how important is AMH?

AMH testing has enhanced fertility assessment and treatment in the past 2 decades. Initial research showed it to be a reliable predictor of fertility, however in the past 5 years more studies have questioned how much we should rely on it…

  • Antimullerian Hormone (AMH) is considered the most sensitive blood test for measuring a woman's ovarian reserve

  • It shows how active the ovaries are but it isn’t a measure of egg quality.

  • It can be used as part of your fertility assessment and IVF clinics will use it to decide what dosage of medication to start you on.

  • It will be low if ovarian reserve is reducing, but it is still possible to get pregnant with low or undetectable AMH levels.

  • It may be raised in PCOS because the ovaries are hyperactive.

  • Results are age specific.  The lab reports will include the reference range for the woman's age.

  • Vitamin D plays a role in regulating AMH so Vitamin D deficiency should be tested for.

how much should we rely on AMH results?

AMH has been shown to be the best measure of ovarian reserve and the most reliable indicator of IVF success

BUT… Not all studies agree

  • a 2017 trial in Copenhagen found that AMH levels didn’t relate to the time taken to conceive in natural conception. Natural pregnancy was still possible with undetectable AMH https://www.ncbi.nlm.nih.gov/pubmed/28846864

  • an 2017 American study found that women with low AMH (<0.7 ng/mL) didn’t have a statistically different likelihood of conceiving within 6 months than women with normal levels https://www.ncbi.nlm.nih.gov/pubmed/29049585

  • AMH levels related to the number of eggs retrieved, but not pregnancy rates, women over 40 in first IVF cycles. Patients with extremely low AMH still had a chance of pregnancy http://www.ncbi.nlm.nih.gov/pubmed/23640374

  • AMH used to be regarded as a predictor of how long a women has before menopause. A 2018 review shows that the rate of decline in AMH varies between women so AMH isn’t a reliable predictor. The same review states AMH to be a poor predictor of pregnancy in natural or assisted conception https://www.ncbi.nlm.nih.gov/pubmed/29517134

more about AMH research

While AMH may not be as reliable as first thought it’s still an extremely useful part of decision making. Information is power when making life plans. While a low AMH shouldn’t trigger fertility despond, it is still an indicator to be taken seriously as part of the overall picture when making decisions.