Anti-Müllerian Hormone (AMH) has emerged as a significant indicator in assessing a woman’s fertility potential. This hormone provides valuable insights into ovarian reserve, which is the number of eggs remaining in the ovaries. Understanding AMH levels is an important aspect of fertility planning, offering a snapshot of reproductive health.
What AMH Reveals About Fertility
AMH is a protein hormone produced by granulosa cells, which surround the eggs within developing ovarian follicles. These follicles are tiny fluid-filled sacs in the ovaries that contain and release eggs. AMH production is highest in the early stages of follicular development, specifically in pre-antral and small antral follicles.
The level of AMH in the blood directly correlates with the number of these small, growing follicles. A higher AMH level generally indicates a larger pool of remaining eggs, also known as ovarian reserve. Lower AMH levels suggest a diminished ovarian reserve. AMH primarily reflects the quantity of eggs, not their quality.
Deciphering Your AMH Level in pmol/L
When interpreting AMH levels, it is most helpful to consider them in pmol/L, although some labs may report in ng/mL. A common conversion factor is 1 ng/mL = 7.14 pmol/L. An AMH level greater than 16.2 pmol/L is considered typical for a fertile woman. Levels above 21.98 pmol/L are satisfactory.
A level under 4.9 pmol/L is considered very low, indicating reduced ovarian reserve. Typical AMH ranges by age include:
- 20-29 years: 13.1 – 53.8 pmol/L
- 30-34 years: 6.8 – 47.8 pmol/L
- 35-39 years: 5.5 – 37.4 pmol/L
- 40-44 years: 0.7 – 21.2 pmol/L
- 45-50 years: 0.3 – 14.7 pmol/L
It is worth noting that a very high AMH level, such as over 48 pmol/L, can indicate Polycystic Ovary Syndrome (PCOS). Studies suggest that AMH levels of 71 pmol/L or more are strongly associated with PCOS. These ranges are general guidelines; individual circumstances and overall health influence interpretation.
Factors Affecting AMH and Fertility Considerations
Age is the primary factor influencing AMH levels, as ovarian reserve declines. As a woman ages, the number of follicles decreases, reducing AMH production and indicating diminishing ovarian reserve.
Certain medical conditions can also impact AMH levels. Women with Polycystic Ovary Syndrome (PCOS) have higher AMH levels due to a larger number of small, immature follicles. Conditions like premature ovarian insufficiency or endometriosis can lead to lower AMH levels. Medical treatments like chemotherapy or ovarian surgery can also reduce AMH by damaging ovarian reserve.
Individuals with low or very high AMH levels should consult a fertility specialist. A low AMH level indicates a smaller egg reserve, but it does not necessarily mean natural conception is impossible. However, it may suggest that ovaries will not respond as robustly to fertility medications during treatments like IVF, potentially requiring higher doses or multiple cycles to retrieve a sufficient number of eggs. A fertility specialist can provide personalized advice, recommend further testing, and discuss family planning options based on an individual’s reproductive health.