AMH- the ‘egg timer’ test
Have you heard of the ‘egg timer’ test? Women are being sold that assessing their anti-mullerien hormone (AMH), will help to tell them how many eggs they have left, and it is creating anxiety in those that have been told they have a low level. Sounds like a great thing to assess doesn’t It to understand your fertility potential and “how much time you have left”. The problem is: AMH is NOT an accurate measure of your fertility.
What is AMH?
AMH is the hormone secreted by the granulosa cells in the ovary and is involved in ovulation.
Supposedly if you have a higher AMH, you have a higher egg reserve and therefore better chances of conceiving. However, this is not true.
Research has shown that AMH is not a good predictor of fertility and ability to conceive. (1)
This is for a number of reasons.
AMH levels fluctuate throughout a cycle, being highest just after your period end and before ovulation and lowest just after. Depending on when you are testing your AMH will determine what level you have.
The oral contraceptive pill also lowers AMH levels, most likely because the pill shuts down ovulation so AMH is not needed. (3) So if you have been on the pill or have recently been on the pill you are potentially getting a lower result.
A higher BMI and also a BMI below 18 has also been shown to cause lower levels of AMH, so depending on your weight, you could be being misled by AMH. (4)
And finally, stress has been shown to lower AMH levels. (5)
And yet despite what the research says above, this is a direct quote I have taken from an Australian IVF clinic’s website:
“AMH levels don’t change during your menstrual cycle, so we can take this blood sample at any time of the month, even if you are still using oral contraception.”
I can’t imagine how many women are out there thinking they have low egg reserve and making life changing decision because they had their AMH level tested while on the oral contraceptive pill.
So is AMH useful at all?
Your AMH level can be useful if going through IVF as depending on if it is if high or low, you will have a different response to medication protocols and your fertility specialist may make decisions based on your level.
And what about for your fertility potential?
If you are going to test your AMH, you would want to make sure the following applies to you:
- you have tested in the correct time frame- day 5-7 of your cycle would be ideal,
- - have not been on the OCP in the last year,
- - have a healthy BMI (between 19-25)
- And are not stressed
If you still got a low result for your age with the above factors, I would consider also looking at your cycle day 2-3 FSH, LH and Oestrogen and as an elevated FSH and low oestrogen at this time frame could also potentially indicate lowered fertility potential.
And even then, please do not freak out!
Take a breath, and consider that you really only need 1 egg to conceive. And so the real importance with your fertility is QUALITY over QUANTITY and this is something we can work on (next week’s post will be all about egg quality).
Confused about your cycle days and when you ovulate? Download my FREE guide to your fertile window here
References.
1. https://jamanetwork.com/journals/jama/fullarticle/2656811
2. https://www.nature.com/articles/s41598-020-76543-y?fbclid=IwAR14oobK6w7jOrT8ryPUBsbtjcgxE0fpGhBJEtJae12j0_CRz6AiXHcaABQ
3. https://pubmed.ncbi.nlm.nih.gov/26311148/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5182136/
5. https://rbej.biomedcentral.com/articles/10.1186/s12958-017-0271-4