So what is AMH? What does it mean? Why is it so important? We turned to a leading clinic, IVF Spain, to explain.
From the emergence of assisted reproduction techniques, a solution has been found for most known infertility issues, and nowadays it is possible to achieve pregnancies and healthy babies even in the most complex cases. This can be, for example, selecting the viable or best quality embryos through genetic diagnostic techniques, using sperm cells obtained from a testicular biopsy and suchlike.
In recent times, the anti-müllerian hormone (AMH) has gained importance in evaluating ovarian function and ovarian reserve, which means ‘the amount of remaining oocytes (eggs)’.
By testing this hormone, it gives gynaecologists an approximate idea of the amount of viable eggs left in the ovaries of a patient. This way they can offer an adequate treatment to maximise the chances of achieving a pregnancy.
The production of anti-müllerian hormone progressively decreases with age, and this decrease is an indication the ovaries are aging.
AMH is secreted by the oocytes (eggs), and since we cannot observe eggs directly except for when they activate, its measure in blood is used to determine indirectly, and roughly, ovarian reserve.
In our clinical experience we have encountered cases in which the AMH was normal, but the ultrasound did not show many active follicles.
AMH does not determine the egg quality. Sometimes we have also had patients with a good ovarian reserve but poor egg quality.
On the other hand we have also encountered cases in which the AMH was low but the ultrasound showed an acceptable number of follicles to start a treatment, which was carried out successfully.
There have already been numerous times that we have assisted patients coming from other clinics with a diagnosis of low AMH and a recommendation of a treatment with donated eggs as the only solution for their fertility problem. However, the reproductive capability with a patient’s own eggs is not solely due to AMH level.
Care and attention to detail are key to successfully carry out a fertility treatment; that is why at IVF Spain we do not give up when we are faced with a low AMH.
In these cases we perform other tests, for example ultrasounds in successive follicular phases of the patient in order to find the ideal time to start a treatment, that is, a time when the ultrasound shows enough active follicles to start the stimulation.
Furthermore we have mastered techniques of follicular pre-activation and other resources that improve egg quality, and of course we rely on other tests that help us determine other equally important factors for achieving a pregnancy, such as genetic viability of the embryo, the endometrial receptivity and immunity, etc.
As experts in reproductive medicine and fertility we would like to advise patients not to get too obsessed about the AMH level
It is an indirect indicator of ovarian reserve, however, there are other factors to take into consideration when evaluating a woman’s ability to conceive with her own eggs.
If you or your partner have any queries about AMH and would like to discuss further, you can request more information from IVF Spain, where thanks to their specialist fertility doctors and gynaecologists they will be able to offer you a totally personalised solution.