7 Symptoms of Low AMH Level

by | Feb 22, 2023 | IVF

What is AMH?

Anti-Müllerian Hormone (AMH) is a hormone that is produced by the cells in a woman’s ovaries. It is an important marker of ovarian function and can be used to estimate a woman’s ovarian reserve, which refers to the number and quality of eggs remaining in her ovaries. It plays an important role in the development and maturation of ovarian follicles, which contain a woman’s eggs. let’s read about Symptoms of low AMH level.

 

7 Symptoms of Low AMH:

  1. Irregular Menstrual Cycles
  2. Difficulty conceiving
  3. Early Monopause
  4. Poor Response to Ovarian Stimulation
  5. Elevated Follicile-Stimulating Hormone (FSH) Levels
  6. Bad Egg Quality
  7. Increased Risk of Pregnancy Complications

 

Explaining 7 Symptoms of Low AMH:

  1. IRREGULAR MENSTRUAL CYCLES: Irregular menstrual cycles can be a symptom of low AMH levels. Women with low AMH may experience shorter or longer menstrual cycles than usual. They may also experience changes in the amount of blood flow or the duration of their periods. Women with low AMH may also have fewer periods in a year.
  2. DIFFICULTY CONCEIVING: Low AMH levels can make it difficult for women to conceive. This is because AMH is an important predictor of ovarian reserve, and women with low AMH may have fewer eggs available for fertilization. As a result, women with low AMH may experience infertility or subfertility.
  3. EARLY MENOPAUSE: Women with low AMH levels may experience early menopause. Menopause is described as natural process when a woman’s ovaries stop producing eggs. However, women with low AMH levels may experience menopause earlier than usual, which can have significant implications for their fertility and overall health.
  4. POOR RESPONSE TO OVARIAN STIMULATION: Women with low AMH levels may have a poor response to ovarian stimulation. Ovarian stimulation is a technique used in fertility treatments such as in vitro fertilization (IVF) to encourage the ovaries to produce multiple eggs. However, women with low AMH levels may not respond well to ovarian stimulation, which can make it difficult to achieve a successful pregnancy.
  5. ELEVATED FOLLICLE-STIMULATING HORMONE (FSH) LEVELS: Women with low AMH levels may have elevated follicle-stimulating hormone (FSH) levels. The hormone that stimulates the ovaries to produce eggs is known as FSH. When AMH levels are low, the body may produce more FSH to compensate for the low ovarian reserve. High FSH levels can indicate that the ovaries are not responding well to hormonal signals, which can make it difficult for women to conceive.
  6. REDUCED EGG QUALITY: Low AMH levels can also be a sign of reduced egg quality. As women age, the quality of their eggs naturally declines, but women with low AMH levels may experience a more significant decline in egg quality at a younger age. Poor egg quality can make it difficult for women to conceive and can also increase the risk of miscarriage and chromosomal abnormalities.
  7. INCREASED RISK OF PREGNANCY COMPLICATIONS: Women with low AMH levels may be at increased risk of pregnancy complications. Low AMH levels can be a sign of reduced ovarian reserve, which can increase the risk of miscarriage, preterm birth, and other pregnancy complications. Women with low AMH levels may also have a higher risk of delivering a baby with a low birth weight.

In conclusion, low AMH levels can be a sign of diminished ovarian reserve, which can have significant implications for a woman’s fertility and overall health. Women with low AMH levels may experience irregular menstrual cycles, difficulty conceiving, early menopause, poor response to ovarian stimulation, elevated FSH levels, reduced egg quality, and increased risk of pregnancy complications. If you are experiencing any of these symptoms, it is important to speak with your healthcare provider about your fertility options and to discuss any potential underlying conditions that may be contributing to your low AMH levels.

Also Read: AMH Test Price

What are AMH Levels:

AMH levels can provide valuable information about a woman’s fertility and ovarian reserve. AMH levels are typically measured through a blood test, which can be done at any time during a woman’s menstrual cycle. The test measures the amount of AMH present in the blood, which can help determine a woman’s fertility potential. The normal range of AMH levels can vary depending on the laboratory that conducts the test and the units of measurement used. However, the following are generally considered to be the average AMH levels for women of different age groups:

  1. For women in their 20s and early 30s: AMH levels are typically between 2.0-4.0 ng/mL (nanograms per millilitre) or 14.28-28.6 pmol/L (picomoles per litre).
  2. For women in their late 30s and early 40s: AMH levels are typically between 0.5-2.0 ng/mL or 3.57-14.28 pmol/L.
  3. For women over 40 years of age: AMH levels may be significantly lower than 0.5 ng/mL or 3.57 pmol/L.

 

Average AMH levels in the Table for women according to age:

Women Age Nanograms per millilitre Picomoles per litre
20 – 30 2.0-4.0 14.28-28.6
30 – 40 0.5-2.0 3.57-14.28
>40 <0.5 <3.57

 

It’s important to note that these are just general guidelines and AMH levels can vary widely between individuals. Additionally, AMH levels can be influenced by factors such as genetics, certain medical conditions, and certain medications. If a woman’s AMH levels fall outside of the normal range for her age group, it may indicate that she has a higher or lower ovarian reserve than expected. However, AMH levels should be evaluated in conjunction with other fertility tests and a woman’s medical history to get a complete picture of her fertility potential.

  • In general, NORMAL AMH LEVELS are typically considered to be between 1.0 and 4.0 ng/mL or between 7.14 and 28.6 pmol/L.

It’s also worth noting that while AMH levels can provide important information about a woman’s fertility potential, they do not provide a complete picture of her ability to conceive. Other factors such as the quality of a woman’s eggs, the health of her uterus and fallopian tubes, and her partner’s fertility can all play a role in a couple’s ability to conceive.

Also Read: What is IVF

What does High AMH Indicate?

High AMH levels can indicate that a woman has a large number of ovarian follicles and a higher ovarian reserve, which may increase her chances of conceiving. However, high AMH levels can also be a sign of polycystic ovary syndrome (PCOS), which can cause irregular menstrual cycles, ovarian cysts, and infertility.

High AMH = High Ovarian Reserve

 

What does Low AMH Indicate?

Low AMH levels, on the other hand, can be a sign of diminished ovarian reserve, which means that a woman has a lower number of ovarian follicles and eggs available for fertilization. Low AMH levels may also be a sign of premature ovarian failure or menopause.

Low AMH = Low Ovarian Reserve

 Also Read: What is a Good AMH Level to Get Pregnant?

Low AMH Causes:

Understanding the causes of low AMH levels can help women and their doctors develop an appropriate treatment plan.

  • AGE: As women age, their ovarian reserve naturally declines, and their AMH levels decrease accordingly. Women in their 20s and early 30s typically have higher AMH levels than women in their late 30s and 40s. After menopause, AMH levels become undetectable.
  • POLYCYSTIC OVARY SYNDROME (PCOS): PCOS is a common condition that can cause hormonal imbalances and irregular periods. Women with PCOS typically have higher-than-normal levels of male hormones, which can affect their ovarian function and lead to high AMH levels. However, in some cases, women with PCOS may also have low AMH levels.
  • OVARIAN SURGERY: Women who have undergone ovarian surgery, such as ovarian cyst removal or ovarian cancer treatment, may experience a decrease in their AMH levels. This is because ovarian surgery can damage the ovarian follicles, leading to a reduction in ovarian reserve and AMH production.
  • CHEMOTHERAPY AND RADIATION THERAPY: Chemotherapy and radiation therapy can also damage the ovarian follicles, leading to a decrease in AMH production and ovarian reserve. The degree of damage depends on the type and duration of treatment.
  • GENETICS: Some women may have a genetic correlation to low AMH levels. Certain gene mutations, such as those associated with primary ovarian insufficiency (POI), can lead to a decreased ovarian reserve and low AMH levels.
  • OTHER FACTORS: Other factors that may contribute to low AMH levels include autoimmune disorders, such as thyroid disease or lupus, and environmental toxins, such as pesticides or chemicals in plastics.

To Summarize, low AMH levels can have several causes, including age, polycystic ovary syndrome (PCOS), ovarian surgery, chemotherapy and radiation therapy, genetics, autoimmune disorders, and environmental toxins. Understanding the underlying cause of low AMH levels can help women and their doctors develop an appropriate treatment plan to address their specific needs and increase their chances of getting pregnant. Women who are concerned about their AMH levels should speak with their doctor to determine the best course of action for their individual situation.

 

Low AMH Diagnosis:

Diagnosing low AMH levels typically involves a blood test to measure the amount of AMH in a woman’s bloodstream. Here are some key points about the diagnosis of low AMH:

  • TIMING: AMH levels are typically measured on day 3 of a woman’s menstrual cycle, which is when her follicle-stimulating hormone (FSH) levels are also checked. This helps to provide a comprehensive picture of a woman’s ovarian function.
  • INTERPRETATION: The interpretation of AMH levels depends on a woman’s age and other factors, such as the type of assay used to measure AMH levels. Generally, AMH levels are considered to be low if they are below the normal range for a woman’s age.
  • NORMAL RANGE: The normal range for AMH levels can vary depending on the laboratory that performs the test and the assay used. However, in general, AMH levels are considered to be normal if they are between 1.0 and 4.0 ng/mL for women in their 20s and early 30s, and between 0.5 and 2.0 ng/mL for women in their late 30s and 40s.
  • OTHER TESTS: In addition to AMH levels, other tests may be used to evaluate a woman’s ovarian function, such as antral follicle count (AFC) on ultrasound or FSH levels. These tests can provide additional information about a woman’s ovarian reserve and can help to confirm a diagnosis of low AMH.
  • FOLLOW-UP TESTING: If a woman has low AMH levels, her doctor may recommend follow-up testing to confirm the diagnosis and evaluate her ovarian function. This may involve repeat AMH testing, as well as other tests such as AFC or FSH levels.
  • CLINICAL EVALUATION: In addition to laboratory tests, a clinical evaluation may also be conducted to assess a woman’s overall reproductive health, including her menstrual history, sexual history, and any previous fertility treatments.

Overall, diagnosing low AMH levels involves a blood test to measure the amount of AMH in a woman’s bloodstream, as well as other tests and a clinical evaluation to assess her overall reproductive health. Women who are concerned about their AMH levels should speak with their doctor to determine the best course of action for their individual situation.

Also Read: Low AMH Success Stories

Low AMH Treatment:

Treatment for low AMH levels typically focuses on addressing the underlying cause of the low levels and improving ovarian function to increase the chances of pregnancy. Here are some key points about treatment for low AMH levels:

  • FERTILITY MEDICATIONS: Fertility medications such as clomiphene citrate, letrozole, or gonadotropins can be used to stimulate the ovaries and increase the number of follicles produced each month. This can help to improve ovarian function and increase the chances of getting pregnant. Fertility medications may be used alone or in combination with other treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
  • IVF: IVF is a type of assisted reproductive technology (ART) that involves harvesting eggs from the ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryos into the uterus. IVF can be an effective treatment option for women with low AMH levels because it bypasses the need for the ovaries to produce multiple follicles each month. Instead, a woman’s ovaries are stimulated with medications to produce multiple follicles, which are then harvested for IVF.
  • IVF WITH DONOR EGGS: In cases where a woman’s own eggs are not of sufficient quality or quantity, donor eggs can be used for IVF. Donor eggs are typically obtained from younger women with higher AMH levels and can provide a higher chance of success for IVF treatment.
  • LIFESTYLE CHANGES: Lifestyle changes such as maintaining a healthy weight, eating a balanced diet, and reducing stress can help to improve ovarian function and increase the chances of getting pregnant. Regular exercise can also help to improve overall health and fertility.
  • SUPPLEMENTS: Supplements such as CoQ10, DHEA, and myo-inositol have been studied as potential treatments for low AMH levels. While some studies have shown promising results, more research is needed to determine the effectiveness of these supplements.
  • SURGERY: In some cases, surgery may be necessary to remove ovarian cysts or tumours that are affecting ovarian function. However, surgery can also damage the ovaries and lead to a further decrease in AMH levels, so it is generally only recommended when other treatment options have been exhausted.

Overall, treatment for the lowest AMH levels can involve a range of approaches, including fertility medications, IVF, donor eggs, lifestyle changes, acupuncture, supplements, and surgery. The best treatment approach will depend on the individual woman’s situation, including her age, overall health, and fertility goals. Women with the lowest AMH levels should work closely with their doctors to develop an appropriate treatment plan that addresses their specific needs and increases their chances of getting pregnant.

Also Read: Low AMH Treatment

What are the Risk Factors affecting Low AMH?

  • Advancing age is a significant risk factor for the lowest AMH levels, as the ovarian reserve naturally declines with age.
  • Genetic disorders that affect ovarian function, such as Turner syndrome or Fragile X syndrome, may also result in short AMH levels.
  • Certain medical treatments, such as chemotherapy or radiation therapy for cancer treatment, can damage the ovaries and reduce AMH levels.
  • Autoimmune diseases such as Hashimoto’s thyroiditis or lupus can cause inflammation and damage to the ovaries, leading to reduced AMH levels.
  • Surgery to remove one or both ovaries can also decrease AMH levels, as it reduces the overall ovarian reserve.
  • Medical conditions such as polycystic ovary syndrome (PCOS) can affect ovarian function and may result in lower AMH levels.
  • Lifestyle factors such as smoking, obesity, and exposure to environmental toxins may also have an impact on AMH levels.
  • Certain medications or hormonal treatments, such as hormonal contraceptives or hormonal therapy for menopause, may affect AMH levels.
  • It is important to identify any potential risk factors for tshort AMH and discuss appropriate management options with a healthcare provider.

Also Read: IVF with Low AMH

FAQs:

Q: What happens when AMH is very low?

A: Low AMH indicates a decreased ovarian reserve and reduced egg supply, which can make it more challenging to conceive naturally.

Q: What is the reason for low AMH?

A: Low AMH levels can be caused by various factors, such as advancing age, genetic disorders, chemotherapy, radiation therapy, autoimmune diseases, or surgical removal of the ovaries.

Q: Can low AMH levels be improved?

A: While it is not possible to increase the number of eggs a woman has, some lifestyle changes, supplements, and medications may help to optimize the remaining eggs’ quality.

Q: Can I conceive with low AMH?

A: Low AMH does not mean that pregnancy is impossible, but it may require fertility treatments such as in vitro fertilization (IVF), intrauterine insemination (IUI), or egg donation.

Q: What is the minimum AMH to get pregnant?

A: There is no minimum AMH level required for pregnancy, but higher levels may increase the chances of conception.

Q: Does vitamin D increase AMH?

A: Some studies suggest that vitamin D may have a positive effect on AMH levels, but more research is needed to confirm this relationship.

Q: What is the best treatment for low AMH?

A: The most effective treatment for low AMH depends on the individual’s circumstances and may include lifestyle modifications, supplements, medications, or assisted reproductive techniques such as IVF or IUI.

Q: What is the minimum AMH for IVF?

A: There is no specific minimum AMH level for IVF, but higher levels may increase the chances of a successful outcome.

Q: Can stress lower AMH?

A: Chronic stress may have negative effects on fertility and reproductive hormones, including AMH.

Q: Does low AMH mean no eggs?

A: No, low AMH levels do not necessarily mean that a woman has no eggs left. It simply means that the remaining egg supply is lower than average.

Q: What causes low AMH at a young age?

A: Low AMH at a young age may be due to genetic factors, autoimmune diseases, or medical treatments that damage the ovaries.

Q: How can one have lowest  AMH but regular periods?

A: Low AMH levels can occur even in women with regular periods because AMH reflects the ovarian reserve, which can vary independently of menstrual cycles.

Q: How to increase AMH levels?

A: While it is not possible to increase the number of eggs a woman has, some lifestyle changes, supplements, and medications may help to optimize the remaining eggs’ quality. These may include a healthy diet, regular exercise, reducing stress, and taking supplements such as DHEA, CoQ10, or myoinositol.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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