Anti-Müllerian Hormone (AMH) is a protein hormone generated by the granulosa cells of small follicles within the ovaries. This hormone serves as a measurable indicator of a woman’s ovarian reserve, reflecting the approximate number of remaining follicles. Because AMH levels remain relatively stable throughout the menstrual cycle, a blood test for this hormone has become a standard tool in fertility assessments. As many people seek methods to optimize or increase these levels to improve their chances of conception, a deeper look into the science of ovarian health is helpful.
Understanding AMH and Ovarian Reserve
AMH is directly produced by the granulosa cells of the preantral and small antral follicles, the earliest stages of the developing egg sacs. The level of AMH in the blood correlates with the size of the remaining pool of primordial follicles. This pool naturally decreases over time, leading to a gradual, age-related decline in AMH levels throughout the reproductive years.
AMH is primarily a marker of the quantity of eggs, not the quality. The number of primordial follicles is fixed before birth, and no current medical intervention can create new eggs or significantly increase this finite number. While some studies have shown small fluctuations in AMH with certain interventions, the focus for improving fertility should shift toward enhancing the health and function of the existing eggs. Low AMH indicates a smaller egg supply, but it does not automatically predict a poor chance of pregnancy, since egg quality is the main determinant of conception success.
Lifestyle Changes That Support Ovarian Health
Adopting specific lifestyle modifications can create a more favorable environment for the existing follicles, directly influencing egg quality. Chronic stress management is important, as persistent stress triggers the release of cortisol. High cortisol levels can negatively affect the hormonal balance required for optimal reproductive function and ovulation. Simple practices like yoga, meditation, or regular light exercise can help mitigate this hormonal disruption.
Maintaining a healthy body weight is important. Being either underweight or overweight can disrupt hormone regulation, which directly impacts ovulation and egg maturation. Experts recommend aiming for a Body Mass Index (BMI) within the healthy range of 18.5 to 24.9 to optimize reproductive hormone balance. Eliminating exposure to known reproductive toxins is necessary for protecting egg DNA integrity. Smoking, excessive alcohol consumption, and exposure to environmental endocrine-disrupting chemicals can accelerate egg loss and damage the viability of the remaining eggs.
Targeted Supplements for Fertility Support
Targeted supplementation focuses on supporting the health of the oocyte’s internal machinery, particularly the mitochondria. Coenzyme Q10 (CoQ10) is frequently recommended because of its role in cellular energy production. Since the oocyte has one of the highest concentrations of mitochondria in the body, ensuring adequate energy for cell division and maturation is thought to improve egg quality, especially in older women. Typical doses range around 600 mg per day.
Dehydroepiandrosterone (DHEA) is a hormone precursor that has been studied for its potential to improve egg quality and increase the number of eggs retrieved during IVF in women with diminished ovarian reserve. DHEA is converted into sex hormones like testosterone, which acts on the granulosa cells that nurture the egg. However, DHEA is a powerful hormone that requires medical supervision and is not recommended for women with Polycystic Ovary Syndrome (PCOS) or a history of hormonal cancers.
Vitamin D is a commonly supplemented nutrient, as deficiency is widespread and the vitamin plays a role in ovarian function and follicle development. Correcting a deficiency can potentially lead to improvements in AMH levels in pre-menopausal women. Antioxidants are also used to combat oxidative stress, a factor that degrades egg quality. Myo-inositol supports ovarian function and insulin sensitivity, while Melatonin is believed to improve egg quality by acting as a powerful antioxidant within the ovarian fluid.
Clinical Strategies When AMH Levels Are Low
For individuals with confirmed low AMH, consultation with a reproductive endocrinologist is the next step to develop a personalized treatment plan. When conception is not achieved through lifestyle and supplement changes, specialized fertility treatments are often necessary. In vitro fertilization (IVF) is the most successful therapeutic option for women with low AMH, although the protocols are often tailored to address the challenge of a limited egg supply.
Fertility specialists may use specific IVF protocols, such as the GnRH antagonist protocol or minimal stimulation IVF, to maximize the quality and number of eggs retrieved from a low-responding ovary. Beyond medical interventions, adjunctive therapies are used. Acupuncture is thought to improve blood flow to the ovaries and help reduce the stress and anxiety associated with fertility treatments. Managing underlying medical conditions is important. Conditions like thyroid disorders, autoimmune issues, or endometriosis can suppress AMH levels and compromise fertility, making their treatment an integral part of the overall strategy.