What is low AMH all about?

You’ve had an AMH test, and you have low AMH levels. Now you want to know…what do you need to know about Anti Mullerian Hormone?


Let’s break down low Anti Mullerian Hormone (Low AMH) and try and make it simple. In this article, you will find essential information about your Low AMH test and what it means to you and your fertility. You will also find truths about low AMH & IVF your doctor may not have told you.


Alfred Jost discovered AMH in the 50’s while researching sex hormones. He found that granulosa cells in the ovaries produce Anti-Mullerian hormones (AMH). AMH limits how many eggs are created in the ovaries every month. It does so by holding back Follicular Stimulating Hormone (FSH). There’s no point growing 100 eggs every month when you only ovulate 1. Healthy women have 6-7 eggs (follicles) growing in each ovary every month. AMH stops FSH from getting too carried away.

So why are LOW AMH LEVELS such a PROBLEM?

AMH holds back FSH in the first half of the growth of an egg. But it’s primary job is to turn ‘primordial’ eggs into ‘teenage’ eggs.

A diagram showing the development of primordial eggs into secondary eggs during the AMH preantral phase and the FSH antral phase leading up to ovaultion.
The Preantral phase is governed by AMH turning primordial follicles into secondary follicles. The Antral phase is governed by FSH that finishes the egg ready for ovulation. 

AMH does a great job of turning baby eggs into teenage eggs. It’s like the tender loving care that a baby needs from its mother until it turns into a teenager. Follicular Stimulating Hormone (FSH ) takes the teenage egg and turns it into the best it can be. FSH is like a coach who doesn’t take any lip and doesn’t care if you like him. FSH gets the job done but is not suitable for babies.

Keeping this in mind; if AMH is too low, it does a poor job of growing the baby eggs. Low AMH can’t keep FSH at bay until it has done its egg raising job: if AMH struggles FSH steps in and finishes the job. What you end up with is an egg that is hard to fertilize and turn into a baby.

You’ve got a LOW AMH TEST. What does the mean for you?

In a nutshell, it means your eggs are hard to fertilize. The lower your AMH levels are, the harder they are to fertilize. You can still produce eggs and ovulate them with low AMH. But how does that translate into fertility? It means it is harder to get pregnant than people with normal AMH levels. Your eggs won’t, and they won’t turn into a baby for you.
Think of popcorn. You know how there is always some corn that doesn’t pop and lies in the bottom unchanged? That’s low AMH on your eggs.

How much harder is it to get PREGNANT with LOW AMH?
In short…. very. If you’ve got low AMH it is likely you are going to need help getting pregnant.


So how low is low?

Charts vary, and so do measurements. Optimistic doctors expect the best ranges to be 28-46 pmol/l or 4-6.8 ng/ml. realistic ranges for pregnancy are 14+pmol/l or 2.2+ ng/ml. Ranges go down to 0.01 pmol/l and >0.1 mg/ml.
The author has seen successful natural pregnancies between 1-3 pmol/l or 0.14-0.42 ng/ml.
If you want to convert your AMH test reading from ng/ml to pmol/l use this link and enter your numbers for conversion: http://unitslab.com/node/155

DOCTORS tell me IVF is my only option.

You may very well need IVF. Ten years ago IVF clinics would not treat women with low AMH levels because the success rate was too small. It still is the same level of low except now they are treating women with it.
IVF treatments have not changed in that time.
IVF doctors use the same drugs for stimulating egg production for every woman, regardless of AMH levels.

IVF uses FSH injections for women to grow eggs; this is the procedure.
We already know that FSH does a lousy job of growing eggs with low AMH.

Some people suggest that the result of your AMH test indicates how likely IVF is to work. That is not the full story, but it is close to the truth. The lower your AMH, the less likely IVF is to succeed.

LOW AMH and IVF. What do you need to KNOW?

Success rates link to levels. There are websites out there that quote ridiculous degrees of success with IVF.

They ‘massage the data.’
It means they are not telling the whole truth.
10-35% success rate per cycle is a downright lie.

See actual success rates for low AMH levels and live births rates in this 2010 study. https://doi.org/10.1016/j.fertnstert.2010.04.067
This chart shows that women with AMH levels under 1.05 ng/ml or 7.5 pmol/l have a 2%-6% chance of falling pregnant per cycle.


The figure demonstrates at various AMH levels percentages of live births (LB), terminations of pregnancy for aneuploidy (TOP), and spontaneous miscarriages (SAB) per IVF cycle (upper panel) and cumulatively over length of infertility treatment with IVF (lower panel).
The figure demonstrates at various AMH levels percentages of live births (LB), terminations of pregnancy for aneuploidy (TOP), and spontaneous miscarriages (SAB) per IVF cycle (upper panel) and cumulatively over the length of infertility treatment with IVF (lower panel).
Yes, that is a terrible success rate. And it without a doubt the greatest money spinner IVF has ever seen. How many times you have to do it before it works is anybody’s guess.
“It is what you do outside of the IVF clinic that can improve your chances, not in it”

What can you do to help yourself?


Posted 12th March 2018

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