All about Low AMH: Causes, Symptoms, Treatment?

What is low AMH?

Antimullerian hormone or AMH refers to a hormone which is produced by the follicles inside a woman's ovaries. With a blood test, it provides a good measure of the ovarian reserve and therefore the fertility of each patient.

The analysis of AMH is done by a blood test at any time of the cycle (unlike the FSH and LH hormones which must be carried out at the very beginning of the cycle).

Understanding ovarian reserve:

The ovarian reserve has always been an essential parameter in assisted reproduction, but its importance is ultimately and relatively unknown to women. The ovarian reserve refers to the amount of eggs in each ovary and gives us information about a woman's fertility and the chances of success for an ART treatment.

When we talk about ovarian reserve, we must differentiate between the follicles available in a cycle and the totality of follicles available throughout the woman's life.

From birth, the woman will have a predetermined amount of follicles and this reserve will decrease as the woman ovulates. It is this reserve that will be sought with the high or low AMH level. This will give us an idea of the follicles available in the fertile life of the patient.

The follicles available for a cycle, the antral follicles, are those which appear at the very beginning of the cycle (between the 1st and the 3rd day of menstruation) and which will be visible on ultrasound. In a natural cycle, the ovaries release a certain amount of follicles for each cycle, but only one will cause ovulation, the rest will be lost. In the case of IVF treatment, all of these follicles will be stimulated so as to obtain as many mature oocytes as possible for fertilization.

AMH is therefore more useful for diagnosis than FSH and LH because the latter refers to a concrete cycle whereas antimullerian hormones calculate the whole reserve of the ovaries.

Low AMH symptoms 

This condition does not have any explicit low AMH symptoms but the condition of irregular periods or no periods is something which many women suffering from this problem, face in common. Blood test comes out to be the most effective way to assess and know AMH level.

Low AMH causes

The low AMH causes include the following-

 Hormonal Imbalance

 Advancing Age

 Environment related causes

 Endometriosis condition

 Different Genetic factors

 Unknown causes

Different values of AMH?

The AMH values are classified as follows for a woman under 35:

High AMH levels: more than 4.0 ng / ml

Normal levels: 1.5-4.0 ng / ml

Normal to low AMH levels: 1.0-1.5 ng / ml

Low AMH levels: 0.5-1.5 ng / ml

Very low levels: less than 0.5 ng / ml

However, even if the AMH is a reliable measurement, it must be able to be interpreted by looking at other factors too, such as the patient's age and the number of antral follicles (by ultrasound) to be able to establish an accurate diagnosis.

Age is one of the most determining factors for fertility treatments, and even with good ovarian reserve, the chances of pregnancy for women over 40 are reduced to less than 10%.

Other factors that can have a negative influence on AMH include ovarian operations, endometriosis, etc.

What is low ovarian reserve and low AMH treatment?

There is no treatment to improve a patient's ovarian reserve, since there are a predetermined number of follicles from birth.

The chances of successful treatment in case of low ovarian reserve generally depend on the age of the patient.

For a woman under the age of 40 and with a decrease in ovarian reserve, the most appropriate treatment would be in vitro fertilization to stimulate ovarian activity and obtain as many follicles as possible on a cycle. The oocytes will then be fertilized in the laboratory to obtain embryos, to be transferred to the patient.

For women over the age of 40 and with an AMH level less than 1 ng / ml, the most appropriate treatment would be egg donation, thereby benefiting young oocytes and having a good chance of pregnancy (around 65% ).

Finally, for women who do not wish to have a child immediately, but with a reduced ovarian reserve, they will have the possibility of having recourse to vitrification of oocytes, thereby preserving their fertility for a future pregnancy. Low AMH treatment includes techniques like IVF and donor eggs, according to the condition and need.

IVF – It is a potential option for those women who are suffering from the condition of poor ovarian reserve as it can make the maximum and optimum usage of the few eggs which are left in the ovary. But if there are no eggs or few eggs, the result might not come on the positive side.

Donor Eggs – Women who are facing infertility due to this condition, can go with IVF with Donor eggs to conceive because donor eggs have good success rate and are advisable for women with very little or no eggs in the ovaries.

To know more about low AMH treatment, visit the best IVF centre in India and get the right solution.

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