{"id":46504,"date":"2024-01-25T10:53:16","date_gmt":"2024-01-25T08:53:16","guid":{"rendered":"https:\/\/ivi-fertility.com\/?p=46504"},"modified":"2024-01-31T16:35:39","modified_gmt":"2024-01-31T14:35:39","slug":"low-amh-levels-fertility","status":"publish","type":"post","link":"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/","title":{"rendered":"Low AMH Levels: understanding the impact on fertility"},"content":{"rendered":"<p>Low AMH levels are generally <strong>considered to be an indicator of a low ovarian reserve<\/strong>. It is quite normal for a woman\u2019s AMH levels to decline as she gets older. In younger women this may be a sign of premature loss of fertility. Low AMH fertility treatment could consist of IVF together with hormone treatment.<\/p>\n<p>High AMH levels for IVF are anything within the range of normal for a woman under 38. However, looking at what are the AMH levels in an individual is only part of the diagnostic process.<\/p>\n<p><img decoding=\"async\" width=\"300\" height=\"225\" class=\"alignnone size-medium wp-image-109740\" src=\"https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-300x225.jpeg\" alt=\"amh\" srcset=\"https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-300x225.jpeg 300w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-1024x768.jpeg 1024w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-768x576.jpeg 768w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-1536x1152.jpeg 1536w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-2048x1536.jpeg 2048w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-200x150.jpeg 200w, https:\/\/ivi-fertility.com\/wp-content\/uploads\/sites\/12\/2018\/06\/amh-667x500.jpeg 667w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_68_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#What_is_Anti-Mullerian_Hormone_AMH\" title=\"What is Anti-M\u00fcllerian Hormone (AMH)?\">What is Anti-M\u00fcllerian Hormone (AMH)?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#How_AMH_impacts_fertility\" title=\"How AMH impacts fertility\u00a0\">How AMH impacts fertility\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Reduced_egg_quantity_and_quality\" title=\"Reduced egg quantity and quality\">Reduced egg quantity and quality<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Increased_risk_of_miscarriage\" title=\"Increased risk of miscarriage\">Increased risk of miscarriage<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Challenges_in_conception\" title=\"Challenges in conception\">Challenges in conception<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#What_AMH_test_results_tells\" title=\"What AMH test results tells\">What AMH test results tells<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Causes_of_Low_AMH_Levels\" title=\"Causes of Low AMH Levels\">Causes of Low AMH Levels<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Age\" title=\"Age\">Age<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Pathologies_PCOS_endometriosis\" title=\"Pathologies: PCOS, endometriosis\">Pathologies: PCOS, endometriosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Premature_ovarian_failure_POF\" title=\"Premature ovarian failure (POF)\">Premature ovarian failure (POF)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Oncological_therapies_environmental_factors\" title=\"Oncological therapies, environmental factors\">Oncological therapies, environmental factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Autoimmune_diseases\" title=\"Autoimmune diseases\">Autoimmune diseases<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Treatment_Options_for_Low_AMH\" title=\"Treatment Options for Low AMH\">Treatment Options for Low AMH<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#In_vitro_fertilization_IVF\" title=\"In vitro fertilization (IVF)\">In vitro fertilization (IVF)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/ivi-fertility.com\/blog\/low-amh-levels-fertility\/#Egg_and_embryo_donation\" title=\"Egg and embryo donation\">Egg and embryo donation<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"What_is_Anti-Mullerian_Hormone_AMH\"><\/span><strong>What is Anti-M\u00fcllerian Hormone (AMH)?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>AMH refers to the <a href=\"https:\/\/ivi-fertility.com\/blog\/anti-mullerian-hormone-amh\/\">Anti-Mullerian Hormone<\/a>. This hormone is secreted by the granulosa cells surrounding the developing egg cells in the ovary. <strong>AMH levels provide information about your ovarian reserve<\/strong>, which is the quantity of egg cells remaining in your ovaries.<\/p>\n<p>Therefore, a low level is considered to be a sign of a low ovarian reserve, i.e. few remaining follicles. This would be normal for a woman who is approaching menopause. Conversely,<strong> a woman who has polycystic ovarian syndrome, characterised by the presence of many small ovarian follicles, would normally be expected to show high levels of AMH<\/strong>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"How_AMH_impacts_fertility\"><\/span><strong>How AMH impacts fertility\u00a0<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>As we have explained, high AMH levels indicate a higher quantity of oocytes, and vice versa. If these levels show diminished ovarian reserve,<a href=\"https:\/\/ivi-fertility.com\/blog\/ovarian-reserve-and-what-does-it-mean-for-fertility\/\"> fertility may be at risk,<\/a> and there is even a possibility of early menopause.<\/p>\n<p>It is important to note that <strong>AMH is just one contributing factor to fertility<\/strong>. Other factors such as age and the cause of low Anti Mullerian hormone levels also play a role. Next, we will examine some effects resulting from low levels of this hormone.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Reduced_egg_quantity_and_quality\"><\/span>Reduced egg quantity and quality<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The decrease in ovarian reserve due to age is often accompanied by a lower quality of oocytes. Therefore, <strong>AMH indicates not only a reduced quantity of oocytes but also a higher likelihood of aneuploidy<\/strong> (chromosomic abnormalities).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Increased_risk_of_miscarriage\"><\/span>Increased risk of miscarriage<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Low anti mullerian hormone levels also entail an increased risk of miscarriage, although specialists emphasize the need to consider other factors as well. For instance, <strong>the risk may escalate if low AMH coincides with advanced maternal age<\/strong>.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Challenges_in_conception\"><\/span>Challenges in conception<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The significance of AMH levels in the quest for pregnancy will depend on its origin. For instance, <strong>if the decline in levels is due to conditions such as polycystic ovary syndrome (PCOS), an appropriate treatment may increase AMH levels<\/strong>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_AMH_test_results_tells\"><\/span><strong>What AMH test results tells<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Typically, <strong>AMH normal range of values range between 1 and 4 ng\/ml<\/strong>. The assessment of ovarian reserve based on recorded parameters would be as follows:<\/p>\n<table style=\"height: 81px;width: 66.3487%;border-collapse: collapse;border-style: solid;border-color: #000000\">\n<tbody>\n<tr>\n<td style=\"width: 35.1317%\">2 \u2013 1 ng\/ml<\/td>\n<td style=\"width: 47.4371%\">Low ovarian reserve<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.1317%\">1 \u2013 3 ng\/ml<\/td>\n<td style=\"width: 47.4371%\">Normal ovarian reserve<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.1317%\">3 ng\/ml<\/td>\n<td style=\"width: 47.4371%\">High ovarian reserve<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>However, <strong>it is crucial to consider the woman&#8217;s age when interpreting blood hormone results<\/strong>. The following are reference AMH values based on age:<\/p>\n<table style=\"height: 148px;width: 66.4817%;border-collapse: collapse;border-color: #0a0a0a;border-style: solid\">\n<tbody>\n<tr style=\"height: 37px\">\n<td style=\"width: 38.2793%;height: 37px\">Under 33 years<\/td>\n<td style=\"width: 14.2144%;height: 37px\">2.1 ng\/ml<\/td>\n<\/tr>\n<tr style=\"height: 37px\">\n<td style=\"width: 38.2793%;height: 37px\">Between 33 and 37 years<\/td>\n<td style=\"width: 14.2144%;height: 37px\">1.7 ng\/ml<\/td>\n<\/tr>\n<tr style=\"height: 37px\">\n<td style=\"width: 38.2793%;height: 37px\">Between 38 and 40 years<\/td>\n<td style=\"width: 14.2144%;height: 37px\">1.1 ng\/ml<\/td>\n<\/tr>\n<tr style=\"height: 37px\">\n<td style=\"width: 38.2793%;height: 37px\">41 years and older<\/td>\n<td style=\"width: 14.2144%;height: 37px\">0.5 ng\/ml<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>It is important to note, as mentioned earlier, that AMH levels do not always correlate with age. Therefore, <strong>to make a comprehensive assessment of female fertility, additional tests will also be conducted<\/strong>. Follicle count, as well as tests for FSH, estradiol, or prolactin, are among them.<\/p>\n<p>These measurements can also be used to help predict the response to fertility treatments such as in vitro fertilization.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Causes_of_Low_AMH_Levels\"><\/span><strong>Causes of Low AMH Levels<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In general,<strong> there is no single answer to determine the origin of low anti-mullerian hormone levels<\/strong>. Below, we list some possible causes:<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Age\"><\/span>Age<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>As mentioned before, <strong>age is the most common cause of low anti mullerian hormone levels<\/strong>, as well as diminished ovarian reserve.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Pathologies_PCOS_endometriosis\"><\/span>Pathologies: PCOS, endometriosis<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>PCOS or endometriosis can lead to high AMH levels, causing fertility problems.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Premature_ovarian_failure_POF\"><\/span>Premature ovarian failure (POF)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Premature Ovarian Failure (POF) involves the<strong> cessation of ovarian activity in women younger than 40<\/strong>, and this can result in low AMH levels and infertility.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Oncological_therapies_environmental_factors\"><\/span>Oncological therapies, environmental factors<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Chemotherapy, radiation or exposure to environmental toxins can have an impact on reproductive capacity and AMH levels.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Autoimmune_diseases\"><\/span>Autoimmune diseases<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Lupus or rheumatoid arthritis can inflame or damage the ovaries, leading to a decrease in AMH levels.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Treatment_Options_for_Low_AMH\"><\/span><strong>Treatment Options for Low AMH<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>For many women,<strong> a declining level of fertility and failure to conceive is the trigger to consult for advice<\/strong>. Providing your clinical consultant at IVI considers there is an AMH normal range level for IVF, in vitro fertilisation could well be the treatment recommended. If on the other hand the AMH levels and thus the ovarian reserve are so low that this form of intervention is unlikely to succeed, your clinician may advise you to consider the use of egg donation.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"In_vitro_fertilization_IVF\"><\/span>In vitro fertilization (IVF)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The process is relatively straightforward. These are the different steps of IVF:<\/p>\n<ul>\n<li><strong>Ovarian stimulation<\/strong>. This consists of the administration of daily injections which cause the ovaries, instead of producing a single ovum, to create more oocytes. A more significant number of embryos can therefore be obtained. Depending on the stimulation protocol chosen, the treatment takes between 10 and 20 days. Our health professionals indicate the type of medication and appropriate dosages for each woman, based on each individual case. During the process follicle tracking is performed through transvaginal ultrasound scans, and serum levels in the blood are also measured to check on ovarian follicular growth and maturation.<\/li>\n<li><strong>Retrieval of the eggs.<\/strong> This is scheduled when the follicles have reached the appropriate size. A hormone injection is administered to trigger ovulation and, approximately 36 hours afterwards, egg collection can take place. The patient attends the clinic and a light sedative is administered to prevent discomfort. The procedure takes 15 minutes and is carried out by a gynaecologist, an embryologist and the anaesthesiologist.<\/li>\n<li><strong>Oocyte fertilisation.<\/strong> It takes place when the sperm is mixed with the retrieved eggs to allow fertilisation to occur. This can happen by one of two methods: conventional IVF, which consists of placing the eggs in contact with sperm in a petri dish or alternatively ICSI (Intracytoplasmic sperm injection) which consists of microinjection of the sperm directly into the mature egg with the help of a pipette.<\/li>\n<li><strong>Embryo transfer into the uterus.<\/strong> This is a simple painless procedure for which no sedation is necessary. It takes just 15 minutes, after which the patient return home.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Egg_and_embryo_donation\"><\/span>Egg and embryo donation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>For those women who do not have a good AMH level for IVF or where IVF treatment has not been successful, using donor eggs is an alternative approach. <strong>Egg donation is the process in which women use eggs from a donor in order to have their own child<\/strong>. The donor\u2019s eggs are fertilized with sperm, usually from the woman\u2019s partner, to produce embryos. These are then transferred into the womb in the same way as with IVF, making pregnancy possible.<\/p>\n<p>IVI has a network of clinics across Spain which have for many years been working with international patients who require egg donation. There are some significant differences in the regulatory framework regarding anonymity. <strong>Egg donation is anonymous in Spain<\/strong>, where IVI has one of the largest frozen egg banks in the world. We therefore have access to egg donors with all characteristics, with no waiting list. If you decide, with the help of your clinical consultant, that this is an option you would like to explore, you can familiarise yourself by reading more about IVI clinics in Spain.<\/p>\n<p>In conclusion, <strong>AMH is a hormone that plays a vital role in female reproductive function<\/strong>. Low AMH levels can be a sign of decreased ovarian reserve and can occur naturally with age or due to certain medical conditions and treatments. It is essential to consult with a healthcare provider if you have concerns about your AMH levels or fertility.<\/p>\n","protected":false},"excerpt":{"rendered":"Low AMH levels are generally considered to be an indicator of a low ovarian reserve. It is quite normal for a woman\u2019s AMH levels to decline as she gets older. In younger women this may be a sign of premature loss of fertility. 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