What is Anti-Mullerian Hormone (AMH), and How Does it Affect Fertility?
Modern technology allows us access to more information than ever. From connecting with long-lost friends to understanding our genealogy via our spit, sometimes it’s a blessing. And other times, easy access to such intimate information can cause anxiety. Case in point: recent trends among ‘testing’ our fertility from the comfort of our bathrooms, with companies like Modern Fertility. If I could know—right now—if I’m probably fertile enough to get preggers? I’d sign up purely for peace of mind. Because like many other women in their late twenties and early thirties, I’ve been curious about how much time is left ticking in my biological clock.
At age 31, I’m in a happy, fulfilling, long-term relationship, and we plan to have children… but neither my partner nor I are in a rush to have a baby. I’m definitely not alone, considering more and more people are delaying the whole marriage-and-children tango to build their careers, advance their education, and ya know, not say ‘I do’ to their college sweetheart.
Though from a divorce-statistic standpoint this is probably favorable, it also means that more women are starting the baby-making process later, into their 30s and even 40s, according to Dr. Temeka Zore, a reproductive endocrinologist with Reproductive Medicine Associates (RMA). Because fertility declines with age, it’s important for women to really understand their own health so they can make informed decisions about their timelines. That’s why a take-home kit can provide important information — but shouldn’t serve as an end-all-be-all picture into our state of fertility. This is because AMH tests, as you can guess, only test our AMH levels. This offers a sliver of insight into what’s happening under our hood. Truth be told, many women are so eager to have any data, that they don’t always read the fine print. And that’s OK, an AMH test could still be helpful, as long as we understand it isn’t exhaustive.
Here, what you need to know about AMH—and why it matters.
The basics of female fertility
You already know that every woman is unique—from their insight and genius to their traits and appearance. Many factors play a part in female fertility, and various conditions can impact our ability to conceive. But from a general standpoint, understanding the bare-bone basics of female fertility is vital knowledge to have.
As Dr. Zore explains, women are born with all the eggs they will ever have, around one to two million at birth. Throughout our lifespan, starting with our very first menstrual cycle, the body recruits a group of follicles (each with a small, immature egg inside) that have the potential to respond to hormones, grow, and ovulate.
“Usually a woman will ovulate one egg per month, the eggs that do not get selected to ovulate will dissolve and the process repeats itself if a woman is not pregnant that month,” she explains. This is why age is a big part of conception: the more periods you have, the fewer eggs you have, and thus, the harder it may be to successfully stimulate and maintain a pregnancy.
So what are AMH levels? Why do they matter?
AMH—or anti-mullerian hormone—is a laboratory test that OB-GYNs and fertility doctors may use to assess a woman’s ovarian reserve or egg count, according to Dr. Zore. “AMH is a hormone produced by cells from the small follicles in a woman’s ovaries and is used as a marker of oocyte quantity,” she explains. Though this number may seem insignificant in the scheme of fertility, it actually can give a woman a ballpark figure on her chance of conceiving naturally. In simple terms, if you have a low reserve, you can make choices to preserve your fertility.
“The value of this test is that a woman with a low AMH can choose to do something about her fertility now if she desires a family for the future,” Dr. Zore continues. “It gives an overall picture of what you look like today. It can help with setting realistic expectations on the number of eggs that may be retrieved or how you will respond to medication should you decide to proceed with IVF either for infertility or for egg freezing.”
If you’re worried about cost, check with your insurance provider. Some do cover it—while others don’t consider it necessary unless you have a history of fertility issues.
What can’t AMH test?
Say you take an at-home fertility test, and it reveals you have a normal AMH level. Awesome. Fast forward a year from now, and you’re struggling to see two lines on a pregnancy test. What gives? Dr. Zore warns women that AMH isn’t an exhaustive blueprint of your ability to get pregnant since many other factors contribute to our fertile health. To put it bluntly, Dr. Zore says the only true test of whether a woman is able to conceive—regardless of her AMH values—is for her to try to get pregnant on her own. AMH gives some insight, but it shouldn’t be relied on for all lifestyle choices concerning starting a family.
“A large cohort study demonstrated that there was no difference in pregnancy rates in women with normal AMH values trying to conceive versus women with low AMH levels trying to conceive. If you check your AMH today and get a low number, that does not mean you can’t get pregnant tomorrow or in three months if you were to try on your own,” she explains.
So, is it worth it?
One of the biggest debates I have about testing my own AMH level is how it would change my psyche. All the women in my family have been incredibly fertile, and while fertility isn’t purely genetic, it does play a part. This fact alone has helped to ease my nerves around having children and allowed me to take life at my own speed. If I found out my AMH levels were low, I’d probably be in a rush to freeze my eggs—or have a serious heart-to-heart with my boyfriend on our timeline. Others, however, might value this information—it’s important to know what you might like to get out of this data.
And though Dr. Zore is a proponent of women being educated on their fertility so they’re empowered to make decisions, think critically before you test. And more importantly: understand what it can and can’t tell you. “One piece of that education is knowing what your ovarian reserve looks like at a given point in time and once you have that information, what, if anything you want to do about it. AMH values can help you determine if you want to do something now for your fertility,” she explains.
And if, like me, you’re not prepared now to make a move or change, perhaps wait until you are. Information is power, but so is choice. And with all things concerning your body, it’s your right to make a decision that works for you, wherever you are.
Author Bio Lindsay Tigar is a travel and lifestyle journalist. Her work has appeared in Travel + Leisure, Vogue, USA Today and countless other publications. When she isn't collecting another passport stamp, she can be found scouring a city for the best coffee, going to a boxing class or falling in love with each stray dog she meets. A collection of her work can be found at LindsayTigar.com.