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If you’ve been going through infertility treatments, you have likely been bombarded with a number of acronyms from your fertility specialist (i.e. FSH, IUI, LH, ICSI etc.) and while they all have their importance and we should all do our best to understand what they mean, there is one acronym you should take the time to learn, if you haven’t already.
AMH or anti-mullerian hormone, is a hormone secreted in the granulosa cells of follicles and is fast becoming the “go to” measurement for ovarian reserve. A simple blood test is all that is needed to measure your AMH level and many clinics will include it when you get your regular Day 3 blood-work. AMH also correlates to the antral follicle count (AFC) which is another method of determining a woman’s fertility potential. If you haven’t been asked to do an AMH test, ask your doctor if it is something you should do.
Getting your AMH level can help you and your partner decide what the best course of action may be for your fertility situation. For example, say you get your levels tested and they are in the optimal range, this may allow you to hold off on going right into IVF and to perhaps try less invasive procedures such as IUI or trying naturally. Your AMH level will also help determine how well (or not so well) you will respond to any stimulating medications (a high AMH will generally respond well to follicle stimulating medications). On the other side, receiving a low AMH number can be difficult to take but it will make your plan that much more clear rather than wasting months of your time trying methods that have a low success rate. Some specialists speculate that in the future, women in their twenties will test their AMH to ensure they have time to pursue a career before having children. Those with low AMH levels may consider having a family earlier in an attempt to avoid difficultiesconceiving.
In the past (and still), most fertility clinics will do a Day 3 blood test to test the FSH levels of females along with other hormones related to fertility. Your FSH number can indicate how hard your body is working to produce and grow follicles…a high number (above 10 or 12 depending on the clinic) indicates that your body is working extra hard to produce follicles and may be a sign that your fertile potential is decreasing. A low FSH (below 10) should indicate that your body is still responding well to its own internal hormones and may indicate a higher fertility potential.
However, there are some problems with the FSH test. For example, the FSH levels of females fluctuate throughout the menstrual cycle and can vary from month to month, which is why most clinics attempt to do the test on day 3 of the menstrual cycle. In addition to that, estrogen may suppress a high FSH level into a normal range, creating an inaccurate result…and wasted time doing treatments that may not work.
An AMH test is ideal as levels are consistent throughout the cycle so you don’t have to wait until day 3 to do one. In Ontario (where I practise), you have to pay out of pocket to get the results of this test but the cost is usually under $200.
AMH levels vary and are dependent on age and the presence of certain conditions (i.e. PCOS – I know of clients who have had an AMH level over 90 pmol/L). It is important to note that two different units of measurement are used so when you receive your AMH results, so be sure to get the unit it was measured in or else you may be very confused.
Here is a chart* outlining the two different measurements as well as the ranges.
*from
Don`t get me wrong, AMH testing is not the best test ever…it`s simply the best we have at the moment for measuring ovarian reserve and the likelihood of your ovaries responding to medication. Much like any other test processed in a lab, mistakes can be made and tests sometimes need to be performed twice to ensure reliability. The following article looked at women with low AMH levels and still found that pregnancy was a good possibility! Don`t let a low AMH take away your hope of having a family…there is still a reasonable chance that a pregnancy can occur.
In conclusion, if you are getting involved in fertility treatments and you have not been offered the chance to do an AMH test, ask your specialist if it is right for you. After all, it`s an inexpensive way to get a much clearer picture of what your ovarian reserve may be. The result of this test will certainly help you make better informed decisions for you and your future family.
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