For women experiencing difficulties conceiving, particularly those using assisted reproductive technologies (ART), one substance in the body that is commonly measured are levels of a glycoprotein called anti-Mullerian Hormone (AMH). AMH has been the topic of much research in recent years, particularly pertaining to its biological functions in the body and clinical relevance to fertility.
The main reason AMH is measured is to evaluate the number of eggs (oocytes) in the ovary, also known as the ovarian reserve, that together with an ovarian ultrasound can help estimate a woman’s likely responsiveness to fertility treatment. It has also been used to help diagnose polycystic ovarian syndrome (PCOS).
Levels of AMH vary significantly between individuals, however across the female population they are generally observed to be highest at around 25 years of age, followed by a gradual, non-linear decrease that accelerates between 40-55 years of age. Certain conditions including PCOS, thyroid imbalances, endometriosis and breast cancer can result in variable AMH levels, as can diet, medications, smoking and stress.
However, while AMH is generally accepted to be a useful indicator of the number of eggs present, it is not a clinically accurate indicator of egg quality, a key factor contributing to fertility outcomes.
Also the value of using AMH as a predictor of reproductive potential in women who are not experiencing fertility difficulties has been questioned, with research indicating that in this population, AMH may not accurately predict fertility potential and pregnancy outcomes. However, in women with fertility difficulties, AMH is considered to be a useful indicator of ovarian reserve and likely responsiveness to fertility treatment.
While AMH can be a useful measurement, it is important that it is viewed as just one measurement in the context of the overall individual and couple trying to conceive, and that many modifiable physiological, dietary and lifestyle factors contribute to fertility health, chance of conception and good pregnancy outcomes.