Women are born with around one million eggs in their ovaries, though this supply naturally decreases as they get older and go through menstruation. Understanding how many eggs you have remaining can be useful knowledge when trying to get pregnant or considering fertility treatment, and the best way to find this out is through the AMH test. But what does it actually look for, and how can you use your results?
What is the AMH test?
The anti Mullerian hormone test — also known as an egg timer or ovarian reserve test — is a simple blood test for fertility, used to assess the amount of anti Mullerian hormone (AMH) present in your bloodstream. AMH is secreted by the follicles in your ovaries, which are the small sacs in which eggs develop. The level of AMH that is detected by the test is an indicator of the number of eggs still stored in your ovaries.
However, it is very important to note that while the test can reveal the number of remaining eggs, it cannot accurately assess the health of those eggs, or their likelihood of contributing to successful conception.
Who should get an AMH test?
Any woman who is looking to fall pregnant could benefit from testing their AMH levels, with the results able to be applied in a variety of areas of fertility. There are some instances though where a test would be greatly recommended. In particular, women who have actively been struggling to conceive for six months could benefit from knowing whether their reserve is at a normal level for their age.
Patients who are considering fertility treatments like IVF or egg freezing could use the results of an egg reserve blood test to identify how likely they may be to have success with their treatments. Additionally, anyone who has an autoimmune disease or has had surgery that may have affected their fertility could benefit.
Getting an AMH test
Having an egg reserve test is quite a simple process, with the test itself consisting of a blood draw, similar to any other regular blood test. The draw can be completed at any point in your menstrual cycle. Your blood is then analysed for the level of AMH, and you will typically receive your results within a week.
Benefits
Checking your ovarian reserve is a useful part of assessing your overall likelihood of conceiving. While there are many factors that go into it, having an average or above ovarian reserve indicates that your eggs are not depleting too quickly and the amount of time you have to conceive is normal for your age. Your AMH results can also be used to understand how successful you might find egg freezing or IVF, in terms of how many eggs that are likely to be collected in these processes.
Considerations
Unfortunately, while knowing your ovarian reserve can be helpful for practical decisions, AMH test results can also cause a lot of anxiety or stress, particularly for patients who receive a below average result. This can lead to a sense of urgency that pushes them towards treatment. Similarly, an average or high result can give a sense of security about delaying your efforts at conception. An ovarian reserve blood test also cannot tell us how quickly your reserve may be diminishing, as it only provides a snapshot of the specific moment in which you tested.
Overall, your age is the biggest determinant in the health of your eggs and the likelihood of conceiving. Whether your ovarian reserve is low, average, or high, it still only takes one egg to fall pregnant.
Understanding AMH levels
When you complete an AMH test, your results are compared with the average results for a woman your age, which helps the specialist understand your personal ovarian reserve. If the test detects a higher level of the hormone, it indicates that you have a high ovarian reserve, meaning more eggs stored in your ovaries than an average woman your age.
What is a good AMH level?
AMH levels are measured in picomoles per Litre (pmol/L) and typically rise throughout adolescence until they hit their peak at 25 years old. From then, your AMH levels naturally begin to decline with age. Normal AMH levels typically sit between 10 to 20 pmol/L. Low AMH levels are typically thought of as the worst result, as they indicate a diminished reserve or potentially early menopause. However, high AMH levels can be an indication of Polycystic Ovary Syndrome (PCOS), or even Ovarian Hyperstimulation Syndrome (OHSS).
Our below AMH level graph provides information about typical AMH levels by age, and what you might expect to see in your results.
What causes low AMH?
The primary factor contributing to a low egg count is age, with a natural decline as the number of follicles reduces over time. Low AMH can also be caused by an autoimmune condition or smoking, as well as a high intake of Vitamin B7. Women who have previously had surgery to treat endometriosis or ovarian cysts are also likely to see lower AMH levels.
Some symptoms of low AMH to look out for can include short and irregular menstrual cycles, as well as early symptoms of menopause like mood swings, hot flushes and vaginal dryness. If you receive a low result, your specialist will help you understand any particular reasons as to why if they can be identified.
Can you increase your AMH levels?
As AMH levels are determined by your genetics and age, there is unfortunately no means of increasing your AMH levels or the number of eggs remaining in your ovaries. However, there are still ways to improve your overall fertility health, including eating a well-balanced and nutritious diet, maintaining a healthy weight, and managing stress levels. Freezing your eggs can also prevent them from ageing and preserve their health from whatever age you are when they are frozen.
Next steps
There are so many factors that go into achieving fertilisation and a successful pregnancy than just the eggs, including sperm health, timing of intercourse, and a variety of lifestyle choices. It is important to consider assessing these areas as well if you are struggling to fall pregnant. Additionally, combining an AMH blood test with specialised ultrasounds can provide a fuller look at your overall fertility potential, with the specialists better able to see the health of your ovaries.
Our team at Create Fertility offers a variety of tailored fertility assessments and treatments to give you every chance of falling pregnant. If you’re after fertility testing in Melbourne, have a chat with our friendly team to find out how we can help you achieve your family dreams.
