Anti-Müllerian hormone, or AMH, is a hormone test to help determine your ovarian reserve. AMH is produced by the granulosa cells in the ovarian follicles (where the eggs live in the ovary). The more follicles you have, the more AMH you produce. Your AMH level is easy to determine with a regular blood draw that can be done anytime during the menstrual cycle. So, AMH testing is simple and can be helpful, right?
Well, YES and No
So far, the best interpretation we can give of your AMH level is to say that it is low, normal or high. That information is very useful for one reason, and probably only one reason: It helps us predict ovarian responsiveness during your IVF cycle and helps to dose medications. Currently, there are no universal reference ranges for AMH, so every clinic -including SIRM St. Louis – uses slightly different values. In addition, the AMH assay systems have been inconsistent, making it even harder to standardize.
AMH levels suggest how well your ovaries will respond to medication. We give smaller doses of medications if your AMH level is high and higher doses if your AMH level is low. What knowledge of your AMH level cannot do is be an accurate predictor of the likelihood of achieving pregnancy or having a live birth.
There is a silver lining: having only a low AMH should not discourage any couple from moving forward with treatment! There is currently a debate on whether AMH is associated with egg quality which is the most important predictor of success. It is the belief of fertility doctors at SIRM St. Louis that AMH should not be used alone to guide treatment, but rather be used with other information, like maternal age. We have many couples who were successful with IVF treatment with a low AMH. I have been researching the role of AMH and fertility for the past two years in high quality, gold standard studies and am passionate about getting this message out to the community!
We know that low AMH levels are not a barrier to successful fertility therapy! Please contact our St. Louis infertility specialists with any questions or stories related to your experience with testing. We would love to hear them!