Anti-Müllerian Hormone (AMH) Test : Normal Levels, Purpose & Results

Many diagnostic advances have helped gynaecological and fertility treatments today, and an example of this is the AMH test. AMH, or the anti-Mullerian hormone test, is not a routine diagnostic procedure that forms a part of your health checkup packages and is performed only on a doctor's recommendation.

The AMH test measures the level of the anti-Mullerian hormone in the blood, which is an indicator of a woman's egg reserve. Let's understand more about the anti-Mullerian hormone test, its performance, and how to interpret the results.

What is The Anti-Mullerian Hormone?

To understand the importance of an Anti-Mullerian hormone (AMH) test, we must first acquaint ourselves with the anti-Mullerian hormone (AMH). This hormone plays multiple roles throughout a woman's lifetime:

• The cells in a woman's follicles produce this hormone, so AMH levels correspond to the number of eggs or a woman's ovarian reserve.

• AMH plays a crucial role in the development of a baby's sex organs in the uterus during pregnancy. It has been found that AMH levels are higher in male babies, which prevents the development of female reproductive organs. AMH levels in female babies are low.

Why is an AMH Test Done?

If you are a woman experiencing difficulty conceiving or battling fertility issues, your doctor will most likely recommend an AMH test. An AMH test gives your doctor a starting point for understanding your chances of conceiving a baby.

In women undergoing fertility treatments like IVF, the AMH test gives the doctor an idea about the success of the procedure. A high AMH indicates you have more than the required number of eggs for your age, and you are more likely to respond better to hormonal stimulation. Low AMH levels mean you have fewer than the required number of eggs.

An AMH test may also be recommended if you have symptoms of PCOS (Polycystic Ovarian Syndrome), which include:

• Acne
• Menstrual disorders
• Excessive body and facial hair
• Weight gain
• Reduces breast size

You may require an AMH test if you are undergoing treatment for ovarian cancer to determine if your treatment is working.

What Does an AMH Test Help With?

One of the primary uses of an AMH blood test is to determine a woman's egg reserve and chances of conception. Since the follicles make the anti-Mullerian hormone in a woman's ovaries during her child-bearing years, AMH levels indicate how many eggs she has left and how difficult it is for her to conceive.

Other uses of an AMH blood test include:

• Predicting when menopause will begin
• To determine the reason for early menopause
• Help identify the cause of amenorrhoea (lack of menstruation)
• To diagnose PCOS
• To check infants with genitals that are not identified as male or female
• Monitor and evaluate women with few types of ovarian cancers

What Happens During an AMH Test?

An AMH test is a blood test. You do not require any preparation for this test.

A laboratory technician will collect a blood sample from a vein in your arm using a fine needle during the test. Once the needle is inserted, a small amount of blood is collected in a vial. This process takes around five minutes. The collected blood samples are sent for further analysis.

What Do The AMH Test Results Mean?

The results of AMH may take a day to come. AMH blood test results can mean different things to different people, depending on why they got it done.

The normal range of AMH depends on the age and gender of a person. Here is how you can understand different AMH levels.

In Unborn Babies

• If the baby has XY chromosomes and AMH levels are high, there will be normal development of the sex organs. 
• If the baby has XY chromosomes and AMH levels are low, there is a high chance of having ambiguous genitalia. 
• In a baby with XX chromosomes, low levels of AMH are normal. 

In Females Of Reproductive Age

The ovaries start producing AMH from the onset of puberty. And up until menopause, there are many fluctuations in the levels of this hormone. Here is an average range of AHM levels in the blood serum, mentioned in nanograms per millilitre (ng/mL):

• Average Levels: Between 1 ng/mL to 3 ng/mL
• Low Levels: 1 ng/mL or below
• Very Low Levels: 0.4 ng/mL or below

Different Levels are Normal at Different Ages:

• On reaching puberty, AMH production begins in the ovaries and keeps rising throughout adolescence. 
• The levels of AMH in the blood serum peak around the age of 20. This is when the woman has the maximum number of viable eggs, is the most fertile, and has the maximum chance of conceiving. 
• After the age of 25, the levels of AMH in the blood serum start declining. The decline is slight up to the age of 30; after 35, the levels decrease rapidly. 
• As a woman nears menopause, AMH levels are at their lowest. 

Based on the data mentioned above, there is an average normal level of serum AMH for women of different ages.

• Around 25 years: 3 ng/mL
• Around 30 years: 2.5 ng/mL
• Around 35 years: 1.5 ng/mL
• Around 40 years: 1 ng/mL
• Around 45 years: 0.5 ng/mL

Please note that conditions such as polycystic ovarian syndrome (PCOS) and ovarian cancer can also affect the levels of AMH. 

Higher AMH levels indicate:

• You have sufficient or more than the required number of eggs (ovarian reserve). It also means you have better chances at conception.
• You have PCOS. Though there is no cure for this condition, its symptoms can be managed with lifestyle modifications and medications.

Lower AMH Levels Indicate:

• You have fewer eggs (low ovarian reserve), which means you may experience difficulty in conception.
• You are close to menopause.

If you are undergoing ovarian cancer treatment, an AMH blood test can help determine if your treatment is on track.

Once you receive your AMH test results, you must visit your doctor to understand what the results mean for you and the best way to manage your condition.

Key Takeaway

An AMH blood test is a minimally invasive procedure that helps give a deeper insight into a woman's reproductive cycle and her chances of conception. Fertility issues can be stressful, and a simple test like this one enables doctors to help women with conditions like PCOS and low ovarian reserve.