The human body is a complex marvel, and its inner workings are full of intricate processes that keep everything functioning as it should. One such process is the regulation of a hormone known as Anti-Müllerian Hormone, or AMH for short. While many may not be familiar with this hormone, it plays a crucial role in a woman’s reproductive health. So, Let us understand what AMH is, why it’s important, the symptoms of low AMH, how it’s diagnosed, and the various reasons behind low AMH levels. 

What is AMH?

AMH, or Anti-Müllerian Hormone, is a protein hormone produced by small follicles in a woman’s ovaries. Its primary role is to inhibit the development of the Müllerian ducts in male fetuses during embryonic development. In females, AMH continues to be produced throughout their reproductive years, but its function changes. It becomes an indicator of the number of eggs (ovarian reserve) a woman has left in her ovaries.

Why is AMH important?

AMH serves as a valuable marker for a woman’s ovarian reserve. In other words, it helps doctors estimate the number of eggs remaining in her ovaries, which is vital information for assessing fertility potential. Understanding a woman’s AMH levels can be particularly useful when planning fertility treatments like in vitro fertilization (IVF) or when assessing the likelihood of successful conception.

What is a Low AMH Level?

The amh levels between 1.0 ng/ml – 4.0 ng/ml are considered as healthy or normal ovarian reserve indicating a fertile woman with good chances of natural pregnancy. If the amh level is below 1.0 ng/ml then it denotes low chances for pregnancy and anything below 0.4 ng/ml is said to be a severely low AMH level. 

What are the symptoms of Low AMH?

Low AMH levels often don’t present any noticeable symptoms on their own. Instead, the symptoms are typically related to infertility issues. Some common signs that may indicate low AMH levels include:

1. Difficulty getting pregnant: Women with low AMH levels may struggle to conceive naturally.

2. Irregular menstrual cycles: Low AMH can lead to irregular or absent menstrual cycles.

3. Early menopause: Some women with low AMH may experience early menopause symptoms, such as hot flashes and night sweats.

4. Responsiveness to treatments: Increased difficulty in responding to fertility treatments like IVF.

How is low AMH diagnosed?

Diagnosing low AMH levels involves a blood test that measures the concentration of AMH in the bloodstream. This test is usually performed on specific days of the menstrual cycle, often on days 2-4 of the cycle, to obtain accurate results. The AMH level is expressed in nanograms per milliliter (ng/mL), and the interpretation of the results can vary depending on the laboratory and the individual’s age.

Reasons for Low AMH Levels

Several factors can contribute to low AMH levels, and it’s important to understand that these factors can vary from person to person. Here are some common reasons for low AMH levels:

1. Age

As women age, their ovarian reserve naturally decreases, leading to lower AMH levels. This decline typically begins in the late 20s or early 30s and accelerates as a woman approaches her 40s. By the time a woman reaches menopause, her AMH levels are usually undetectable. Therefore, age is one of the most significant factors influencing AMH levels, and women over 40 are more likely to have low AMH.

2. Medical Conditions

Certain medical conditions can affect AMH levels. These conditions include:

a. Ovarian Cysts: The presence of ovarian cysts, particularly endometriomas (cysts associated with endometriosis), can lead to lower AMH levels.

b. Endometriosis: This condition, characterized by the presence of uterine tissue outside the uterus, can contribute to low AMH levels due to ovarian damage.

c. Premature Ovarian Failure: Premature ovarian failure, also known as early menopause, can result in extremely low or undetectable AMH levels.

d. Autoimmune Diseases: Certain autoimmune disorders can directly affect ovarian function and decrease AMH levels.

e. Polycystic Ovary Syndrome (PCOS): Women with PCOS often have elevated AMH levels, but this doesn’t necessarily indicate good fertility, as the quality of eggs may be compromised.

3. Lifestyle Factors

Several lifestyle factors can impact AMH levels:

a. Smoking: Smoking has been linked to decreased AMH levels and a higher risk of infertility.

b. Obesity: Excess body weight can disrupt hormonal balance and negatively affect AMH levels.

c. Unhealthy Diet: Poor nutrition and inadequate intake of essential nutrients can influence ovarian function and AMH levels.

d. Excessive Exercise: Intense and prolonged physical activity, especially in athletes, can affect hormone production, including AMH.

e. Stress: Chronic stress may disrupt hormonal regulation, potentially leading to decreased AMH levels.