Anti-Mullerian Hormone (AMH)

How Do Low AMH Levels and FSH Affect Fertility?

Get-Pregnant-with-low-amh-high-fsh-levels

AMH is one of the most accurate tests to assess a woman's ovarian reserve (OR) . AMH levels can be measured at any point of a woman's menstrual cycle. Follicle Stimulating Hormone (FSH) is another important method of ovarian reserve testing. AMH and FSH levels are used in combination to get a better picture of a patient’s overall ovarian reserve, as each hormone reflects the follicles in the ovaries at different stages of development. Typically, FSH and AMH levels move in the opposite direction as women age, with AMH going down and FSH going up, indicating the age-related natural deterioration of ovarian reserve.

Low AMH and high FSH levels are an indicator of diminished ovarian reserve (DOR), a decline in the ovaries’ ability to produce good-quality eggs. DOR is one of the major causes of infertility among women.

In reverse, high AMH can signal polycystic ovary syndrome (PCOS). While low AMH is usually accompanied by high FSH, when a woman’s AMH levels are normal or high and her FSH levels are also high, this can signal hypoandrogenic PCOS, a relatively new type of PCOS that CHR researchers were the first to identify.


What’s the Connection Between Low AMH and Normal FSH Measurements?

AMH levels are often measured along with follicle stimulating hormone (FSH) levels. However, AMH and FSH levels have a few important differences:

  • AMH levels can be measured at any time. FSH has to be measured on a specific day in her cycle.
  • AMH appears to be a better predictor of pregnancy chances than FSH, according to recent research. It has been reported, however, that AMH loses its prognostic ability in women above age 42, although it remains a more reliable predictor than FSH alone. Low AMH levels and high FSH levels can vary greatly according to the person tested and their age.
  • AMH levels reflect how many very immature eggs are “on deck” to start the journey toward maturation, while FSH levels reflect the eggs that are currently going through the maturation process and will be available for ovulation (or egg retrieval, if going through an IVF cycle).

What is a Normal AMH Level According to Age?

It is important to remember that AMH levels decline and FSH levels increase as women age. In other words, normal AMH and FSH levels change depending on a woman’s age. For example, a normal AMH level for a woman at 42 could suggest premature ovarian aging (POA) if the same AMH level was found in a 32-year-old woman. It’s crucial to evaluate AMH and FSH levels in this age-specific way. In this example, the 32-year-old woman would struggle to conceive if she is not diagnosed with POA and given a one-size-fits-all IVF protocol that does not address her declining ovarian reserve.

Because of this, CHR researched and established age-specific levels of AMH and FSH. Focusing on age-specific AMH and FSH levels allows us to best assess a woman’s ovarian reserve, devise an appropriate treatment plan and estimate her IVF pregnancy chances.

Anti Mullerian Hormone Levels Chart

It is important to remember that AMH levels decline and FSH levels increase as women age. In other words, normal AMH and FSH levels vary depending on a woman’s age. For example, a normal AMH level for a woman at 42 could suggest premature ovarian aging (POA) if the same AMH level was found in a 32-year-old woman.

Because of this, CHR researched and established age-specific levels of AMH and FSH. Focusing on age-specific AMH and FSH levels allows us to best assess a woman’s ovarian reserve, devise an appropriate treatment plan and estimate her IVF pregnancy chances.

Age Specific Baseline FSH and AMH Levels

Age FSH AMH
< 33 Years < 7.0 mIU/mL = 2.1 ng/mL
33-37 Years < 7.9 mIU/mL = 1.7 ng/mL
38-40 Years < 8.4 mIU/mL = 1.1 ng/mL
= 41+ Years < 8.5 mIU/mL = 0.5 ng/mL

"Pregnancy is still possible with low AMH."

Center For Human Reproduction: Dr. Norbert Gleicher, best fertility specialist in the US Dr. Norbert Gleicher

Questions About Your AMH Level for IVF?

At CHR, we specialize in advanced fertility treatments and hard-to-treat cases, including women with low, even undetectable, AMH levels. Contact us to learn whether you’re a candidate for treatment.

How to Increase AMH Levels For Better Pregnancy Chances

Treating Low AMH levels with DHEA

DHEA can be used to significantly increase pregnancy chances in women with low AMH and high FSH levels.

How can I increase AMH levels to get pregnant? That is a commonly asked question. However, that’s not quite the right way to frame the question, as low AMH is just a symptom of a real condition: diminished ovarian reserve. Addressing the causes and negative effects of diminished ovarian reserve is what’s necessary to achieve a successful outcome: a healthy pregnancy and a baby to take home.

Many patients come to CHR after being told by other fertility specialists that their chance of pregnancy is less than 1% because of their low AMH and high FSH levels. But proper treatment designed to address AMH/FSH problems considerably increases the likelihood of success with low AMH and high FSH. In many cases, CHR physicians have found that those “less than 1% chance of pregnancy” prognoses are outright wrong, with many patients having far higher chances of IVF pregnancy using their own eggs, especially if they can produce multiple embryos in an IVF cycle.

A recent analysis of CHR’s IVF outcomes for women with very low AMH found that even above age 41, as long as the patient’s ovaries still produce more than two transferable embryos, pregnancy rates were in the 6-7% range. This means that it’s particularly important to seek out fertility treatments from an IVF center with specialized expertise in treating women with low AMH/DOR.

Read more about Anti-Müllerian Hormone

What is AMH?

Anti-Müllerian Hormone (AMH) is a hormone secreted by the cells of the developing...

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AMH and FSH

One of the most accurate tests to assess a woman's ovarian reserve (OR)...

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Treatment for Low AMH

Unfortunately, many fertility centers don't use age-specific hormone levels...

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infertility physician

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned reproductive endocrinologist, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

Follow Dr. Norbert Gleicher on Google+ Center for Human Reproduction: Follow us on Google+. IVF center with best fertility options for each infertility patient. or LinkedIn Center for Human Reproduction: Follow us on Google+. IVF center with best fertility options for each infertility patient.

Last Updated: July 5, 2019

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