Low AMH level? How to increase AMH levels naturally (2023)

Written by:Dra. Ashley Eskew MD, MSCI

Edited by:dr Will Haas, MD, MBA

Last update:30. May 2022

Have you ever wondered if there is a way to check your fertility with a simple blood test?

Or what does your anti-Müllerian hormone (AMH) value actually mean?

What if there is a way to increase AMH?

Well you are not alone!

Here's a quick overview of what you'll discover:

• What is AHM?
• What Causes Low AMH?
• Can IVF work with low AMH levels?
• Steps to increase AMH levels

Anti-Müllerian hormone (AMH) is a glycoprotein produced by granulosa cells, which are tiny cells that line the dormant follicles of the ovary (antral follicles). It is a general indicator of the number of eggs a woman has left.

How do I test the AMH?

AMH can be determined from a serum sample, which can be obtained from a typical blood draw or a drop of blood (fingerstick). Unlike other ovarian reserve markers, AMH can be tested at any time during the menstrual cycle.

Understand your AMH results

Serum levels of anti-Müllerian hormone in adult females correlate with the amount/number of oocytes remaining (hence its use as a marker forovarielle Reserve) and better predicting response to ovarian stimulation with injectable gonadotropins (the injectable drugs used in IVF). Normative values ​​are determined by age and the assay used.

Contrary to popular belief, an AMH test does not predict the likelihood of pregnancy, live birth, infertility, or fertility (but more on that below).

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  Hohe Levels:

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  Normal Levels:

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  Low levels:

As mentioned above, low AMH levels and lower normal limits are determined by age. In general, the lower limits of normal based on age are as follows (1):

• 0.5 ng/mL every 45 years
• 1 ng/ml every 40 years
• 1.5 ng/mL every 35 years
• 2.5 ng/mL every 30 years
• 3.0 ng/mL every 25 years

Some clinics use an AMH threshold of < 0.7 ng/mL or < 1 ng/mL to be considered “low” in all age groups. Low AMH levels have been associated with earlier age at menopause (2-4), decreased ovarian reserve (OR) (fewer oocytes), poorer response to IVF drugs (5, 6), and higher rates of cycle termination (7 ). Interestingly, it wasn't linked to fertility or the likelihood of conceiving. Women with lower AMH often require more aggressive IVF treatment regimens to achieve a positive response.

How is Follicle Stimulating Hormone (FSH) used with AMH?

Follicle-stimulating hormone (FSH) is the hormone produced by a small area in the brain called the anterior pituitary gland that is secreted at the beginning of the menstrual cycle to recruit a follicle each month. If a serum FSH is measured with a serum estradiol level on day 2 or 3 of the menstrual cycle, this is a good indication of how well the ovary is communicating with the brain.

High FSH early in the menstrual cycle indicates deficient ovarian hormone production as part of a declining number of follicles/ova or reduced ovarian reserve. High estradiol and low FSH can be interpreted similarly.

Unlike AMH, FSH cannot be collected at any point in the menstrual cycle and must also be collected with estradiol for correct interpretation. It is also highly variable from cycle to cycle. And while high FSH (usually > 10 mIU/mL) is a good predictor of diminished ovarian reserve and poor ovarian response to gonadotropins, normal FSH is less predictive.

If an initial FSH is abnormal or inconsistent with the AMH, it is usually repeated due to the high variability mentioned above, which can help confirm which treatment regimen might be best.

Limitations of the AMH

Although AMH levels are highly correlated with ovarian response to gonadotropin stimulation in IVF, it is a poor predictor of non-pregnancy, infertility, or fertility. That said, just having a woman with low AMH doesn't mean she has a lower chance of conceiving (8).

In addition, data have shown that AMH levels are a poor predictor of pregnancy and childbirth when using assisted reproductive technologies (ART) and in vitro fertilization (IVF) (9, 10). This would support the fact that AMH better predicts egg quantity but not egg quality.

When interpreting the AMH values, all possible influencing factors should also be taken into account in order to be able to estimate the ovarian reserve or the number of remaining egg cells as accurately as possible.

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  Alter:

  
  Women are born with about 2 million follicles, but in their first period, that number drops to about 400,000. The number of oocytes continues to decline over time and somewhat more rapidly in quantity and quality in a woman in her early 30s. The loss of ovarian reserve over time is irreversible and the rate of loss can vary greatly from woman to woman. AMH levels tend to decrease linearly over time, while age is the best predictor of oocyte quality. With increasing age, reduced egg cell quality and a corresponding decrease in fertility is observed, which is why a discussion can be usefulfreeze eggwith your fertility doctor at a younger age.

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  Genetic factors:

  
  Genetic disorders such as BRCA1 (11, 12) and Fragile X premutation (FMR1—which is associated with an increased risk of premature ovarian failure) and certain karyotype abnormalities (such as Turner syndrome) are also associated with decreases in AMH like others health concerns. If any of these conditions apply to you, early consultation with a reproductive specialist and considering egg freezing in certain situations can be extremely beneficial.

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  Ovarialchirurgie:

  
  Previous surgeries on the ovaries, including cystectomy (removal of a cyst) or oophorectomy (removal of an entire ovary), are associated with a decrease in AMH because the destruction or removal of follicles also removes the surrounding granulosa cells that produce AMH.

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  environmental factors:

  See Also

  How to increase AMH level through yoga? (4 best poses)Boost Low AMH Levels Naturally | Clinics in Mumbai, SuratFertilitypedia - High level of AMHHow to increase AMH levels naturally - Dr. mona dahiya

  
  Environmental factors have been inversely associated with AMH levels, including smoking (13, 14), low vitamin D (15), and elevated BMI (16-18).

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  Polyzystisches Ovarialsyndrom (PCOS):

  
  As mentioned above, PCOS is usually characterized by a larger number of antral follicles and therefore a higher AMH. And although women with PCOS often have high or normal AMH, medication to induce ovulation is often needed because ovulatory dysfunction is a hallmark of the condition. Thus, normal or high AMH does not correlate with ovulation either.

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  Use of medication:

  
  Taking certain medications, such as combined hormonal contraceptives (CHC), can suppress AMH levels. However, it is important to realize that this does NOT mean that CHDs will decrease fertility in the short or long term, as AMH levels usually return to baseline within 3-4 months after stopping (19-21).

  If a woman checks her AMH while using CHCs and finds that it's low, it may be worth going through a washout period (while continuing to use birth control to avoid unwanted pregnancy) and repeating the AMH to get one to get more accurate picture consider using egg freezing. It also makes sense that CHCs lower AMH since their whole purpose is to prevent pregnancy by suppressing stimulation of the ovaries by the brain's natural hormones to prevent ovulation, or the monthly release of an egg.

As mentioned above, age is the biggest predictor of egg count and quality. But the question remains: is there anything a woman can do to increase her AMH levels?

Luckily, there are some things you can control that will also benefit your overall health.

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  If you smoke tobacco products, work with your doctor to quit as soon as possible.

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  If you are overweight or obese, work towards a normal BMI range. Losing as little as 5-10% of body weight can improve response to fertility drugs and improve reproductive outcomes.

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  Consider getting your vitamin D levels checked and discuss with your doctor whether you should replenish if you are deficient.

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  The Sister Study (22) found that dietary fat intake may be inversely related to AMH concentration - however, specific dietary patterns were not examined (Mediterranean diet versus Western diet), which is a major limitation...

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  The EARTH study showed no association with dietary habits and AFC, but did not specifically examine associations with AMH levels (23).

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  In a study I conducted on a grant, AMH was positively associated with increased adherence to a fertility diet in women of childbearing potential with no history of infertility and a BMI > 25 kg/m2 (24).

In short, consume afertility diethigh in fruits and vegetables, high-quality carbohydrates, plant-based or seafood sources of anti-inflammatory proteins and fats, maintaining a healthy weight and not smoking can have positive effects on overall health and fertility.

However, if you tend to search for alternative answers to Dr. Google, beware of anyone or anything that promises to increase your AMH or egg count, lower your FSH, or guarantee you will get pregnant with a magic treatment or a simple diet or lifestyle fix...

Because it's really not that simple.

The AMH is an incredibly useful tool that fertility professionals use to support fertility treatments and general patient counseling, but it's important to understand its limitations and that it cannot be interpreted in a vacuum.

If you have been trying to conceive for some time, the AMH will be part of your basic fertility assessment. And if you're not trying to conceive but just curious, knowing your AMH can be very empowering and informative.

Regardless of your test results, be sure to discuss this with a fertility doctor to get a good understanding of the bigger picture of your overall fertility and family building goals.

with love and strength,

dra Ashley Eskew and Dr. Will Haas

Count on me