Understanding Anti-Müllerian Hormone (AMH) and Its Role in Fertility
Anti-Müllerian Hormone (AMH) is a key player in fertility assessments, offering valuable insights into a woman’s ovarian reserve. Originally discovered for its role in fetal development—specifically in the regression of female reproductive ducts in males—AMH has become a cornerstone in modern fertility evaluations.
What Is AMH?
AMH is a dimeric glycoprotein produced by the cells of small ovarian follicles. Its levels in women vary with age:
- Rise steadily during adolescence, peaking in the mid-20s.
- Decline gradually as women age (ie 35+), becoming undetectable at menopause.
Unlike other hormones, AMH levels remain relatively stable throughout the menstrual cycle, making it a reliable marker for ovarian reserve testing at any point during the month.
Why Is AMH Important for Fertility?
AMH has gained widespread attention for its ability to:
- Assess ovarian reserve: A higher AMH level typically indicates a greater number of remaining eggs.
- Plan fertility treatments: It is a critical factor in in vitro fertilization IVF protocols, helping specialists tailor treatments.
- Monitor ovarian health: AMH levels can be measured before and after procedures or treatments that may impact fertility, such as chemotherapy, pelvic radiation, or ovarian surgery.
How Is AMH Measured?
In Canada, AMH levels are measured in picomoles per liter (pmol/L). For those referencing American resources, the conversion factor is 0.14 to convert pmol/L to nanograms per milliliter (ng/ml).
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Testing availability:
- In Alberta, AMH testing is covered by provincial healthcare and available at public laboratories.
- In British Columbia, patients must pay privately, with LifeLabs offering the test for approximately $70.
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Timing: AMH testing can be performed on any day of the menstrual cycle. Hormonal contraceptives may slightly lower AMH levels (by around 10%), but this is not typically clinically significant.
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Results timeline: Most labs provide results within a week.
Understanding AMH Levels
Interpreting AMH levels requires context, including a patient’s age. While there is no definitive AMH level diagnostic of polycystic ovary syndrome (PCOS), the following guidelines can provide clarity:
- High AMH levels: Indicate a higher ovarian reserve.
- Low AMH levels: Defined as below 8 pmol/L (or <1.1 ng/ml) and may suggest diminished ovarian reserve, which could impact fertility.
It’s essential to consult with a fertility specialist to interpret AMH results and develop an appropriate plan for achieving pregnancy or preserving fertility.
AMH and Fertility Treatments
One of the most common uses of AMH testing is in the planning and execution of fertility treatments, particularly IVF. By understanding ovarian reserve, clinicians can:
- Determine the most effective medication protocols.
- Predict ovarian response to stimulation.
- Optimize the chances of success while minimizing risks, such as ovarian hyperstimulation syndrome (OHSS).
Empowering Your Fertility Journey
Whether you’re considering starting a family soon, preserving your fertility, or undergoing treatment for conditions that may impact your ovarian reserve, AMH testing provides a reliable snapshot of your reproductive potential. If you’re ready to explore your fertility options or have questions about AMH, our team at PCRM can help.
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About the PCRM Blog
Welcome to the Pacific Fertility Centre for Reproductive Medicine Blog! Nationally and internationally recognized for providing exceptional reproductive care, our team believes in empowering people with the knowledge they need to navigate their unique fertility journeys.
From information on the latest fertility treatments to valuable insights on egg donation, surrogacy, and everything in between, the Pacific Centre for Reproductive Medicine Blog is your ultimate resource for all things reproductive care and support. Read on to learn more, and contact us today if you have any questions or want to schedule a new patient appointment.