amh test : what is it ? what is the amh test normal range ?

Anti-Mullerian hormone or AMH is one of the most important parameters taken into consideration for identifying fertility. If you have ever got a fertility test done, you might have come across this term in your test report. The AMH hormone acts as a key indicator of fertility in women. These levels help the couple, especially the women, to decide whether she wants to start a family now or later. Also, whether or not she can wait or should she get her eggs frozen, as aprecaution, at an infertility centre.
Interesting, right..!! In this article, let us discuss about what AMH means, what is the normal range of AMH, what AMH levels are ideal for egg freezing, and how you can increase your AMH levels naturally.

What is the AMH test?

AMH or anti-Mullerian hormone is produced by the granulosa cells present in the ovarian follicles. The hormone is present in both males and females in their reproductive tissues. The levels of AMH play a crucial role in the development of sex organs in the embryonal stage. The levels of AMH in the foetus depend largely upon their gender, that is, the male foetus has higher AMH levels in order to inhibit the development of female organs, whereas, the female foetus has lower levels of AMH. The condition of ambiguous genitalia or intersex develops in the male fetus while the AMH levels are not high enough. Apart from sex organ development, the AMH comes into play at puberty and regulates the production of eggs by a female ovary. As the levels of AMH increase, the number of eggs produced in a female also increases. Thus, AMH levels enable the gynaecologist to effectively determine the fertility possibilities of a female.

What is the normal range of AMH?

The AMH levels remain constant during the early years of life and start increasing as the female reaches the adolescent stage. At the age of 25, the AMH levels in a female are at their peak which start decreasing as the women ages further, thereby, decreasing the egg count in subsequent years and finally leading to menopause. If a female wants to get pregnant, the optimum AMH levels required are 1.5 ng/mL to 4.0 ng/mL. The table below tabulates the inference of different AMH levels.

S.No. AMH levels Inference
1. < 0.5 ng/mL Very low
2. 0.5 – 1.0 ng/mL Low 
3. 1.0 – 1.5 ng/mL Low-normal range
4. 1.5 – 4.0 ng/mL Normal range
5. > 4.0 ng/mL High (Indicates PCOS)

AMH levels according to age

According to a study presented in the annual meeting of the American College of Obstetricians and Gynaecologists (ACOG), average levels of AMH in a female as per her age is tabulated below:

S.No. Age Average AMH levels
1. < 30 years 2.91
2. 30 – 34 years 2.42
3. 35 – 37 years 2.03
4. 38 – 40 years  1.50
5. 41 – 42 years 0.92
6. > 42 years 0.59

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AMH levels and freezing of eggs

With the women becoming more career-oriented and the marriages now being at a later stage, the cases of infertility have increased exponentially. This is because the number of eggs in a female decrease at a certain age which is evident by the decrease in the AMH levels. Therefore, in dealing with the rising cases of infertility in recent times, science has made freezing eggs possible. This means that the women can get their eggs frozen in an infertility centre and later on use those eggs to get pregnant whenever they are ready for a family. However, the number of eggs that can be frozen in a female depends upon their age. It is also important to know that not all eggs that are frozen successfully turn into an embryo, thus, there is a minimum number of eggs that are required to ensure a 50% chance of live birth. The table below summarises the number of eggs that can be frozen in a female as per research, the minimum number of eggs that are required as per the model published in Human Reproduction in 2017, and the AMH levels that indicate the minimum number of eggs that are required for 50% live births as per the Centre for Fertility Research and Education (CFRE). 

S.No. Age Average number of eggs frozen per cycle Minimum number of frozen eggs required for a 50% chance of live birth AMH levels required to reach the optimum egg level
1. < 34 years 17.2 7 1.25 ng/mL
2. 35 – 37 years 15.48 9 1.50 ng/mL
3. 38 – 40 years 12.87 11 1.75 ng/mL
4. > 41 years 9.67 20 2.25 ng/mL

How to increase AMH levels naturally?

You can increase the levels of your AMH by making certain modifications to your lifestyle. These modifications include:

  • Quitting smoking and other tobacco products
  • Maintaining a healthy weight and body mass index (BMI)
  • Take a diet rich in vitamin D and deficient in fat

Takeaway

AMH levels are an important indicator of the antral follicular count in females. The levels of AMH give gynaecologists a clear view of the number of eggs that are left in a female before she goes into the menopausal stage. Thus, AMH levels play a key role in planning your IVF protocol. Now, that you know the levels of AMH which are considered normal, the average AMH levels as per your age, and the minimum number of eggs that are required for freezing, you can better decide whether you should go for an IVF treatment or get your eggs frozen for future as per your AMH test report.

Frequently Asked Questions (FAQs)

  1. What is the normal AMH level to get pregnant? 

    The normal AMH level for a woman to get pregnant lies between 1.5 ng/mL to 4.0 ng/mL.

  2. What is a good AMH level for IVF? 

    The AMH levels above 1.6 ng/mL are considered good for IVF.

  3. What AMH level indicates PCOS?

    A high AMH level, that is, AMH levels above 4.0 ng/mL indicates PCOS.

Prekshi Garg is a young, dynamic, energetic, and meritorious professional biotechnologist. She is a merit rank holder in her post-graduation and a skilled bioinformatician with great zeal to do her best in neurosciences. She is currently working in the area of Neurotranscritomics dealing with neurodevelopmental and neurodegenerative disorders. She has presented many papers at different scientific forums and is awarded ‘Representing the Institution in Scientific Events’ citation by Amity University Uttar Pradesh and Top position in Student Assistantship Program held at Amity University in addition to awards won for oral presentations in different scientific deliberations. Prekshi has published a good number of papers and book chapters during the start of her academic career itself. Her tremendous skills and knowledge make her a good blend of biotechnology and bioinformatics.

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