What is the AMH test? In what situations is it used?
Antimullerian Hormone (AMH) is a substance that is usually released from the granulosa cells of small eggs that are starting to grow. In women, since AMH can provide information about even small cells that are sometimes invisible with ultrasound, it is the most important marker used in recent years to determine the reserve of ovaries (working capacity of the ovaries).
As a woman gets older, the number of egg cells visible on ultrasound decreases and AMH levels also begin to decrease. While very low levels can be detected in a woman close to menopause, sometimes very high (2-3 times normal) AMH levels can be encountered in women with polycystic ovary syndrome having many small egg cells.
Low AMH levels are a stimulus for early menopause especially in women under 35. These patients should be informed about the options of either starting treatment as soon as possible if there is a desire to become pregnant or egg freezing if there is no desire to become pregnant yet.
It is an advantage to be able to check the AMH value on any day of the menstrual cycle. Since it is not affected by the levels of other hormones such as FSH, it gives us more reliable information about the reserve of ovaries. Usually, very large differences are not observed between the AMH levels obtained in different menstrual periods.
AMH is a successful marker to show the treatment response in our IVF patients. Fewer eggs are collected at low AMH levels, while at high levels (such as polycystic ovary syndrome) a large number of eggs can be collected. Very high AMH levels are important to demonstrate the risk of overstimulation of the ovaries (hyperstimulation syndrome). In such cases, drug doses should be adjusted more carefully.
How to analyze AMH values?
High ( AMH > 4 ng/ml )
Normal ( AMH 1.5-4 ng/ml )
Low ( AMH < 1.5 ng/ml )
Very low ( AMH <0.5 ng/ml )
It is very important not to be alarmed immediately, but to use time wisely in case when very low AMH levels are detected. Most of the time we inform our patients who apply with questions such as "Won’t I have a baby?" that first of all the AMH value is mostly related to the number of eggs and that they have a chance of developing high-quality eggs and getting pregnant.
As a result, although the AMH level is low, we may not be able to obtain a large number of eggs/embryos or embryos to be frozen with treatment, but very high-quality embryos with a high probability of pregnancy can still be obtained. In our clinic, many pregnancies have occurred even when the AMH value is below 0.1 ng/ml, thus don't give up and don't worry. You just have to make use of the time well.