Low Egg Reserve (AMH) What is it?, Causes and Treatment

The decrease in the number of eggs in women is a common cause of infertility today. In women, both the number of eggs and egg quality decrease after a certain age. This may prevent individuals from having children by reducing the chance of eggs being fertilized. This condition, which means a decrease in the fertility hormone called AMH, can sometimes be seen in young women. You can take a look at the rest of the text to learn more about low egg reserve.

What is Low Egg Reserve (AMH)?

Low ovarian reserve is a condition that affects a woman’s reproductive ability, often indicated by low anti-mullerian hormone (AMH) levels. AMH is a protein produced by small follicles in the ovaries, and these levels are used as an indicator of ovarian reserve. Ovarian reserve refers to the number and quality of a woman’s remaining eggs.

A low AMH level indicates that a woman has fewer eggs available for fertilization. This can make it more difficult for women to conceive naturally or with supportive reproductive technologies such as in vitro fertilization. Low ovarian reserve can occur for a variety of reasons, including age, genetic factors, certain medical conditions, and lifestyle factors.

Women with low ovarian reserve may have difficulty conceiving, have an increased risk of miscarriage, and may respond less effectively to fertility treatments. But low AMH levels don’t just mean that a woman can’t get pregnant; it is simply an indicator of a decrease in reproductive potential.

What Should the AMH Hormone Value Be?

The ideal or “normal” value of an AMH (anti-müllerian hormone) level may vary from one laboratory to another and depending on factors such as the testing method used and may be affected by factors such as the age of the individual. However, in general AMH levels can be categorized as follows:

• High Normal or Elevated Range: Approximately 2.0 to 6.8 ng/mL (nanograms per milliliter) or higher. Elevated AMH levels may indicate a greater ovarian reserve, which can be associated with conditions such as polycystic ovary syndrome (PCOS).
• Mid Range (Typical Normal Range): Approximately 1.0 to 2.5 ng/mL. This is considered typical normal AMH levels for healthy women of reproductive age.
• Low Normal Range: Below 1.0 ng/mL. Although still considered normal, lower AMH levels may indicate slightly reduced ovarian reserve.

Interpretation of AMH levels should be made in consultation with a healthcare professional, especially if a woman is concerned about her fertility or will be undergoing assisted reproductive treatments such as in vitro fertilization (IVF).

What are the causes of low AMH?

Low anti-mullerian hormone (AMH) levels can be affected by a variety of factors, and in many cases the exact cause may not be immediately apparent. Common factors associated with low AMH levels may include:

• Age: AMH levels naturally decrease as a woman ages. Older women often have lower AMH levels, which is considered a sign of decreased ovarian reserve.
• Premature Ovarian Aging (Premature Ovarian Failure): Some women experience a significant decline in ovarian reserve earlier than expected, a condition known as premature ovarian aging or premature ovarian failure. This can be triggered by genetic factors, autoimmune diseases, or certain medical treatments.
• Polycystic Ovary Syndrome (PCOS): While PCOS is often associated with high AMH levels, some women with PCOS may have lower than expected AMH levels, indicating that AMH levels may vary within the condition.
• Some Medical Treatments: Some cancer treatments, such as chemotherapy and radiation therapy, can damage the ovaries and lead to low AMH levels.
• Genetic Factors: Genetic factors may play a role in determining a woman’s ovarian reserve and AMH levels.
• Lifestyle Factors: Smoking and exposure to environmental toxins can negatively affect ovarian reserve and, in turn, AMH levels.

It is important to remember that low AMH levels are not always an indication of infertility, and many women with low AMH can still become pregnant. It is worth noting that other factors such as general health and the age of the individual also play an important role in determining fertility.

When Should AMH Test Be Done?

The timing of anti-mullerian hormone (AMH) testing may depend on your specific condition and why you are considering testing. Common scenarios in which AMH testing is usually performed include:

• Fertility Evaluation: Many women have AMH testing as part of their fertility evaluation. If you are questioning your fertility status and the possibility of pregnancy, this test can usually be done at any time during your menstrual cycle. It is not cycle dependent, so you can have it done at any time you want.
• Evaluating Ovarian Reserve: For women who are concerned about their ovarian reserve or planning reproductive treatments such as in vitro fertilization (IVF), AMH testing is usually done early in the menstrual cycle, usually between the second and fifth day (Days 2-5). This timing is more suitable for a more accurate assessment of ovarian reserve.
• Assisted Reproductive Technologies: If you are considering assisted reproductive technologies such as in vitro fertilization (IVF), your healthcare provider may recommend AMH testing as an initial evaluation to determine the best treatment plan.
• Monitoring Ovarian Function: In cases where medical conditions or treatments may affect ovarian function, AMH testing may be done at various times to monitor as needed.

It is important to consult with a healthcare professional, especially a reproductive specialist, to determine the optimal time for AMH testing based on your particular circumstances and why you want the test. They can help you make informed decisions about your reproductive health by guiding you through the timing and interpretation of results.

Is There a Treatment for Low Egg Reserve?

There is no specific medical treatment that can significantly increase a woman’s egg reserve, which is naturally low due to reasons such as aging. However, there are a variety of options and approaches that can be considered depending on the individual’s specific situation and goals:

• Fertility Preservation: Women with low egg reserves who want to have children in the future may consider fertility preservation methods such as egg freezing (oocyte cryopreservation). This allows them to keep their eggs younger and potentially of better quality, which they can then use for assisted reproduction.
• In Vitro Fertilization (IVF): For women with low egg reserve, IVF may still be an option. The quantity of eggs may be limited, but the quality of the remaining eggs is important. Some women with low ovarian reserve have successfully become pregnant through IVF.
• Donor Eggs: Particularly in cases of severely diminished egg reserve or poor egg quality, the use of donor eggs from a young, healthy donor may be a valid option to achieve pregnancy.
• Hormonal Stimulation: Some women with low ovarian reserve may be candidates for gentle ovarian stimulation protocols in IVF. This can help increase the number of eggs retrieved in a cycle.
• Consultation with a Reproductive Specialist: It is extremely important for individuals with low egg reserve to consult with a fertility specialist. Specialists can provide a detailed evaluation, discuss options, and create a treatment plan tailored to the individual’s unique situation.
• Lifestyle and Holistic Approaches: Maintaining a healthy lifestyle can support overall reproductive health, as can a balanced diet, regular exercise, and stress reduction. Some individuals explore holistic treatments or alternative therapies, although the effectiveness of these methods may vary.

Can Early Menopause Be Prevented?

Early menopause generally refers to menopause under the age of 40 and is mainly influenced by genetic and hormonal factors. It cannot be completely prevented, but individuals can take steps to promote reproductive health and postpone the onset of early menopause. Maintaining a healthy lifestyle that includes a balanced diet and regular exercise can be beneficial. For people at risk, reproductive preservation methods such as egg freezing are also an option. Managing underlying medical conditions and discussing hormone replacement therapy with a healthcare professional may also offer other options.

Individuals who have problems with low AMH or early menopause can consult a healthcare institution to get more information on these issues.