Anti-Müllerian Hormone (AMH) is a protein produced by specialized cells within a woman’s ovaries. It is a widely used indicator in reproductive medicine, offering a snapshot of a woman’s current ovarian reserve, which is the total number of eggs remaining. AMH testing, typically done through a simple blood draw, provides insight into this remaining egg supply, aiding in family planning and fertility treatment assessment. This exploration delves into the scientific basis of AMH and addresses the question of whether its levels can be reliably increased.
The Relationship Between AMH and Ovarian Reserve
AMH is secreted by the granulosa cells surrounding the earliest stages of growing ovarian follicles, specifically the preantral and small antral follicles. These small, fluid-filled sacs each contain an immature egg, and their number directly correlates with the overall pool of resting, primordial follicles. Since AMH production is highest in these early-stage follicles, the level measured in the blood serves as a proxy for the total remaining population of eggs.
The hormone plays a regulatory role within the ovary, acting as a gatekeeper that limits the rate at which primordial follicles are recruited into the growth process. By inhibiting the early, hormone-dependent growth of follicles, AMH helps manage the continuous depletion of the ovarian reserve pool. AMH levels are therefore a measure of egg quantity, which is a finite supply established before birth.
AMH is a metric of quantity, not quality. While a higher AMH level indicates a larger number of remaining eggs, it offers no information regarding the genetic health or viability of those eggs. Egg quality is primarily determined by a woman’s age, meaning a woman with high AMH at age 40 may still have lower fertility potential than a woman with lower AMH at age 30.
What AMH Levels Reveal About Fertility Potential
The primary clinical utility of AMH testing is predicting how a woman’s ovaries will respond to stimulation during fertility treatments like In Vitro Fertilization (IVF). A low AMH level, generally below 1.0 ng/mL, suggests a diminished ovarian reserve and a potentially poor response, meaning fewer eggs will likely be retrieved after ovarian stimulation. Conversely, a high AMH level, often above 3.5 ng/mL, indicates an ample reserve and a robust response.
High levels are frequently seen in women with polycystic ovary syndrome (PCOS) due to the large number of small follicles that accumulate in the ovaries. In these cases, the AMH test helps physicians anticipate the risk of Ovarian Hyperstimulation Syndrome (OHSS), allowing them to adjust medication protocols. AMH also offers an estimate of the time remaining until menopause, as levels become near-undetectable approximately five years before its onset.
AMH is not a reliable predictor of a woman’s chance of conceiving naturally in any given month. Women with low AMH levels can still conceive spontaneously because only one high-quality egg is needed each cycle. While a very low result may suggest a shorter reproductive window, fertility specialists often combine AMH data with age and Antral Follicle Count (AFC) for a comprehensive assessment.
Scientific Efforts to Influence AMH and Ovarian Reserve
The question of whether AMH levels can be increased remains largely cautious. Since AMH reflects a fixed, finite pool of eggs, science currently holds that it is not possible to generate new eggs or reliably increase the ovarian reserve. Research into increasing AMH levels focuses instead on improving the function of the existing follicles or temporarily optimizing the hormone’s measurement.
Temporary fluctuations in AMH levels have been observed in studies involving certain supplements, though these changes do not consistently correlate with improved live birth rates. For example, supplementation with Dehydroepiandrosterone (DHEA) has been shown in some small studies to increase AMH levels by 20 to 30 percent in women with diminished ovarian reserve. Correcting a vitamin D deficiency in women who have low levels may also lead to a subsequent rise in their AMH measurement.
These observed increases are likely due to the supplements optimizing the environment of the existing granulosa cells, causing them to secrete more AMH, rather than creating new follicles. Lifestyle factors, such as maintaining a healthy weight, reducing chronic stress, and avoiding smoking, are consistently recommended to support overall ovarian health and egg quality. The focus remains on preserving the existing reserve and enhancing egg quality, rather than artificially inflating the AMH number.
Emerging Strategies for Managing Reproductive Lifespan
Current research focuses on interventions that can genuinely delay ovarian aging or improve egg health, moving beyond simply measuring AMH. Cutting-edge approaches aim to address factors causing the decline in egg quality, such as mitochondrial dysfunction and oxidative stress. Supplements like Coenzyme Q10 (CoQ10) are being studied for their ability to support mitochondrial energy production within the aging egg cell.
Other experimental approaches involve pharmaceutical candidates to modulate the rate of follicular depletion. Compounds such as Metformin and Rapamycin are being investigated in preclinical models for their potential to slow down the activation of resting primordial follicles, conserving the ovarian reserve. Regenerative medicine techniques, including Platelet-Rich Plasma (PRP) therapy, are also being explored, though early data suggesting increased follicle count and AMH levels remain investigational.
These efforts represent the scientific attempt to overcome the limitations imposed by a finite egg supply. For women seeking to preserve their fertility immediately, established methods like egg or embryo freezing remain the most reliable way to hedge against age-related decline. This allows women to secure their reproductive potential by utilizing younger, higher-quality eggs for future use.