How does the Anti-Mullerian Hormone (AMH) test assess ovarian egg reserve?

Anti-Mullerian Hormone (AMH), a hormone produced by the ovarian antral follicles, is now regarded as a much better predictor of a woman’s ovarian egg reserve than the previously measured Follicle Stimulating Hormone (FSH) level. Unlike FSH, AMH levels in a woman’s blood do not fluctuate during a woman’s menstrual cycle, nor does its level significantly differ from month to month. For these reasons the Anti-Mullerian Hormone, or AMH Test, is regarded as a far more reliable assessment of a woman’s fertility potential.

All women are born with an individual pre-defined ovarian egg reserve. The eggs in the ovary will remain in a dormant state until the start of the menstrual cycle at puberty. This set number of eggs starts to decline from birth, and especially after puberty, until the egg supply becomes exhausted and menopause sets in. During each menstrual cycle, a cohort of eggs is recruited from the reserve, with normally just one of these selected to develop into a mature egg which is ovulated in that cycle. The ovarian reserve predicts a woman’s fertility potential, by providing a measure of the number of remaining follicles in the ovaries at a given snapshot in time.

A woman’s AMH level can be determined by a simple blood test taken at any time during the cycle. Although AMH is primarily a measure of egg reserve, recent evidence shows that to a certain extent it is also a measure of egg quality. The higher the AMH result, the greater the remaining reserves. An AMH result is typically available within a week after the blood sample is taken. The testing laboratory provides a numerical figure which is used with a correlating scale relating to the assay performed, to provide a fertility potential. The result fits in to 1 of 4 ranges: Very Low, Low, Normal or High ovarian fertility potential.

AMH is routinely tested in female patients presenting at fertility clinics, and at the Herts & Essex Fertility Centre this blood test is included in the consultation package price. The test is useful for both patient and clinic alike, as it provides information on the current ovarian reserve and fertility potential of the female patient, as well as giving useful guidance to stimulation regimes suitable for the patient embarking on treatment.

AMH test helps you to plan for the future

AMH assessment can benefit not just individuals or couples experiencing difficulty in conceiving. AMH testing can actually benefit any woman or couple, regardless of age; like younger women who may not be considering starting a family immediately but who would like to be reassured that time is on their side, women whose mothers have had an early menopause, and women of advancing maternal age (over 35 years of age), or when circumstances dictate.

Advancements in fertility now allow women choices based on the information at hand. This is not to say that the chances of pregnancy will not decline with maternal age, as egg quality reduces and potential complications rise, as these are unavoidable circumstances for any woman. However, for some women whose AMH result may be lower than expected for their age, this information can empower them to try for children using their own eggs while they can still produce eggs. It may also help give the closure needed for a patient or couple with a very low AMH to explore alternative options such as egg donation or adoption, or for single women with normal AMH to consider options such as egg freezing.

It is important to remember that the AMH test is a snapshot of female egg reserve and is not a guarantee for the future. Retesting should be carried out in individuals who are looking to delay the onset of motherhood following an AMH result. The nursing team at the Herts & Essex Fertility Centre advise our patients on when to retest based on the original result.

If you would like more information about AMH or would like to book an appointment for AMH testing please call us on 01992 78 50 60. The Herts & Essex Fertility Centre also offer a number of fertility investigation packages for individuals or couples looking for information on their fertility, as well as consultations for those considering or seeking treatment.


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