AMH Explained: All you need to know about this hormone test

AMH and female fertility: the basics

Starting from the first menstrual cycle, a woman will ovulate one (or sometimes two) eggs per month, although she can lose up to 1,000 eggs per month. The eggs that do not get selected to ovulate will dissolve. This process repeats every month that a woman is not pregnant and cannot be stopped or slowed.

What is AMH?

AMH, or Anti-Müllerian Hormone, is an essential glycoprotein hormone produced by small follicles in the ovaries and plays a key role in the initial stages of follicular growth.

It's often used as a marker to assess a woman's ovarian reserve - the quantity of eggs remaining. An AMH test measures the levels of this hormone in the blood, giving insights into your fertility.

However, it's important to note that AMH levels alone do not determine fertility. They indicate how many eggs are available but don't predict the likelihood of conception.

Is AMH the same as ovarian reserve?

Ovarian reserve is an estimate of the number of eggs left within the ovaries, and ovarian reserve testing is the process of checking the ovarian reserve. AMH is one of the tests to help determine ovarian reserve. To get a more comprehensive picture of fertility health, a fertility assessment is recommended, as it includes other tests.

As women get older, AMH levels decline. However, how and when this happens depends very much on each individual. This is why understanding how AMH levels compare to other women of a similar age is an essential part of fertility diagnostics for women.

Who AMH tests are for

AMH tests are recommended for women who want to understand their fertility status, whether they are actively trying to conceive or simply planning for the future.

It's particularly useful for those considering fertility treatments, like IVF, as it helps assess ovarian response. Women who suspect they may have conditions affecting fertility, such as polycystic ovary syndrome (PCOS) or early menopause, might also benefit from AMH testing.

If you're wondering how to get your fertility tested, speaking with an Apricity fertility advisor is a great first step. They can talk you through the process and explain the other components of how female fertility tests work.

How is an AMH test done?

AMH is measured with a small blood test kit (finger prick), which we send in the mail for you to do at home. It is quite straightforward but comes with full instructions. Your little finger tends to be the best place to take a sample. 

If you’re doing a finger prick test for the first time, it can be a little tricky. The Apricity patient app (provided to you for free with any Apricity package) has a video to help you collect your sample. We suggest letting your arm hang by your side, allowing blood to flow to your fingertips and avoiding the need to press and squeeze hard. This can damage the quality of the blood sample, which could result in the lab struggling to get a reading. 

Another tip that can really help is to get the blood flow going right before the test. You can do this by taking a warm bath or shower, or exercising. If that’s not possible, you can also try immersing your lower arm in a bowl of warm water for a few minutes beforehand.

Does a low AMH mean low fertility?

A low AMH level does not mean that your fertility is in question, or that you cannot get pregnant or have children. It just means that you may need a higher dosage of drugs if you were to need fertility treatments like IVF, getting pregnant may take a little longer. 

A low AMH does not mean that you are not ovulating. It’s also worth noting that AMH is used as a measure of egg quantity, but not quality.

Should you have any questions about your AMH levels, our diagnostic assessments include an AMH test (among others), alongside a consultation with a fertility doctor. This is an important aspect, as it allows you to ask any questions and review your results with a professional. 

Can AMH levels change over time?

AMH levels can fluctuate and are sometimes affected by certain contraception. The results of an AMH test give a clear indication of your egg reserve at the moment, but you can always test again. If you have any questions about this, don't hesitate to get in touch.

Why is AMH important for fertility treatment?

The goal of egg collection is to collect multiple eggs through ovarian stimulation. An AMH test helps to determine whether you would respond well to the medication used in fertility treatment such as IVF. 

How does ovarian reserve impact fertility?

When ovarian reserve is too low, the process of ovulation (the release of eggs every month) may be affected, making natural pregnancy more difficult. Periods may become irregular and eventually stop.

Ovarian reserve is a spectrum, and it is important to review any results with a fertility professional who can give tailored advice to that individual. There are specific treatments which can help women with low ovarian reserve get pregnant.

When a woman's periods stop for over a year, she is considered menopausal. While the usual age for women to go through menopause is 51, around 1% of women will experience premature menopause (premature ovarian failure) and go through it at an earlier age. This is known as premature ovarian sufficiency (POI). 

When should I test my AMH?

Whether you’ve been trying to conceive for some time, are considering egg freezing or are thinking about starting a family soon, understanding your AMH is a great starting point, so it’s a good idea to know when to do an AMH test. 

NHS and NICE guidelines advise that women under 35 who have been trying to conceive for over a year should seek specialist advice, or for six months if over 35. But you can also get a test if you are looking to better understand your fertility.

If you are considering an AMH test, we recommend our fertility tests for women. In addition to AMH, our diagnostic tests include a thyroid profile, an ultrasound scan to assess the uterus and ovaries, and a virtual consultation with a fertility specialist who will review your results with you and explain what female fertility blood test results mean.

Apricity believes in educating individuals about their fertility, so they feel empowered to make decisions regarding their health and future. If you would like to speak to us about an AMH test or a fertility assessment, get in touch or book a free call using the tool below.