AMH: The Test For Ovarian Reserve

When you’re first being screened by a fertility clinic, Ob-Gyn, or by your naturopathic doctor for any issues that may be present in regards to your fertility potential, one of the tests they’ll run is called AMH, short for Antimullarian Hormone.

During the (often) overwhelming visit where your physician presents all of your test results, it’s a good idea request a copy so you can review them on your own time.  You’ll see among them a test for AMH, and here are a few reasons what it is and why it’s important:

First, a few definitions:
Ovarian follicles = the basic unit of female reproduction, each follicle is basically a spherical conglomeration of cells found in the ovary.  Each follicle should theoretically contain a single oocyte (immature egg cell).

Primordial follicles = indiscernible to the naked eye, these are follicles that have not yet undergone recruitment – ie. they haven’t been called upon to develop into mature ovarian follicles yet.  Each month, follicles are ‘recruited’ to undergo this change with hopes that they’ll produce a healthy egg to be ovulated in about 12 months.

Antral follicles = a new name given to a follicle once it has undergone recruitment and is ‘ripened.’  The main difference is that these follicles can be seen with an ultrasound, and counted by the technician to given an indication of how many mature follicles are present at any given time.

The growing follicles in your ovaries produce AMH, and its function is to prevent the premature recruitment of other primordial follicles.  The value of AMH generally correlates with the number of functional primordial and antral follicles remaining in the ovary.  So, in basic terms, a high AMH means there are more healthy follicles (capable of producing a healthy egg cell) in the ovaries and a greater overall fertility potential.

A measurement of AMH is an estimation of the fertility potential a woman has remaining.  There are levels for optimal fertility, satisfactory fertility, and low fertility potential.  Women with PCOS often have very high values of AMH.

Low AMH often does not give a good prognosis for IVF (in-vitro fertilization) because IVF is based on the stimulation of multiple follicles.  If there are fewer functional follicles remaining in the ovaries, when a women gets IVF stimulation she tends to get fewer follicles that mature.  However, even when an AMH is low, conception is still possible – it only takes one healthy egg to get pregnant!

Although you may have a low number of follicles remaining (read: a low AMH), there are ways to improve the quality of those that remain.  Improving the quality of those eggs is important to increase the chances that a healthy egg will be produced and can then lead to a healthy pregnancy.  We use treatments such as dietary and supplemental antioxidants and therapies that increase circulation to the pelvis such as acupuncture to improve the quality of the follicles that remain.

If your test results are unclear, or you’re having a hard time understanding whether your AMH means you have low, satisfactory, or optimal fertility, book an appointment with your naturopathic doctor.  We can help interpret the labs as well as increase your chances of conceiving and having a healthy baby.

In health,

K.

Photo credit.

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