Anti-Mullerian Hormone (AMH)
How Do AMH and FSH Affect Fertility?
AMH is one of the most accurate tests to assess a woman's ovarian reserve (OR)ovarian reserve (OR) . AMH levels can be measured at any point of a woman's menstrual cycle. Low AMH is an indicator of diminished ovarian reserve (DOR), a decline in the ovaries’ ability to produce good-quality eggs. DOR is one of the major causes of infertility among women.
In reverse, high AMH can signal polycystic ovary syndrome (PCOS). Typically, AMH and FSH move in the opposite direction as women age, with AMH going down and FSH going up, indicating deterioration of ovarian reserve. When AMH levels are normal or high while FSH levels are also high, this can signal hypoandrogenic PCOS, a relatively new type of PCOS that CHR researchers were the first to identify.
What’s the connection between AMH and FSH?
AMH levels are often measured along with follicle stimulating hormone (FSH) levels, which are another common measure of a woman's ovarian reserve. AMH has a few advantages over FSH:
- AMH levels can be measured at any time. FSH has to be measured on a specific day in her cycle.
- AMH appears to be a better predictor of pregnancy chances than FSH, according to recent research. It has been reported, however, that AMH loses its prognostic ability in women above age 42, although it remains a more reliable predictor than FSH alone.
Age and AMH
It is important to remember that AMH levels decline and FSH levels increase as women age. In other words, normal AMH and FSH levels vary depending on a woman’s age. For example, a normal AMH level for a woman at 42 could suggest premature ovarian aging (POA) if the same AMH level was found in a 32-year-old woman.
Because of this, CHR researched and established age-specific levels of AMH and FSH. Focusing on age-specific AMH and FSH levels allows us to best assess a woman’s ovarian reserve, devise an appropriate treatment plan and estimate her IVF pregnancy chances.
Age Specific Baseline FSH and AMH Levels
|< 33 Years||< 7.0 mIU/mL||= 2.1 ng/mL|
|33-37 Years||< 7.9 mIU/mL||= 1.7 ng/mL|
|38-40 Years||< 8.4 mIU/mL||= 1.1 ng/mL|
|= 41+ Years||< 8.5 mIU/mL||= 0.5 ng/mL|
"Pregnancy is still possible with low AMH."Dr. Norbert Gleicher
Questions About Your AMH or FSH Levels?
At CHR, we specialize in advanced and hard-to-treat cases - including women with low (even undetectable) AMH levels. Contact us to learn whether you’re a candidate for treatment.
Pregnancy Chances and AMH Levels
Many patients come to CHR after being told by other fertility specialists that their chance of pregnancy is less than 1% because of their low AMH levels. But proper treatment designed to address low AMH/DOR may increase pregnancy chances in women with low AMH considerably.
A recent analysis of CHR’s IVF outcomes for women with very low AMH found that even above age 41, as long as the patient’s ovaries still produce more than two transferable embryos, pregnancy rates were in the 6-7% range. This means that it’s particularly important to seek out fertility treatments from an IVF center with specialized expertise in treating women with low AMH/DOR.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned reproductive endocrinologist, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
Last Updated: October 8, 2018