From the Guidelines
Low Anti-Müllerian Hormone (AMH) levels are associated with a higher risk of miscarriage, and while there are no proven medical treatments to increase AMH levels, women with low AMH may consider fertility preservation and assisted reproductive technologies. The implications of low AMH levels are significant, as they indicate diminished ovarian reserve, suggesting fewer remaining eggs and potentially reduced fertility 1. According to a systematic review and meta-analysis published in Human Reproduction Update in 2021 1, women with low AMH levels have a significantly higher rate of miscarriage compared to those with medium or high serum AMH concentrations.
Key Considerations
- Low AMH levels are associated with a higher risk of miscarriage, with a pooled odds ratio of 1.35 (95% CI, 1.10–1.66; P = 0.004) 1
- Women with low AMH may consider timely family planning, fertility preservation through egg freezing, or assisted reproductive technologies like IVF
- Some fertility specialists may recommend supplements such as DHEA, CoQ10, or vitamin D, though evidence for their effectiveness is limited
- Lifestyle modifications, including maintaining a healthy weight, avoiding smoking, reducing alcohol consumption, and managing stress, may support overall reproductive health
Fertility Options
- Women with low AMH should consult with a reproductive endocrinologist to discuss personalized fertility options and realistic expectations
- Individual responses to fertility treatments vary considerably, even with diminished ovarian reserve
- Age remains the most significant factor affecting fertility outcomes, and women with low AMH should be aware of this when planning their fertility 1
From the Research
Implications of Low Anti-Müllerian Hormone (AMH) Levels
- Low AMH levels are associated with a lower ovarian reserve, which can impact fertility and reproductive health 2, 3.
- AMH levels can be affected by various factors, including contraceptive use, with some methods showing a significant decrease in AMH levels compared to non-users 4.
- Obesity has been suggested to potentially impact AMH levels, although the current evidence is limited and inconclusive 5.
- High AMH levels can be predictive of poor response to certain fertility treatments, such as clomiphene citrate, in women with polycystic ovarian syndrome (PCOS) 6.
Treatment Options for Low AMH Levels
- There is no direct treatment for low AMH levels, but addressing underlying factors such as obesity or switching to a different contraceptive method may help 4, 5.
- Fertility treatments, such as in vitro fertilization (IVF), may be more challenging for women with low AMH levels, but individualized approaches can be developed to optimize outcomes 2, 3.
- AMH levels can be used to guide fertility treatment decisions, such as determining the optimal dosage of follicle-stimulating hormone (FSH) 3.
Importance of AMH Testing
- AMH testing can provide valuable information about ovarian reserve and fertility potential 2, 3.
- AMH levels can be used to predict the risk of poor response or ovarian hyperstimulation syndrome in fertility treatments 3.
- However, the lack of international standardization of AMH assays can limit the comparison of results and interpretation of AMH values in a clinical setting 2, 3.