AMH i.e. Anti Mullerian Hormone reflects the ovarian reserve in a woman. It is a hormone, produced by the follicles present in the ovary. The normal level of AMH hormone in a woman is 1-4 ng/ml. From the first day of life, the level of this hormone keeps increasing in a girl and reaches its maximum at the age of 25. When a girl reaches puberty, granulosa cells are the parameter used for its expression. Granulosa cells from the smallest Antral follicles in the ovary can turn out to be the best for dominance hence there is a strong correlation with the follicular count.
By the time an adult female hits menopause, it becomes undetectable. Among the common biomarkers of the hormone, like serum FSH and LH also there has been variability among low inter cycle, and intra cycle variability among serum AMH.
An IVF center in Thane may help to find out the factors responsible for variation in female AMH values can be intra-individual and inter-individual. Shreds of evidence from clinical studies show that AMH in the first half of the menstrual cycle has higher values of AMH in comparison to the second half where AMH drops considerably. There are also studies, which show no significant variation in the AMH levels throughout the cycle.
Factors responsible for variation in AMH
1. Age
The amount of eggs presents in the ovary continues to drop with an increase in age. Hence, when menopause approaches, AMH may hit a low level. Thus, it proves to be a good indicator of fertility. When the levels are exceedingly low or much below the detectable limits around five years before menopause, it turns out to be a good marker for ovarian ageing.
2. RACE
Pieces of evidence show that Hispanics and black women have exceedingly low levels of AMH up to 25 per cent in comparison to Caucasians of the same age.
3. BMIs: Body Mass Index
In obese patients, the concentration of vital hormones goes astray from the normal limit. As far as BMI is concerned, there is a negative impact on AMH. The medical fraternity believes that BMI has an inverse relationship with AMH.
4. Smoking
Women who are chain smokers will have poor egg quality, decreased follicular count, and low AMH. The number of cigars smoked every day also turns out to be a determining factor. Women who smoke regularly are vulnerable to hit menopause at an early age in comparison to non-smokers.
5. Caffeine
It is something whose concentration does not influence the level of AMH in a woman’s body. No noticeable differences of AMH have been found in AMH concentration when compared with a drinker and non –drinker of caffeine.
6. Menstrual Cycle
Irrespective of the menstrual cycle days, the concentration of AMH remains stable in a healthy female. You can measure it at any time during the cycle without any significant fluctuations. It goes to prove that random fluctuations are small proving that AMH is an independent marker of fertility, which has nothing to do with the menstrual cycle.
7. Ovarian Surgery
Any kind of ovarian surgery that includes removal of a small or large part of the ovary such as chocolate cyst, and dermoid cyst or for that matter any kind of procedure may affect the blood supply to the ovary and result in normal depletion of AMH hormone.
8. Oral Contraceptive Pills
Its use brings about a decline in the ovarian reserve because of prolonged use and due to the concentration of FSH –Follicle Stimulating Hormone suppression. Women who consume oral contraceptive pills are more likely to have a reduced AMH and Antral Follicular Count. It takes around three to six months before the AMH level returns to normalcy since the discontinuation of the drug.
9. Pregnancy
Results of clinical studies show that during pregnancy, there is a decrease in AMH levels. An indicator of suppression is the reduction in the concentration of AMH levels. The good thing is that AMH levels return to its normal limit following childbirth. The analysis of the AMH hormone may not prove to be an accurate indicator of ovarian reserve. AMH levels during pregnancy are dependent on gestational age.
10. Stress
Reproductive failure in Women may be the result of a higher level of stress and excess concentration of cortisol hormone. IVF treatment will help you to give attention to relieving stress for improving the reproductive health of a woman.
Is it possible to restore the AMH LEVEL?
Research works have shown that dietary modification brings about an improvement in reproductive health in a normal woman. However, there is also evidence, which does not prove a direct relationship between markers of ovarian reserve and dietary factors. Diets rich in DHEA, vitamin D3, can be helpful to restore the AMH level to its normal concentration. Still, due to the lack of consistent evidence, doctors may not recommend it as an effective therapy for improving AMH levels. However, one thing is for sure that Woman over the age of 40 years has to improve the AMH hormone concentration if they desire to become pregnant.