AMH reveals ovarian reserves, or how many healthy eggs a woman has left in her ovaries
When a woman's ovaries fail to react sufficiently to a hormonal stimulation under IVF treatment, this is called "poor response".
Reasons for this are raised FSH levels (Follicle-Stimulating Hormone), which indicates the beginning of the menopausal phase – or a low AMH value (Anti-Mullerian Hormone). In most cases, the mature age of the patient is the reason for the limited functioning of the ovaries, although it can occur in younger women, too.
The AMH value is an indicator of the ovaries’ stimulation capacity and more general and ovarian activity.
The start of a hormone stimulation should not however be based solely on the AMH value. Often - despite a low AMH value - patients react very well to the administration of hormones and a satisfactory number of eggs can be obtained for future IVF treatment.
In such cases, at the fertility clinics recommends a step-by-step stimulation:
The patient is stimulated for 5 days. An subsequent ultrasound examination is used to ascertain the success of the stimulation. If follicles are found to be maturing in the ovaries, the hormone is no longer administered. If there is no reaction at the ovaries, the stimulation is discontinued and an alternative treatment is suggested (e.g. egg donor).
Between the ages of 18 and 29, the AMH's plasma level barely changes and lies constant between 20 and 25 pmol/L.
From the age of 30 onwards, the level drops significantly and by the age of 37 it reaches 10 pmol/L.
When values under 1 pmol/L are recorded it is highly likely that the ovaries will fail to react to hormone stimulation for IVF treatment.
AMH assessment is regularly requested and carried out at the fertility clinics prior to IVF treatment. It only requires a blood sample that can be taken at any time.
This Anti-Mullerian Hormone table gives an overview of the normal values:
Normal fertility - 1 to 5 ng/ml
Residual ovarian function - 0.8 to 1.0 ng/ml
Menopause < 0.1 ng/ml
Polycystic ovary syndrome - 5.0 to 15.0 ng/ml