Low AMH levels – Causes, Symptoms & Treatment

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Low AMH levels Causes, Symptoms Treatment
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Low AMH Levels (Overview)

• Anti-Müllerian Hormone (AMH) is a hormone
  produced by the developing follicles in the
  female ovaries. AMH decreases as the age of the
  women increases naturally. Women have commonly
  low AMH results over the age of 40. This implies
  that the ovarian reserve in women diminishes.
  Although many factors are considered to assess
  the accurate levels of AMH especially including
  age, the reference range for AMH value should be
  within 2.20 6.80 ng/mL. There are no definite
  ways to increase the AMH levels but various
  things can be tried.
• Low AMH and pregnancy are often discussed
  simultaneously. This is because low AMH levels
  signify the decreased number of eggs or very low
  number of eggs in the ovarian reserve. And
  depleted eggs in ovarian reserve implies the
  meagre chances of getting pregnant.
• However there are various differentiating factors
  such as different labs may give different results
  and now it is also recognized that AMH varies
  during the cycles also.

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Causes of Low AMH Levels

• There can be several causes for a low AMH level.
  Let us discuss some of them below

• Age The most influential factor that causes the
  change in AMH levels. All the women possess the
  supply of immature eggs for their lifetime right
  at the time of birth. These eggs get mature and
  are used during the ovulation cycles throughout
  the lifespan of the women till the time of
  menopause. The ovarian reserve decreases with the
  time, so the AMH level starts decreasing as she
  gets older. Till the time women ages to the mid
  or late 30s, the number of eggs in the ovarian
  reserves starts reducing. Thats why fertility
  decreases as AMH starts depleting around the age
  of 35.
• Poor Diet A diet consisting of processed food
  and excess fat is never a good option for a
  healthy AMH level. The unhealthy intake of food
  results in obesity which causes various
  reproductive issues including low AMH levels.
  Also, some studies show that Vitamins deficiency
  especially Vitamin D directly impacts the AMH
  levels and fertility. So, it is advised to
  consume a balanced diet to have ideal levels of
  AMH.

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• Past Medical Record Another factor causing low
  AMH levels apart from age is medical history.
  Medical circumstances can affect the AMH levels
  irrespective of the age. There are instances
  where some women face low levels of AMH even in
  their 20s and 30s while others continue to
  possess high AMH levels a few years after their
  30s.
• The experience of adverse medical conditions
  related to the reproductive system like hormonal
  disorders also impacts the AMH level causing its
  decrease. Also, the women with a previous history
  of ovarian surgery due to the conditions like
  ovarian cysts, endometriosis and ovarian torsion,
  etc., have a greater chance of having low levels
  of AMH.
• Mental and emotional health The next cause of a
  low AMH level is stress. A healthy mind and
  emotional well-being are always beneficial
  particularly for the women who are trying to
  conceive. Living with mental pressure or hyper
  stress continuously may result in failure to
  conceive. Moreover, de-stressing and maintaining
  a peaceful mind can correct the AMH levels.

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Other factors that may cause low levels of AMH
are

• Inherited genetic disorders
• Cancer treatment
• Autoimmune attack on ovaries
• Other Environment causes

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• Low AMH Level Symptoms
• Though, there are no specific or clear symptoms
  of low levels of AMH, getting done an AMH blood
  test when women notice a short cycle, irregular
  periods or premature menopause.
• How low is too low AMH Level?
• AMH levels tend to decrease with age of a woman.
  So, the answer to how low is too low AMH level
  varies from age to age. But a too low AMH score
  can be defined as a level which poses a health
  threat or indicates possible infertility in a
  woman where even an Assisted Reproduction
  Technology has a slim chance of success.

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First, let us look at the list of ideal AMH
levels according to the ages.
Age Ideal AMH level
lt24 months lt4.7 ng/mL
24 months 12 years lt8.8 ng/mL
13 45 years 0.9 9.5 ng/mL
45 years lt1.0 ng/mL
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Interpretation AMH levels
Interpretation AMH level
High levels (Testing for PCOS is advisable) gt5.0 ng/ml
High levels (Ideal for IVF treatment) 3.5 5.0 ng/ml
Optimal levels 1.0 3.5 ng/ml
Low levels (Assisted reproduction is viable) 0.3 0.7 ng/ml
Very low levels lt0.3 ng/ml
NOTE The scale is general and intended for women
only.It may vary according to race, ethnicity,
environmental genetic factors
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As we can see in the above list that the levels
from 0.3 to 0.7 ng/ml are considered low but
Assisted reproduction like IVF treatment may be
viable at these levels. According to a research
in the Middle East Fertility Society Journal
(Zaghloul, Y.I., Amin, Y.M., Mansour, R.T.,
2020), AMH levels under 0.5ng/ml are considered
to be less than desirable. However, even they
have the potential for bearing off-springs with
assisted reproduction IVF. Yet, in the same age
group, normal AMH levels resulted in higher
pregnancy potential than low AMH levels.
Moreover, women enjoyed successful outcomes from
IVF treatments as their AMH levels increased. 1.0
ng/ml to 4.0 ng/ml. So, the levels (around lt0.3
ng/ml) at which the chances of conceiving are
very slim even with the ARTs like IVF can be
considered as too low.
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Low AMH and Fertility issues
AMH levels are considered to be an indicator for
a womans ovarian reserve. AMH levels dont
signify definite infertility. The base of the
relationship between ones AMH levels and
fertility is that a womans fertility declines as
she ages. This correlates with the decline in AMH
levels too. The reduced number of eggs or no eggs
in the ovarian reserve of a woman reduce the
chances of getting pregnant. The quality of the
eggs may also be affected in the age-related low
AMH, as eggs accumulate mutations over time.
Here, the probability of abnormal fertilisation
and miscarriage rise. This especially holds true
for older women who are over 35 or 40. Thats why
the treatment is suggested for women with low AMH
level. While there have been instances when
younger women have not faced hurdles in
conceiving despite low AMH level. In the blood
test, AMH levels signal the potential number of
follicles within the ovaries. Yet, AMH levels
dont portray the quality of eggs in a woman.
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Options if you have low AMH levels?
If you simple worried that your AMH test
currently showed your AMH levels to be low then
you may not worry because AMH levels change. AMH
levels can be increased with certain lifestyle
changes naturally. Some of those ways are
mentioned in this article below. And if you have
been unsuccessful already in raising your AMH
levels to optimum, then, treatments like IVF can
come into your rescue if you want to conceive.
More about IVF is mentioned in the article
further.
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What to expect from the doctor if you have low
AMH Levels?
In the case of low AMH levels, doctors generally
suggest considering the IVF treatments or other
Assisted Reproductive Technology/Methods (ARTs)
for the woman who is looking to conceive. Along
with the AMH test, the medical professional may
evaluate the fertility by conducting some other
tests like FSH (Follicle Stimulating Hormone)
blood test and Antral Follicle Count (AFC) test
as well. Additionally, in some cases, doctors may
ask to bring some changes and adopt new healthy
habits which may help to improve the egg quantity
in the ovaries and hence increase the AMH levels
of the woman.
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Treatment with low AMH Levels?
Natural Treatment The AMH levels in a woman can
be corrected naturally by adopting different
ways. Practising Yoga regularly, getting
acupuncture, consuming wheat germ daily, getting
fertility massages at prescribed times are some
fundamental courses of action which can correct
your AMH levels naturally. IVF with Low AMH
levels A womans ovarian reserve portrays the
possibility of a successful pregnancy. And if a
woman has low ovarian reserve then IVF is a hope
to get pregnant. IVF is an alternative that can
help you conceive with a limited stock of eggs
left in their ovaries, provided if the matured
egg retrieved in a specific cycle of In Vitro
Fertilization (IVF) should be of optimum quality.
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IVF with Donor egg If a woman has left with no
eggs in the ovarian reserve or have a
substantially low quality of eggs and if the
stimulants have failed to retrieve good quality
of eggs, then she can go for the IVF with a donor
egg. In this case, the good quality eggs of a
stranger(donor) are used to carry the process of
IVF and get you pregnant eventually. Low AMH
Does it affect pregnancy? A low level of AMH
signifies that you may have a low chance of
getting pregnant. The decreasing ovarian reserve
shows that you should not delay your motherhood
for long because your ability to get pregnant may
reduce soon. Although, a woman can become
pregnant naturally with low AMH. But the
possibilities reduce as the AMH scores drop below
the low level. Moreover, AMH levels may change
from time to time. Low levels of AMH may also
mean that you are heading towards menopause. Low
levels of AMH are common in women after menopause
and young females. The AMH level test can also
tell whether the treatment is working or not in a
woman who is being treated for ovarian cancer. As
we know that the fertility in women declines with
the increasing ages, so, correspondingly the AMH
levels also start decreasing as women age.
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