Both high and low AMH levels can affect fertility; excessive levels may be linked to diseases like polycystic ovary syndrome (PCOS), while low levels frequently indicate a decreased ovarian reserve.
AMH or Anti-Mullerian Hormone, is a hormone produced by the ovaries' small follicles and serves as a crucial indicator of ovarian reserve that provides accurate information of a woman's remaining egg quantity which helps in planning conception.
• A low AMH level is often associated with diminished ovarian reserve, which means that there are fewer eggs available for fertilization.
• In women planning in vitro fertilization (IVF), a low AMH level before the procedure can be an indicator of poor response or no response to ovarian stimulation.
• Low AMH levels may also indicate reduced fertility potential in certain types of patients, such as those with demonstrated infertility, cancer patients, or individuals who have had significant ovarian injury from radiation or surgery.
• It should be noted that interpretation of AMH levels is laboratory assay-dependent, and there is no international standard. Clinicians should refer to their own laboratory's reference ranges.
The ramifications of this is such that when a woman age there are fewer eggs in the ovaries. A reduced ovarian reserve may make conception more difficult. In addition, women with low AMH may need greater doses of medicine to promote egg production and may respond less well to reproductive therapies like in vitro fertilization (IVF).
• A high AMH level indicates a vigorous response to ovarian stimulation during IVF treatment.
• High levels of AMH may correlate with a higher risk of developing Ovarian Hyperstimulation Syndrome (OHSS), which is a potentially serious complication characterized by enlarged ovaries and fluid accumulation in the abdomen and chest.
• Polycystic Ovary Syndrome (PCOS): in which the ovaries have an abnormal number of tiny, immature follicles, can be linked to high levels of AMH thereby causing irregular menstrual cycles precipitating difficulties in ovulating.
A AMH level of 1.5-4.0 ng/ml is usually considered normal; values below 1.5 ng/ml may suggest a declining ovarian reserve with a reduced egg count. The chance of getting a decent number of embryos for transfer can be influenced by the number of eggs generated during in vitro fertilization. The likelihood of creating viable embryos increases with the number of eggs recovered. Fewer eggs may result in fewer embryos and perhaps poorer IVF success rates as women age because an increased percentage of defective eggs contribute to faulty embryos.
