Understanding women's fertility potential and planning for future family building has become more crucial than ever in today's world. In this process, one of the most valuable markers is the Anti-Müllerian Hormone (AMH) level. The AMH level provides important information about a woman's egg reserve and plays a key role in assessing pregnancy chances. Especially for women planning pregnancy or racing against time, an AMH test can guide the steps to be taken. As Ankara IVF Center, with over 30 years of experience from Prof. Dr. Kubilay Vicdan, we will thoroughly discuss what the AMH value means, how it should be interpreted, and what treatment options are available in cases of low reserve in this article.
What is AMH, and how is it measured?
Anti-Müllerian Hormone (AMH) is an important indicator of ovarian reserve in female reproductive health. This hormone is produced by small follicles (egg sacs) in the ovaries that have not yet begun to grow. Therefore, the AMH level in the blood directly reflects the number of potential eggs remaining in the ovaries, i.e., your egg reserve.
One of the most important features of AMH is that it can be measured on any day of the menstrual cycle. It is not affected by the menstrual cycle or birth control pills, which makes it a more reliable and practical reserve indicator compared to other hormone tests like FSH (Follicle-Stimulating Hormone) and Estradiol. The AMH test is performed with a simple blood test, and results are usually obtained within a few days.
Along with the AMH test, Antral Follicle Count (AFC), which involves counting small follicles in the ovaries via ultrasound, also provides complementary information about egg reserve. Evaluating these two tests together allows us to gain a much more comprehensive and accurate understanding of your overall egg reserve status. Prof. Dr. Kubilay Vicdan and our team evaluate the results of these tests with a personalized approach to guide the creation of the most accurate treatment plan.
AMH Levels by Age
AMH levels naturally tend to decrease with a woman's age. Women are born with a specific egg reserve, and this reserve gradually diminishes over time with each menstrual cycle. Consequently, AMH levels are generally higher in younger women, but these values decline as age progresses and approach zero as menopause nears.
Generally accepted AMH level ranges are as follows (these values may show slight variations depending on the laboratory and the unit of measurement used):
- Optimal Reserve: Values typically 2.0 ng/mL and above indicate a good egg reserve.
- Normal Reserve: Values between 1.0 - 2.0 ng/mL may indicate a normal reserve for her age.
- Low Reserve: Values between 0.5 - 1.0 ng/mL suggest a decrease in egg reserve.
- Very Low Reserve: Values below 0.5 ng/mL indicate a severely diminished egg reserve.
Note: These ranges are intended as a general guide. Because AMH assay kits (such as Gen II, Elecsys, Access and picoAMH) differ in calibration, your result should always be interpreted together with your physician, using the reference range of the laboratory that performed the test.
However, it is important to remember that these values are merely reference points. Every woman's biology is different, and evaluating the AMH level alone can be misleading. It should be assessed in conjunction with factors such as age, general health status, lifestyle, and other hormonal tests. For example, even if a young woman has a low AMH level, her egg quality might be better due to her age advantage. Therefore, it is crucial to consult a specialist to have your AMH level evaluated with a personalized interpretation specific to your situation.
What Does Low AMH Mean?
A low AMH level signifies a reduced ovarian reserve. This condition indicates a decrease in the number of mature eggs available for pregnancy in the ovaries. While receiving a low AMH diagnosis can be concerning for women, it is not a reason to lose hope.
The primary implications of low AMH are as follows:
- Reduced Egg Count: It indicates a diminished number of potentially fertilizable eggs in your ovaries. This can prolong the time to achieve natural pregnancy or reduce its chances.
- Need for a Different Approach in IVF Treatment: Low AMH in IVF treatment may mean a lower response to ovarian stimulation. This situation might necessitate more personalized treatment protocols or higher medication dosages.
- Risk of Early Menopause: In some cases, especially low AMH values at a young age can be an indicator of an increased risk of early menopause.
- Time Constraint: Low AMH may signal that your reproductive potential is decreasing and that you should not delay your pregnancy plans.
However, low AMH absolutely does not mean that pregnancy is impossible. The important thing is early diagnosis of this condition and taking the correct steps. Many women with low AMH levels can achieve successful pregnancies with appropriate treatment methods and personalized approaches. At this point, consulting an experienced IVF specialist and thoroughly evaluating your situation will help you chart the most accurate roadmap.
Treatment Options for Low Reserve
For women facing low egg reserve or a low AMH level, various treatment options are available. It is important to understand that each individual's situation is unique, and the treatment plan should be tailored accordingly. As Ankara IVF Center, under the guidance of Prof. Dr. Kubilay Vicdan, we offer the most current and scientific approaches.
The main treatment options are:
In Vitro Fertilization (IVF) Treatment
For patients with low egg reserve, the most effective and frequently preferred method is In Vitro Fertilization (IVF) treatment. The aim of this method is to collect the maximum possible number of eggs from the ovaries. Different protocols can be applied to stimulate the ovaries in patients with low reserve:
- Personalized Stimulation Protocols: To optimize the ovarian response to medication, special stimulation protocols (e.g., antagonist protocol, microdose flare protocol, or mild stimulation protocols) may be applied, considering the patient's AMH level, age, and previous treatment history.
- Egg Retrieval: Mature eggs are collected from the stimulated ovaries.
- Fertilization and Embryo Development: The collected eggs are fertilized with sperm using the intracytoplasmic sperm injection (ICSI) method in the laboratory, and embryos are developed.
- Embryo Transfer: The healthiest embryos are selected from the developing embryos and transferred to the uterus. When deemed necessary, Preimplantation Genetic Testing (PGT) methods can also be used to assess the genetic health of the embryos, which can increase pregnancy chances, especially in cases of advanced maternal age or recurrent failures.
Egg or Embryo Freezing
If there are young women who do not yet have pregnancy plans but whose AMH levels are declining, egg freezing can be considered to preserve their future chances of pregnancy. This method allows eggs to be collected and frozen for storage while they are younger and of better quality. For married couples, embryo freezing can also be an option.
Lifestyle Changes and Supportive Therapies
A healthy lifestyle, balanced nutrition, regular exercise, and avoiding smoking and alcohol consumption can support overall reproductive health. In some cases, supportive therapies such as antioxidants or vitamin supplements may also be recommended under medical supervision.
In cases of low egg reserve, the most suitable treatment plan is determined with a multidisciplinary approach, taking into account each patient's expectations, age, and general health status. Remember that thanks to modern medical possibilities, even a low AMH level can open many doors to realizing your dreams of pregnancy. The important thing is to connect with the right specialists at the right time.
Regardless of your AMH level, it is possible to increase your chances of pregnancy with accurate information and a personalized approach. As Ankara IVF Center, with Prof. Dr. Kubilay Vicdan and our experienced team, we are here to meticulously evaluate each patient's unique situation and chart the most appropriate treatment path. If you have concerns about your egg reserve or would like a professional opinion on your pregnancy plans, we would be delighted to assist you. You can schedule a free initial consultation to evaluate your situation and create a personalized treatment plan.