There’s a lot of hype around a hormone called Anti-Müllerian Hormone (AMH). We haven’t included it in our female hormone tests (yet) though — here’s why.

 

 

Setting the scene

You’re born with a set number of eggs — loads actually (up to 1-2 million)! Every month when you ovulate, an egg is released from one of your ovaries. Sometimes you might release multiple eggs. This means that over time, the number of eggs you have left goes down. This number is called your ‘ovarian reserve’. The rate at which you lose eggs is unique to you.

 

What does AMH have to do with this?

AMH is a hormone that’s released by your developing egg sacs (also called ovarian follicles). The more eggs you have left, the higher the level of AMH in your blood. Which is why it’s thought that your AMH levels might be able to indicate:

  • your ovarian reserve,
  • your chances of getting pregnant,
  • and how many fertile years you have left.

Sounds great, right? There’s no doubt that measuring your AMH levels is useful in certain scenarios. But some people are making it out to be the holy grail of female hormone tests — unfortunately, we’re not quite there. Let’s take a look at the evidence so far.

 

AMH and fertility

Recent evidence suggests that low AMH levels alone aren’t a good predictor of getting pregnant within your first year of trying. Women (aged between 30-40 years) with low AMH levels had similar chances of getting pregnant when compared to women with normal levels.

However, it might be a useful test to include if you’re considering IVF. Some fertility specialists measure your AMH levels at the start of your IVF journey — higher AMH levels make it more likely that healthy eggs can be harvested. It’s really important to remember that in the instance of IVF, a woman is under the care of a specialist who can properly interpret their results and provide emotional support.

So, it looks like it’s not worth testing your AMH levels to predict your chances of getting pregnant. But it might be useful if you’re considering IVF and have the support of a specialist.

 

AMH and miscarriage

A recently published paper found that very low AMH levels were associated with a higher risk of miscarriage. Although this is an interesting new finding, it’s based off one small study. More research is needed to confirm these findings and to investigate the possible link between AMH and your risk of miscarriage.

 

AMH and PCOS

High AMH levels are associated with polycystic ovary syndrome (PCOS) — a common condition affecting how your ovaries work. So it’s thought that it might be useful in helping diagnose PCOS.

 

AMH and egg freezing

If you know you don’t want to get pregnant until some time in the future, you might have considered freezing your eggs.

Since your AMH levels can be used to indicate your ovarian reserve, some companies suggest testing your levels to help you make an informed decision about whether you want to freeze your eggs or not.

When it comes to harvesting your eggs, most women are aiming to harvest 12-15 eggs — in a normal cycle you usually only release one egg. So for this to happen, your ovaries need to be hyper-stimulated with hormones. One study found that your AMH levels might be a good predictor of the number of eggs that will be harvested.

In the UK, only a small number of people are currently choosing to freeze their eggs. If you might be one of them, find out more information here.

 

AMH and the menopause

The menopause is when you permanently stop having periods and you’re not able to get pregnant naturally anymore.

In the UK, blood tests are rarely used to diagnose the menopause — it’s usually based on age and symptoms. But obviously, there’s a lot of interest in knowing when your reproductive life will come to an end. Some research suggests that AMH is a really good marker for predicting the menopause. However, there’s still a bit of debate here.

The only test which can reliably tell you that you’re not releasing eggs any more is to measure your follicle-stimulating hormone (FSH) levels.

 

Our verdict

There’s no doubt AMH is an interesting hormone and it’s worth measuring in certain situations. However, our view is that it’s most useful when interpreted by a fertility specialist — who knows your medical history and current situation.

We’ll keep you updated with all the latest research about AMH. Who knows, if the evidence base keeps building for AMH testing we might consider offering it in future.

 

References:

Kruszyńska, A., & Słowińska-Srzednicka, J. (2017). Anti-Müllerian hormone (AMH) as a good predictor of time of menopause. Przeglad menopauzalny= Menopause review16(2), 47.

Schumacher, B. M. L., Jukic, A. M. Z., & Steiner, A. Z. (2018). Antimüllerian hormone as a risk factor for miscarriage in naturally conceived pregnancies. Fertility and sterility.

Steiner, A. Z., Pritchard, D., Stanczyk, F. Z., Kesner, J. S., Meadows, J. W., Herring, A. H., & Baird, D. D. (2017). Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. Jama, 318(14), 1367-1376.

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