For many women, the journey to motherhood can be a challenging one, and one of the key factors that influence a woman's ability to conceive is her ovarian health. In recent years, the Anti-Müllerian Hormone (AMH) test has gained popularity as a marker for assessing ovarian health and, by extension, fertility.
AMH alone is NOT a good predictor of fertility.
What is AMH?
AMH, or Anti-Müllerian Hormone, is a protein produced by the granulosa cells in the small, developing follicles within your ovaries. These follicles contain immature eggs, and their number and
quality can significantly affect your fertility. AMH levels can give you insight into the quantity of these developing follicles, often referred to as your ovarian reserve.
The Role of AMH in Infertility
AMH serves as a valuable marker for assessing your ovarian reserve. However, it's essential to understand that it's just one piece of the fertility puzzle. High or low AMH levels alone do not determine your fertility. High levels may indicate polycystic ovarian syndrome (PCOS), which can lead to irregular ovulation, while low levels may suggest a low ovarian reserve.
Assessing Ovarian Health with LH and FSH
In addition to AMH, two other hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), play essential roles in assessing your fertility. LH and FSH are produced by the pituitary gland and help regulate your menstrual cycle and ovulation. High levels of FSH can indicate diminished ovarian reserve, while an imbalance of LH and FSH can be a sign of conditions like PCOS.
Research has shown that AMH and FSH alone are not good predictors of fertility (1). Using these together along with additional testing and a thorough history, can better predict fertility outcomes. One study found that in women <35 years old, FSH seemed to be a better predictor, whereas women >35 years old, AMH was a better predictor (2).
Looking at these Labs:
AMH
Standard lab ranges: 0.5 -6.8 ng/mL
Optimal lab ranges: 2 - 4.0 ng/mL
Too high levels may suggest PCOS. Too low levels suggests 'low ovarian reserve'
FSH
Standard lab ranges: 2-20 mIU/mL
Optimal lab ranges: <10 mIU/mL
Too high levels may suggest PCOS. Too low levels suggests 'low ovarian reserve'
Better Pregnancy Outcomes =
Low FSH + High AMH
Antral count should also be considered
Lower Pregnancy Outcomes =
High FSH + Low AMH
Other Ways to Assess Ovarian Health
Apart from hormone tests, there are other methods to assess your ovarian health, including:
Ovarian ultrasound: A transvaginal ultrasound can provide a visual of your ovaries, detecting the number and size of follicles.
Antral follicle count: Your doctor may count the small, resting follicles visible on ultrasound, which can provide information about your ovarian reserve.
Hormone monitoring: Tracking your LH and FSH levels throughout your menstrual cycle can help your doctor understand your ovarian function.
Menstrual cycle tracking: Regular, consistent menstrual cycles are often indicative of healthy ovarian function.
Improving Ovarian Health Naturally
While your ovarian health is influenced by various factors, there are steps you can take to naturally support and improve it:
A balanced diet: Nutrient-rich foods, including antioxidants, omega-3 fatty acids, and a variety of vitamins and minerals, can support your reproductive health.
Regular exercise: Maintaining a healthy weight and staying active can help regulate hormones and improve overall fertility.
Stress management: High levels of stress can negatively impact your fertility. Practicing relaxation techniques such as meditation or yoga can be beneficial.
Avoid smoking and excessive alcohol: Both smoking and excessive alcohol consumption can harm your fertility and overall health.
AMH Alone Isn't a Definitive Test for Infertility
It's crucial to remember that AMH, while a valuable tool, doesn't provide the complete picture of your fertility. Assessing fertility is a complex process that requires a comprehensive evaluation, including the assessment of other hormonal markers and physical examinations.
References
1) PMID: 30012195
2) PMID: 34421292
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About Dr. Zaremba
Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).
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