Anti-Müllerian Hormone (AMH) is a substance produced by specific cells within the ovarian follicles. These follicles are tiny fluid-filled sacs in the ovaries that contain immature eggs. Measuring AMH levels through a simple blood test provides insight into a woman’s ovarian reserve, which refers to the estimated number of eggs remaining in her ovaries. It is used in fertility assessments to understand reproductive potential.
What AMH Levels Indicate
AMH levels indicate the quantity of eggs, though not their quality. A normal AMH level suggests a healthy ovarian reserve for a woman’s age, between 1.0 and 3.0 ng/mL. Levels below 1.0 ng/mL are considered low and indicate a diminished ovarian reserve. Conversely, high AMH levels, often exceeding 4.0 ng/mL, are associated with a larger number of follicles, often seen in polycystic ovary syndrome (PCOS).
AMH levels naturally decrease as a woman ages, reflecting the gradual decline in her ovarian reserve. This decline begins in the late 20s or early 30s and accelerates in the mid to late 30s. By age 40, AMH levels are lower than peak levels, indicating a reduced egg supply.
Factors That Affect AMH
A woman’s AMH levels are influenced by several factors, some of which are not modifiable. Age is the most significant determinant. Genetic predispositions can also play a role, with some individuals having naturally lower ovarian reserves regardless of age.
Certain medical conditions and lifestyle choices can also impact AMH levels. Smoking is associated with lower AMH values and can accelerate ovarian aging, potentially leading to an earlier onset of menopause. Medical conditions such as endometriosis are often linked to lower AMH levels, particularly in cases of ovarian endometriomas or severe disease. While some studies show lower AMH in women with endometriosis, others suggest the link is complex and requires further research.
Polycystic ovary syndrome (PCOS) often results in higher-than-normal AMH levels due to an increased number of small, immature follicles in the ovaries. Previous ovarian surgery, especially for conditions like endometriomas, can also temporarily or permanently reduce AMH levels. Exposure to environmental toxins, including endocrine-disrupting chemicals found in various products, can negatively affect ovarian health and AMH levels.
Lifestyle Strategies for Ovarian Health
While direct methods to increase AMH levels are not established, adopting a healthy lifestyle can support overall ovarian health and potentially optimize fertility. A balanced diet rich in antioxidants helps protect cells from damage. Incorporating fruits, vegetables, and whole grains provides essential nutrients, and reducing processed foods and excessive sugar benefits reproductive well-being.
Maintaining a healthy body weight is important for hormonal balance and ovarian function. Both very low and very high body mass index (BMI) can influence AMH levels and overall fertility. Regular, moderate exercise supports circulation and metabolic health, creating a favorable environment for ovarian function. However, research suggests that exercise does not directly impact AMH levels.
Managing stress through techniques like mindfulness, yoga, or meditation can positively impact hormonal regulation. Chronic stress can disrupt the balance of reproductive hormones. Ensuring adequate sleep also supports overall health and hormone production.
Avoiding known ovarian toxins is important. This includes quitting smoking. Limiting alcohol consumption and minimizing exposure to endocrine-disrupting chemicals found in plastics, pesticides, and certain personal care products can help protect ovarian health.
Medical Approaches and Considerations
For personalized advice regarding AMH levels and fertility, consult a healthcare provider or fertility specialist. They can interpret individual test results in the context of overall health and reproductive goals. AMH levels are often used in conjunction with other tests, such as antral follicle count, for a comprehensive ovarian reserve assessment.
Certain supplements are discussed for ovarian health, though their direct efficacy in increasing AMH levels is still under research. Dehydroepiandrosterone (DHEA) and Coenzyme Q10 (CoQ10) have been explored for their roles in egg quality and ovarian response, but should only be taken under medical supervision. Vitamin D has also been investigated for its connection to AMH levels.
AMH levels play a role in fertility treatment planning, particularly for in vitro fertilization (IVF). Higher AMH values indicate a better response to ovarian stimulation and the retrieval of more eggs during IVF cycles. While lower AMH levels suggest a reduced ovarian reserve and fewer eggs, they do not necessarily rule out successful pregnancy. Fertility specialists use AMH results to tailor treatment protocols and manage expectations.