Female Infertility - Low AMH

Low AMH

Anti-Mullerian Hormone or AMH tell us about the ovarian reserves which play an important role in the process of conception. The AMH is a hormone secreted by the ovarian follicles and can be measured by a simple blood test. This blood test can be done at any time during the menstrual cycle. Calculation of AMH is not dependent on the day of the cycle. The value of AMH ranging from 2.5 to 4.5 is considered as a satisfactory number.

Symptoms:
A decrease in the value of AMH is indicative of decreased ovarian reserves and it generally happens after the age of 35. The decrease in ovarian reserves and the quality of oocytes is sharp after the age of 38. However, the decrease in these numbers happens at a much earlier age in the case of about 10% of women.

Low AMH is generally not presented with any symptoms and is diagnosed during infertility evaluation. However, patients are known to present with:

Symptoms:
As mentioned earlier, the levels of AMH drop with progressing age. There are a few more causes which result in the low AMH levels. These are:
In a handful cases, AMH levels are known to have dropped without any rhyme or reason.

Once the AMH levels start dropping, for couples planning to start a family soon, the first aim should be to achieve conception as soon as possible. This can be achieved via IVF/ICSI with self-oocytes using various available stimulus protocol options. Premedication with DHEA, testosterone gel and Vitamin D3 are known to help improve the egg reserve marginally. Intra-ovarian PRP and stem cell therapy are the newer modalities which are available today, albeit their efficacy remains to be proven. When the ovaries fail to respond, donor oocytes can be used in achieving pregnancy.

AMH levels are going to be low sometimes in life. This is not a condition that can be avoided. The early onset, on the other hand, can be prevented by lifestyle modifications like maintaining a healthy diet regimen, avoiding smoking, alcohol and habit-forming drugs. Regular exercise can also help in delaying the inevitable along with reducing the symptoms associated with the condition.

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