Ovarian Reserve – AMH

Ovarian reserve describes the number of eggs remaining in the ovaries. Assessing ovarian reserve can help couples better understand conception chances and make informed decisions about assisted reproduction treatment. One of the most reliable indicators for estimating ovarian reserve is anti-Müllerian hormone (AMH). This page explains what ovarian reserve is, why AMH matters, and how this information can help couples trying to conceive.

What is Ovarian Reserve?

Ovarian reserve refers mainly to the number of follicles present in the ovaries at a given time. Follicles contain the eggs necessary for conception. As women age, ovarian reserve naturally decreases, which can negatively affect fertility.

Significance of Ovarian Reserve

Ovarian reserve is important for various reasons:

Conception Probability: The quantity and quality of follicles affect conception probability, both naturally and with the help of assisted reproduction.
Success of assisted reproduction treatments: Ovarian reserve can affect the success of treatments such as in vitro fertilisation (IVF).
Treatment Selection: Assessing ovarian reserve helps doctors recommend appropriate treatment for each patient.

Methods for Assessing Ovarian Reserve

There are various methods for assessing ovarian reserve, such as:

Antral Follicle Count (AFC): Counting antral follicles with ultrasound is one of the most common ways to assess ovarian reserve.
FSH (follicle stimulating hormone) levels: Blood tests for FSH levels at the beginning of the menstrual cycle can provide information about ovarian function.
AMH (anti-Müllerian hormone) levels: Measuring AMH in the blood is one of the most reliable indicators of ovarian reserve.

What is AMH?

Anti-Müllerian hormone (AMH) is a hormone produced by antral follicles in the ovaries. The concentration of AMH in the blood is an indicator of the quantity of follicles present in the ovaries and, by extension, ovarian reserve.

How is AMH used in fertility care?

Measuring AMH can help estimate the likely ovarian response to stimulation.

1. Predicting ovarian response

AMH helps predict ovarian response to stimulation during in vitro fertilisation. Women with high AMH levels usually have better response to stimulation and produce more eggs.

2. Adjusting treatment protocol

AMH results can help clinicians individualise an ovarian-stimulation protocol alongside age, ultrasound findings and treatment history.

3. Fertility assessment

AMH helps estimate egg quantity and the likely response to ovarian stimulation; it does not, by itself, measure egg quality or predict natural conception.

4. Planning egg freezing

For people considering egg freezing, AMH may help estimate the likely number of eggs retrieved, while age at the time of freezing remains the main determinant of egg quality and future treatment outcomes.

How is AMH measured?

Measuring AMH is a simple blood test that can be done on any day of the menstrual cycle. The test results provide information about ovarian reserve and help assess fertility.

What do AMH levels mean?

High AMH: May be associated with a higher ovarian response to stimulation and an increased risk of ovarian hyperstimulation syndrome (OHSS). Higher AMH levels are also common in people with polyendocrine metabolic ovarian syndrome (PMOS), formerly called polycystic ovary syndrome (PCOS).
AMH within the expected range: Suggests an expected response to ovarian stimulation but does not guarantee pregnancy or live birth.
Low AMH: May indicate a lower expected egg yield after ovarian stimulation. It does not, by itself, diagnose infertility or predict natural conception.

Factors Affecting AMH Levels

Various factors can affect AMH levels, such as:

Age: AMH levels naturally decrease with age.
Underlying medical conditions: Conditions such as PCOS may increase AMH levels.
Surgical interventions: Surgical procedures on the ovaries may affect AMH levels.
Cancer treatments: Treatments such as chemotherapy and radiation therapy may reduce AMH levels.

Can ovarian reserve be increased?

Ovarian reserve cannot be increased. A healthy lifestyle supports general and reproductive health but does not restore the number of eggs in the ovaries.

Healthy diet: Consuming a balanced diet rich in fruits, vegetables, and proteins can help preserve ovarian health.
Exercise: Regular exercise can improve overall health and help maintain a healthy weight.
Avoiding toxins: Avoiding toxic substances, such as smoking and excessive alcohol consumption, can help preserve ovarian function.
Stress management: Relaxation techniques such as yoga and meditation may support wellbeing, but they have not been shown to increase ovarian reserve.

Conclusion

Ovarian reserve is a critical factor affecting a woman’s fertility. Assessing ovarian reserve through AMH measurement can provide valuable information about the success of assisted reproduction treatments. If you are trying to have a child or considering egg freezing, measuring AMH can help you make informed decisions about your reproductive health. Contact Dr Venetis to learn more and begin your journey toward achieving your fertility dream.