If you or anyone close to you has been trying to get pregnant, you may have heard a term being discussed frequently – AMH. AMH is an important marker in fertility evaluation. What is it and why is it high in cases of PCOS? How to reduce AMH levels in PCOS? We will try to explain it all in this article.
What is AMH?
AMH, Anti Mullerian Hormone, or Mullerian Inhibiting Substance (MIS) is a hormone secreted by reproductive tissues in males and females. In a female foetus, low levels of AMH trigger the development of female reproductive organs. In a male foetus, high levels of AMH lead to the development of male reproductive organs.
AMH levels are related to how many small follicles (also called antral or resting follicles) are found on the ovary every month.
Why is AMH Score Important?
In females, AMH is produced in ovarian follicles, which are fluid-filled sacs containing eggs. These eggs, when released from the follicles, help you conceive.
The American College of Obstetricians and Gynecologists (ACOG) states that the production of AMH is reflective of your ovarian reserve. However, AMH levels are not representative of the egg quality, which also determines fertility.
AMH levels are diagnosed through a blood test on any day of your menstrual cycle. For accurate analysis, AMH tests should be performed in combination with an antral follicle count (AFC), a test for the number of small follicles within both ovaries.
A higher AMH score indicates that you have more eggs to be released. However, the AMH score decreases as the ovarian reserve (egg count) declines with age.
As a general guideline, the lower limit of serum AMH values by age in nanograms per millilitre are:
- 45 years old: 0.5 ng/mL
- 40 years old: 1 ng/mL
- 35 years old: 1.5 ng/ mL
- 30 years old: 2.5 ng/mL
- 25 years old: 3.0 ng/mL
How is AMH related to PCOS? What are the AMH levels in PCOS? Let’s find out.
AMH Levels: PCOS
An AMH score above 4.0 ng/mL may be regarded as it can be a sign of PCOS. However, it is important to discuss your AMH score with a doctor as it should be read taking a number of factors into account, especially your age.
Polycystic ovary syndrome(PCOS) is a hormonal disorder common among women of reproductive age. In women with PCOS, the ovaries produce more than the normal amount of male hormones called androgens.
The high levels of androgen produced in your body lead to inhibited follicular development and high levels of AMH. As a result, the ovaries cannot release eggs (ovulation), which causes irregular menstrual cycles and other PCOS symptoms.
Although AMH levels may be high in women with PCOS, it is not used as a diagnostic criterion for PCOS.
How to Reduce AMH Levels in PCOS Naturally?
If you have high AMH levels, it needs to be managed effectively in order to prevent infertility. PCOS cannot be cured. It can only be managed. If PCOS is managed successfully, AMH levels are also expected to come down along with the resolution of other PCOS symptoms.
PCOS can be managed with lifestyle changes. Eating a balanced diet, regular physical activity, and maintaining weight in a healthy range can help in the improvement of several PCOS symptoms.
Make sure to stay active and exercise regularly. Other than maintaining a healthy weight, exercise also helps you control your blood sugar levels and PCOS symptoms. Aim for 30 minutes of exercise for at least 5 days a week.
Small dietary changes, when practised consistently, can help you manage PCOS. You can adopt a balanced diet including more fruits, vegetables, whole grains, nuts, seeds, and low-fat dairy in your meals. Also, try to have smaller portions multiple times a day.
High AMH Levels and PCOS Treatment
PCOS treatment could help bring down the AMH levels associated with PCOS. The treatment of PCOS with medications and lab procedures depends on whether you want to get pregnant or not. Treatment options include:
- Hormonal Birth Control: It uses a combination of oestrogen and progestin to decrease androgen production and regulate oestrogen levels in the body. This option is available in the form of pills, patches, shots, vaginal rings, or intrauterine devices (IUDs).
- Insulin-Sensitising Medication: Metformin, a drug used to treat diabetes, works on PCOS by reducing insulin resistance.
- Medications to Induce Ovulation: Drugs such as metformin, clomiphene, and letrozole are taken orally, while gonadotropins are given by injection to induce ovulation.
- In Vitro Fertilisation (IVF): Matured eggs are retrieved from your ovaries and fertilised with your partner’s sperm in a lab. The fertilised eggs are transferred into your uterus where they may grow into a healthy pregnancy.
Don’t Have Time To Read?
- Polycystic ovary syndrome (PCOS) is a hormonal disorder common in women of childbearing age. In this condition, your ovaries produce more androgens (male hormones), which leads to problems with ovulation and high levels of AMH.
- AMH or Anti Mullerian Hormone is a hormone secreted by ovarian follicles (fluid-filled sacs containing eggs) in women. A higher AMH score indicates that you have more eggs to be released.
- It is important to know the role of AMH in PCOS. A high level of AMH indicates a good amount of eggs yet to be released from your ovaries. However, increased levels of androgens can also inhibit the formation of follicles, and lead to infertility.
- Although AMH levels may be high in women with PCOS, it is not used as a diagnostic criterion for PCOS.
- The high levels of AMH can be reduced naturally by managing PCOS with regular exercise and a balanced diet including more fruits, vegetables, whole grains, nuts, seeds, and low-fat dairy in your meals.
- PCOS treatment modalities such as hormonal birth control, insulin-sensitising or ovulation-inducing medication, and in vitro fertilisation may bring down AMH levels.
- Use the Phable Care App to consult India’s leading diabetologists, order medicines, book lab tests, integrate blood sugar monitoring and other devices to get real-time remote care from the comfort of your home. Also, check out our Diabetes Management program which provides 360º care. Let’s treat diabetes together.
AMH levels above 4 ng/mL are generally indicative of PCOS. The high number of developing follicles in PCOS releases a large amount of AMH in your body. This, in turn, prevents the release of eggs from the ovaries (ovulation).
No. AMH levels may be high in women with PCOS and a value above 4 ng/mL usually indicates PCOS. However, a high AMH level by itself is not enough to diagnose PCOS because AMH levels vary over the life of a woman and usually reduce as a woman ages. To confirm a diagnosis of PCOS, at least two of the following criteria also need to be met:
- Irregular or missed periods
- An ultrasound showing multiple cysts on the ovaries
- Lab results showing increased levels of androgens or physical signs of the same such abnormal hair growth or acne
Studies suggest that a value between 2.2 - 3.9 ng/mL is considered optimal for fertility. This range of AMH values indicates a good ovarian reserve. However, AMH levels alone cannot predict anybody's fertility. Pregnancy depends on many other factors, including the partner’s sperm quality, the condition of the fallopian tubes, and whether ovulation is occurring.
There is an increase in AMH in PCOS because the condition is characterised by a large number of developing follicles or egg sacs with immature eggs. These follicles in their development stage release more AMH in your body. If you are wondering how to reduce AMH levels in PCOS, the management of PCOS with healthy lifestyle changes and medication if needed may bring down AMH levels as well.
AMH is a hormone secreted by reproductive tissues in males and females. AMH levels may be high in women with PCOS and a value above 4 ng/mL usually indicates PCOS. You can effectively reduce AMH levels by managing PCOS by eating a balanced diet, being physically active, maintaining a healthy body weight and taking proper medications.