Low AMH Level: Causes, Symptoms & Treatment

Low AMH levels could be a cause for concern for women in Mumbai who are trying to conceive. For those who plan to start a family, comprehending the significance of AMH, which plays a pivotal role in assessing fertility potential, is of absolute importance. 

In 2021, a study was conducted to create age-specific percentile charts of anti-Mullerian hormone (AMH) and antral follicle count (AFC) in Indian infertile women; data from over 5500 infertile women aged 20–44 was analyzed. The findings here suggest that 50.5% of females who are 35 years of age and older had extremely low AMH levels. This becomes a concern as low AMH levels indicate that there are fewer eggs in the ovaries, which further leads to difficulty in getting pregnant. 

The purpose of this blog is to help readers in understanding more about low AMH levels, including the causes, symptoms, as well as treatment options available in Mumbai.

What Is AMH (Anti-Mullerian Hormone)?

An AMH level is the measurement of Anti-Müllerian Hormone, a substance produced by granulosa cells in ovarian follicles. It is a rather important indicator of a person’s ovarian reserve, and it can tell the quantity of eggs remaining in the ovaries. While both men and women produce AMH, it is more often measured in women who are undergoing fertility assessments, particularly before IVF treatments.

High AMH levels suggest a greater number of eggs, whereas low levels indicate fewer eggs. Do note that while AMH levels provide insight into egg quantity, they do not when it comes to egg quality.

Ideal AMH Levels To Become Pregnant

Ideally, AMH levels from 1-0 to 4.0 ng/ml can be considered good or normal for those who intend to conceive. Now, when the AMH levels fall below 1.0 ng/mL, they are classified as low, and values under 0.4 ng/mL are regarded as significantly low.

According to experts, the higher the number of eggs produced with an IVF, the better the possibility of developing as well as producing enough embryos for transfer. Embryos are formed when the woman’s eggs are fertilized by the man’s sperm.

So, a higher level of AMH is more preferable in order to get pregnant. 

Causes Of Low AMH Levels

While age plays a major factor in the decrease of AMH levels in women, it is not the sole reason. There are many factors that can come into play when it comes to this particular subject. Following are some of the different reasons why low AMH can occur even in younger women:

Age: 

As mentioned earlier, age is among the top of the list of why a woman’s AMH level decreases. Women are born with the ability to produce eggs, which are then gradually utilized during their reproductive lifespan through their ovulation cycles. The older the woman (30s – 40s), the lower the AMH level. Moreover, when menopause occurs, menstruation ceases and naturally AMH follows suit. 

Poor Diet: 

Another factor that comes into play is diet. Unhealthy food such as junk, oily or fatty foods can highly affect the levels of Anti-Mullerian Hormone. While specific diets to boost AMH levels are still not extensively studied, oysters (zinc and amino acid), berries (antioxidants), leafy greens, especially spinach and kale (folate), salmon (omega-3 fatty acids), as well as nuts and seeds (Vitamin E) are some recommended food choices that can improve ovarian function and egg quality.

Past Medical Record:

A woman who has had medical conditions related to her reproduction system, including any surgeries associated with endometriosis, ovarian cysts, ovarian torsion, etc, has a higher chance of her AMH levels dropping, even if she is not in her late 30s.

Mental And Emotional Health:

The emotional and mental well-being of an individual can impact AMH levels. AMH is influenced by various hormonal processes in the body, particularly those related to stress. High levels of stress hormones can have a negative effect on AMH. Consequently, a woman experiencing poor emotional and mental health may also experience decreased AMH levels.

Cancer Treatment:

In one particular study, researchers investigated the relationship between anti-Müllerian hormone (AMH) levels and breast cancer in young women. They recruited 58 women with early breast cancer who had not received any treatment and 58 healthy controls. Blood samples were taken from all participants to measure AMH levels.  The researchers found that although the mean AMH level was not statistically too significant between the two groups, there were more women in the breast cancer group with either very low or very high AMH levels compared to the control group.  This suggests that abnormal AMH levels may be a risk factor for breast cancer in women of younger age.

Vitamin Deficiency:

Low levels of AMH can be caused by Vitamin D deficiency. This can easily be rectified by correcting the levels of vitamin D, which improves both egg quantity and quality.

Other Causes:

Factors such as autoimmune attacks on ovaries, Inherited genetic disorders, as well as other environmental causes also carry the possibility for women to have low AMH levels. 

Symptoms Of Low AMH Levels

Low AMH level symptoms manifest in various ways, often impacting menstrual cycles and fertility. Here are some to be on the lookout for:

• A woman may experience irregular monthly periods, characterized by shorter cycles typically lasting 23-24 days or even the absence of menstruation altogether.
• Difficulty conceiving a child as diminished ovarian reserve caused by low AMH level affects reproductive potential.
• Early signs of menopause may occur, such as hot flashes, anxiety, irritability, mood swings, and vaginal dryness.

Do Low AMH Levels Affect Fertility?

While low AMH levels do not directly cause infertility, they indicate diminished egg reserve. A decrease in the number of developing eggs within the ovaries reduces the chance of releasing a mature and healthy egg for fertilization. Furthermore, in cases of age-related low AMH, the quality of eggs may be compromised due to accumulated mutations over time. Also, the risk of abnormal fertilization and miscarriage is heightened, highlighting the importance of addressing concerns related to low AMH levels in reproductive health.

How are Low AMH Levels Diagnosed?

Low anti-mullerian hormone levels can be diagnosed by doing an AMH test, which is a simple blood test. 

What Are the Risk Factors Affecting Low AMH?

A study conducted in 2021 found that risk factors affecting Low AMH include:

• Younger age at menarche (a female’s first menstrual period)
• Alcohol consumption
• Adnexal surgery (surgical procedure performed on the ovaries or fallopian tubes) 

Based on this research, these factors have a more significant impact on younger women (under 37 years old) than on older women. For instance, women aged 20-30 who have undergone adnexal surgery and consume alcohol are at a higher risk for a decline in AMH levels.

How Can You Determine Your AMH Level?

Determining an AMH level involves getting an AMH blood test that can provide valuable insights into various aspects of reproductive health. This test is particularly useful for assessing a woman’s ability to produce eggs that are viable for fertilization. Moreover, an anti-mullerian hormone test can help in identifying potential reasons for early menopause or abnormal menstruation in women.

While an AMH test is generally considered safe, like any medical procedure, there may be minimal risks associated with it. These possible risks include minor bruising or soreness at the site where the blood is drawn. However, these side effects are usually temporary and resolve quickly.

How Do I Raise My AMH Levels?

Lifestyle changes (mentioned below) have the potential to increase AMH levels and even improve overall fertility health: 

• Maintain a healthy weight and exercise regularly.
• Avoid smoking and limit alcohol consumption.
• Eat a balanced diet that is rich in vitamins, antioxidants, and omega-3 fatty acids.
• Get enough sleep and manage stress levels.
• Consider supplements like DHEA, CoQ10, and folic acid after consulting a healthcare provider.
• Limit exposure to environmental toxins and chemicals found in plastics, cosmetics, and pesticides.
• Reduce processed foods, refined carbs, and sugar intake.
• Explore alternative therapies like acupuncture and yoga.

Treatment For Low AMH Levels

While there is till no absolute cure for low AMH levels, adopting lifestyle changes as mentioned earlier such as maintaining a healthy weight, eating right, avoiding alcohol and tobacco-related products, intaking of supplements (DHEA, CoQ10, and folic acid), experiencing with acupuncture and yoga, among others, can definitely aid in enhancing low anti-mullerian hormone levels.

Also Read: AMH level – Understanding Its Causes & Treatment Options

IVF With Low AMH Level

It’s important to note that low AMH levels do not necessarily indicate an inability to conceive naturally, but they may affect fertility and the likelihood of getting pregnant. With that being said, for those who have difficulty in conceiving, in vitro fertilization (IVF) is a widely used assisted reproductive technology for individuals with low AMH levels. During IVF, eggs are taken from the ovaries, fertilized with sperm in a lab setting, and then transferred to the uterus. With advancements in IVF techniques, individuals with low AMH levels can still have a chance of successful pregnancy. At FertilTree, with our fertility experts, we can ensure the best IVF treatment in Mumbai as per your condition, along with suitable tests and counselling.

IVF with Donor Eggs 

In situations where the AMH level is extremely low, and the retrieval of viable eggs through IVF is unsuccessful, utilizing donor eggs becomes a viable alternative. In such cases, the treatment for low AMH involves using high-quality donor eggs in the IVF process. At FertilTree’s Donor Eggs and Donor Embryo Program, each and every donor is physically, medically and genetically screened thoroughly.

Low AMH: Does It Affect Pregnancy? 

While low AMH levels can indicate a lower chance of pregnancy, it doesn’t necessarily mean a woman cannot get pregnant naturally. 

A low AMH level can indicate a lower egg reserve, which can make it more difficult to get pregnant. However, many women with low AMH levels are still able to conceive naturally. Age is a much bigger factor than AMH levels when it comes to fertility.

Conclusion

Given the various factors contributing to infertility in Mumbai’s women of reproductive age, Anti-Müllerian Hormone (AMH) testing becomes an important tool for comprehensive reproductive health evaluation. Lower AMH levels can suggest a higher risk of infertility, making consultation with a fertility specialist highly advisable.

Found this post informative? Read more insightful Blogs at FertilTree. For expert guidance on fertility treatments, visit Dr. Firuza Parikh’s profile and explore the wealth of resources available on FertilTree.

For further inquiries, you can reach out to us at [email protected] or call us at +91-22-66573175.

FAQs : Low AMH Level: Causes, Symptoms & Treatment

Sources:

HemavathiShivapura Krishnarajabhatt, Anjaly Muraleedharan, Parvathy Unnikrishnan, & Narayan, P. (2017). An Ayurvedic treatment protocol to improve anti-mullerian hormone: A prerequisite for assisted reproductive technique- A case report. Ayu, 38(1), 66–66. https://doi.org/10.4103/ayu.ayu_167_17

Wang, Ying, et al. “Effects of Environmental, Social and Surgical Factors on Ovarian Reserve: Implications for Age‐Relative Female Fertility.” International Journal of Gynecology & Obstetrics, vol. 154, no. 3, 11 Feb. 2021, pp. 451–458, https://doi.org/10.1002/ijgo.13567.

Amirmohsen Jalaeefar, et al. “Abnormal Anti-Müllerian Hormone Level May Be a Trigger for Breast Cancer in Young Women: A Case-Control Study.” International Journal of Reproductive Biomedicine, 21 Feb. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC7922299/, https://doi.org/10.18502/ijrm.v19i2.8476. Accessed 14 May 2024.

Murali, Rajaam, et al. “Age-Specific Distribution of Serum Anti-Mullerian Hormone and Antral Follicle Count in Indian Infertile Women.” Journal of Human Reproductive Sciences, vol. 14, no. 4, 2021, p. 372, https://doi.org/10.4103/jhrs.jhrs_65_21.

Ou, Miaoxian, et al. “AMH Is a Good Predictor of Metabolic Risk in Women with PCOS: A Cross-Sectional Study.” International Journal of Endocrinology, vol. 2021, 12 Aug. 2021, pp. 1–7, www.ncbi.nlm.nih.gov/pmc/articles/PMC8376462/, https://doi.org/10.1155/2021/9511772. Accessed 14 May 2024.