to medications.

AMH with Assisted Reproduction (IUI/IVF/ICSI)

• Women with lower AMH may not respond as well to drugs given in assisted reproduction meaning a reduced chance of pregnancy

• If AMH is high, it can help predict a complication called ovarian hyperstimulation syndrome

• The result of your AMH assessment will help your fertility specialist decide what treatment and dose of drugs you need

How do I find out my result? What is a good level?

• Your fertility clinician will inform you of your result at your appointment after the blood test

Current Lab Values in Derriford Hospital:

  < 3 pmol/L           Very low

      3 - 8                  Low

      9 - 25                Satisfactory

      26 - 40             Optimal

   > 40                    High

It is important to know different clinic laboratories use different testing methods. Therefore, if you have had a test in another clinic, we will repeat it so we have the best understanding of your result.

• Decreased AMH levels means less follicles and therefore reduced ovarian reserve

• Usually women with Polycystic Ovary Syndrome (PCOS) will have higher AMH levels because they have more follicles. This does not necessarily mean a better chance of pregnancy.

Can I improve my AMH?

• You cannot change your AMH and it is not due to lifestyle factors.

• AMH cannot tell us if you will achieve a pregnancy

• But it is considered the best hormone to help us understand how to treat you

• It will never increase and only decreases as you get older

• How much it decreases with age is different for every woman

What can you do to Improve your health for getting pregnant?

• Both men and women need to have a BMI below 29.9 (preferably within the normal BMI range 20-25)

• Do not smoke

• Eat a healthy diet

• Women to take high dose Vitamin D and folic acid

• Men to take Zinc, Selenium and Vitamin C 1g (on top of your normal dietary intake)