Anti-Mullerian Hormone and Fertility

    There are several markers of a women’s reproductive health when it comes to making a baby.   Many are familiar with common hormone tests such as estrogen, progesterone and the follicle stimulating hormone (FSH).  New research is showing that the anti-mullerian hormone (AMH) might be a better predictor for those looking to undergo invitro fertilization (IVF) however it may also be advantageous to check this marker when looking to become pregnant in general.

    To compare, the FSH test is essentially a marker of communication between the anterior pituitary in the brain down to the ovaries.  When the FSH begins to rise on day 2 or 3 of the cycle, it stimulates the growth and development of the follicles such that a dominant follicle is formed  and with the trigger of luteinizing hormone  an egg can be released for pregnancy.  As a woman becomes older, her FSH levels rise as there are fewer and fewer follicles left in the ovary yet the pituitary continues to produce the hormone .  The higher the FSH levels (typically above 10), the less fertile a woman has become.

    Working with FSH is the anti-mullerian hormone that is produced directly by the ovaries in order to help with follicular development as well by controlling excessive follicle stimulation by FSH.  Those with lower AMH are thought to have lower levels of follicles therefore the potential for egg development is a lot less.  Unlike the FSH marker which should be drawn on day 2 or 3 of the menstrual cycle, the AMH can be checked any day as it does not typically vary throughout the month. 

    Research in the February 2013 Journal of Clinical Endocrinology and Metabolism suggests that AMH is a good predictive marker for those women looking to undergo IVF as it can predict the oocyte yield and oocyte quality which is important for a successful transfer.  The higher the AMH level (typically between 3-7 ng/mL depending on the lab and fertility center), translates to a better outcome for IVF which means a successful pregnancy.  Levels above 7ng/mL are indicative of polycystic ovarian syndrome.  Levels less than 2 ng/mL are indicative of lower fertility chances. 

    If you are currently trying to become pregnant, are having difficulty becoming pregnant or are thinking about it in the future, remember that you are more than a number.  There are several factors that contribute to the health of your body, ovaries and eggs however these tests may be powerful indicators of what’s to come.  Talk with your health care provider about getting a work-up and remember to be as healthy as you can be when it comes to making a baby.

References:

1)      Hand, L.  Antimullerian Hormone Levels Predict IVF Success.  Web.  20 February, 2013.

http://www.medscape.com/viewarticle/779410

2)      Jabbour, S., and Griffing, G.  Follicle Stimulating Hormone Abnormalities Workup.  Web.  20 February, 2013.

http://emedicine.medscape.com/article/118810-workup