AMH Blood Test

AMH levels are a valuable indicator of ovarian reserve, but it’s important to understand that a variety of factors can influence your AMH test results. Knowing what can affect your AMH levels helps you and your fertility specialist interpret your results more accurately and plan the best path forward for your fertility journey.

Below are 10 key factors that can influence AMH levels.

• AMH levels naturally decline with age, resulting in a gradual reduction in the number of eggs in your ovaries (your ovarian reserve).
  
• The speed of decline is natural to the individual, with some people seeing a faster drop than others, even at the same age.

• Women with polycystic ovary syndrome (PCOS) or polycystic ovaries often have higher AMH levels. This is because the ovaries contain many small follicles, which collectively produce more AMH.
  
  
• High AMH can suggest a good egg supply, but in fertility treatment, it may also mean a higher risk of ovarian hyperstimulation syndrome (OHSS).

• Ovarian surgery (for example, removal of ovarian cysts) can remove healthy ovarian tissue and lower ovarian reserve, leading to reduced AMH.
• Chemotherapy and some other medical treatments that affect the ovaries can cause a significant drop in AMH, sometimes leading to premature menopause or low ovarian reserve.
• Certain forms of contraception, such as prolonged use of the pill, can lead to a temporary drop of the AMH levels. If it is safe to do so, your specialist will advice to stop the hormonal contraception to get a more accurate assessment of your ovarian reserve

• Lifestyle factors such as obesity and vitamin D deficiency have been linked to altered AMH levels and may impact overall reproductive health.
• Genetic factors, including BRCA or Fragile X gene mutations for example, can affect ovarian reserve and may be relevant for people with a strong family history of these mutations.
• For those at genetic risk, regular AMH testing may help track changes in ovarian reserve over time.

• During IVF and other fertility treatments, ovarian stimulation medications are used to encourage the ovaries to develop multiple eggs.
• These medications can temporarily influence AMH-related measurements, and timing of the test relative to treatment may matter.
• Your fertility specialist will interpret AMH results in the context of your treatment cycle and other test results.

• In rare cases, certain ovarian tumours (such as granulosa cell tumours) can cause abnormal AMH production.
• This may show up as unexpectedly high or low AMH levels when compared to your age and clinical picture.
• If AMH results look unusual, your doctor may recommend further investigations to rule out underlying conditions.

• A key advantage of AMH testing is that AMH stays relatively stable throughout the menstrual cycle therefore it doesn’t need to be measured on a specific day of your cycle.
  
• This makes AMH a convenient and reliable marker of ovarian reserve at almost any time.

• For women considering fertility preservation (such as egg freezing), AMH is an important baseline test.
  
• AMH helps answer: “Should I consider freezing eggs now, and what response can I expect?”
• AMH can help estimate how many eggs might be collected in a stimulation cycle.

It is especially useful if you:

1. are at risk of early menopause
   
2. already know you have a low egg count

AMH helps answer: “Should I consider freezing eggs now, and what response can I expect?”

• Normal AMH levels for your age generally suggest a healthy ovarian reserve.
• Lower AMH levels may indicate fewer eggs remaining, but this does not mean you can’t conceive naturally.
• AMH is one piece of the fertility puzzle. Other important factors include:
  • age
  • egg quality
  • ovarian function
  • sperm factors
  • the condition of your uterus and fallopian tubes

• Fertility specialists use AMH to predict how your ovaries might respond to stimulation in IVF and other treatments.
• Higher AMH often means a stronger response, so medication doses may need to be adjusted to reduce OHSS risk.
• Lower AMH can suggest a reduced response, allowing your specialist to adjust treatment to make the most of your remaining ovarian reserve.

In summary, a simple blood test for AMH provides valuable insights into your reproductive health, but it’s important to consider all the factors that can influence your AMH level. Discussing your results with a fertility specialist ensures you receive personalised advice and the best possible care for your fertility planning and treatment.

If your AMH test reveals you have a low ovarian reserve - don’t panic. You still have options open to you:

• If you’re in a relationship and ready for children, we recommend you try to get pregnant as soon as possible.
• If you’re ready for children but aren’t in a relationship, we recommend looking into accessing donor sperm.
• If you’re not ready for children, you could consider freezing your eggs.
• If you’ve experienced premature menopause, we can talk you through alternate options including using donor eggs.

Low AMH levels can indicate your ovaries are producing fewer preantral follicles. Factors that can lead to you having a low AMH level include:

An autoimmune condition

Environmental factors

Having a high intake of biotin (Vitamin B7)

Smoking

Surgeries for ovarian cysts or endometriosis

Your age, as you get older, AHM levels naturally decline as the number of follicles in your ovaries decline

Your DNA

It’s important to note that low AMH levels don’t necessarily mean you’re infertile or unable to conceive by IVF treatment or naturally. Get more information about the egg timer test and what affects AHM levels here.

Unfortunately, there’s no proven way to increase your AMH levels. The best thing to do would be to either start a family or freeze your eggs sooner rather than later. Freezing eggs is the only way to stop them from ageing.

While having a high AMH level sounds like a good thing, if your levels are higher than normal for your age group, this could indicate a condition known as polycystic ovarian syndrome (PCOS). To learn more about PCOS follow this link.

This is a difficult question to answer, as AMH levels vary widely, even amongst fertile women. The graph below shows the average AMH level by age, though it is important to note that low AMH is not necessarily indicative of poor fertility. It needs to be considered in the context of other test results and family planning.

Yes. AMH levels decline with age, as is visible in graph below. But they may also fluctuate from month to month, or even within the month. The higher your AMH level, the bigger the fluctuations may be. Because AMH levels are higher in young people, young people tend to experience greater fluctuations.

If you are using the Oral Contraceptive Pill, your natural ovarian function is being supressed, so an AMH blood test will often render a lower result than usual. However, there is no evidence to suggest that the Pill negatively impacts fertility, and your AMH levels should return to normal once you stop taking the Pill.

At Monash IVF, we believe knowledge is power. The AMH test provides valuable information about your ovarian reserve, allowing you to take charge of your fertility sooner rather than later.

The truth is, we can delay starting a family for all kinds of reasons - but there’s no question that fertility declines with age. Once your ovaries run out of eggs, the body can’t produce more. And unfortunately, your last remaining eggs may not be of great quality.

The AMH test grants you the knowledge to plan for the future.