When it comes to fertility, there are a lot of acronyms out there â from DPO (days post-ovulation) to IVF (in vitro fertilization), and so many more. But thereâs one acronym thatâs incredibly important, yet not often considered until people are deep into the processing of TTC (trying to conceive).
That acronym is AMH, which stands for antimullerian hormone. Essentially, this hormone is used as a marker of egg quantity. It plays a major role in overall fertility: A 2019 study dubbed AMH the most reliable indicator of ovarian reserve, and one of the most powerful indicators of a personâs reproductive potential.
AMH is an easy way to gauge a bit about a personâs fertility, as it simply involves a blood test â which means if you have any concerns about your overall fertility, thatâs one of the first data points to consider.
If youâve been told you have low AMH, you may be wondering if that number is fixed or if thereâs anything you can do to raise those levels. Boosting fertility is, after all, something many of us think a lot about â weâre willing to do anything to improve our odds of building our families, and in addition to medical intervention, we also seek out lifestyle modifications to do so.
So is there anything we can do to boost AMH levels, whether weâve been told our levels are low or just in the name of improving fertility? Jessica Ryniec, MD, a reproductive endocrinologist, weighs in.
First of all: What does AMH measure?
âAntimullerian hormone is a hormone that is made by granulosa cells in the ovary which are cells that help support the resting follicles that contain eggs,â says Dr. Ryniec. âAMH is used as a marker of the number of eggs someone has remaining [AKA] âovarian reserveâ. People with many follicles (such as with polycystic ovarian syndrome) would be expected to have high AMH levels, whereas people with few remaining follicles (like in diminished ovarian reserve) would be expected to have low AMH.â
As weâve previously shared, diminished ovarian reserve impacts up to 30 percent of women who struggle to conceive. AMH relates to the number of eggs: Women are born with all the eggs theyâll have throughout their lifetime, and that number dwindles with age. AMH is an indicator of egg quantity, but not an indicator of egg quality.
Questions Women Are Asking
What are some causes of low AMH?
Egg quantity declines over time, so age is a major factor when it comes to AMH â but itâs not the only factor.
According to Dr. Ryniec, life events like perimenopause or menopause, hormonal suppression (like with birth control), pregnancy, and breastfeeding, can all affect AMH.
Additionally, medical conditions like endometriosis, autoimmune diseases, and certain genetic conditions can also play a role.
Health interventions like ovarian surgeries, chemotherapy, or other ovarian-toxic medical therapies can also affect AMH levels. As far as lifestyle factors go, smoking can diminish AMH.
Speaking of lifestyle factors â are there any that can raise AMH levels?
You may have heard that things like diet, exercise, supplement use, stress reduction, or other lifestyle modifications can help boost your AMH levels. The reality? Itâs likely not worth overhauling your lifestyle with this goal in mind.
âWhile AMH levels may appear lower or higher at different times or at different labs, there is no way to actually raise your egg count even if the AMH level looks better,â says Dr. Ryniec.
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âThis is because people born with ovaries are also born with all the eggs they are going to have and diet, lifestyle factors, medications, supplements, etc cannot increase that as we do not make new eggs,â she explains.
With that being said, some things can help us not lose eggs faster than is typical.
âThat would be a better thing to focus on: Overall healthy diet and lifestyle, hydration, sleep, exercise, avoiding smoking and endocrine disruptors, for example,â advises Dr. Ryniec. âIf the AMH appears to be lower than anticipated for age, [we] can look at history and current lifestyle factors to see if it could be suppressed or if it appears to be true low ovarian reserve."
Letâs address common misconceptions where AMH levels are concerned
When it comes to health â especially womenâs health â there are a lot of conflicting messages and bold claims that arenât actually grounded in science. That leaves women stressed and expending energy on things that wonât really make a difference.
âThere is a lot of misinformation and to me what seems to be targeting a vulnerable population with supplements and therapies that are proposed to increase AMH levels and thereby possibly improving outcomes and I encourage people to be wary of things that seem too good to be true,â says Dr. Ryniec. âWhile some studies do show blood hormone levels may increase in response to different therapies, these studies have NOT shown that this has translated to improved eggs retrieved, embryos created, or resulting pregnancies in an IVF setting.â
So whatâs a better evidence-based approach?
âUnfortunately right now there are no evidence-based options, however, this is definitely an area of exciting research that I am very hopeful will change over the course of my career,â says Dr. Ryniec.
But for people whoâve been told they have low AMH, thereâs some good news
Dr. Ryniec clears up another common misconception regarding low AMH levels.
âA low AMH does not cause infertility unless it is so low that someone is no longer ovulating,â she says. âSince we only ovulate one egg a month, it does not matter how many eggs we have in the bank, everything relies on that one egg.â
âWhat AMH is more helpful for is predicting a response to IVF which is a treatment that relies on the ability to get more eggs than we are able to make on our own, she adds.
If you have low AMH, hereâs what you can do
If youâve been told your AMH levels are low, itâs probably not a good idea to try and get these levels up on your own. When it comes to fertility, time is often of the essence, and it makes more sense to work with a doctor instead of wasting time attempting to âraise your ovarian reserveâ at home. Ultimately, thereâs no proven way to really do that.
âAnyone at any age with a low AMH should be seeing a fertility doctor from the beginning to understand the nuances of what AMH levels actually mean and what the best next steps are for them (it's not necessarily fertility treatment!),â says Dr. Ryniec. âThey need to understand a low AMH alone doesn't necessarily mean they are going to have difficulty getting pregnant if they haven't already been trying to conceive. If they find a low AMH and they HAVE been already trying to conceive- then they should see a fertility doctor to discuss the best strategies to help them conceive.â
