Among the tests that are performed to determine infertility, there is a blood test that measures the levels of AMH (Anti-Mullerian Hormone). So, what is AMH, what does it tell us and what can we do about it?
 
AMH is produced by the granulosa cells in the follicles of an ovary. The major functions of granulosa cells include the production of sex steroids, as well as growth factors thought to interact with the oocyte (egg) during its development. AMH is produced during the follicular stage. Its production is highest during the preantral and antral stages. After this point, AMH levels decrease and eventually stop as the follicle continues to grow. Therefore, the levels are fairly constant and the AMH test can be done on any day of a woman's cycle.
 
Doctors use this test to measure the amount of growing follicles in the ovaries. Women with low levels of AMH indicate low levels of follicles and produce lower levels of immature eggs. 
 
It is very normal for an older woman to have a lower AMH level. Women with many small follicles, typical in women with PCOS, usually have higher levels of AMH. A test result of high AMH may indicate PCOS and is also used to determine excessive or poor response to ovarian hyperstimulation (hCG trigger shot/IVF preparation).
 
 
Low levels of AMH in women under the age of 40 may also indicate Premature Ovarian Failure. Premature Ovarian Failure (POF) is also known as Ovarian Hypofunction and is defined as a loss of normal ovarian function before the age of 40.
  • Research shows that the size of the pool of growing follicles is heavily influenced by the size of the pool of remaining primordial follicles (microscopic follicles in "deep sleep").
  • Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or "ovarian reserve".
AMH levels probably do not tell us much about egg quality, but having more eggs at the IVF egg retrieval gives the clinician more to work with - so they are more likely to have at least one high quality embryo available for transfer back to the uterus.
 
Studies on mice have shown that female mammals can produce egg cells throughout life. The studies showed that follicles may not originate in the ovaries themselves, but within the bone marrow. Some very interesting studies have been conducted on Q10 and AMH levels.
 
 
In a follow-up study performed by Massachusetts General Hospital, lead by Jonathan Tilly, PhD, director of the Vincent Centre for Reproductive Biology in the MGH Vincent Department of Obstetrics and Gynaecology pointed out: “The discovery of oocyte precursor cells in adult human ovaries, coupled with the fact that these cells share the same characteristic features of their mouse counterparts that produce fully functional eggs, opens the door for development of unprecedented technologies to overcome infertility in women and perhaps even delay the timing of ovarian failure.”
 
AMH levels are not thought to determine the quality of the eggs, which is good. So how can someone with a low AMH level increase the amount of follicles they have or support the health in maintaining the ones you currently have?
 
It is extremely important to protect your egg count and health now. It is possible to increase the health of your eggs, which may help protect egg die off, which may help to sustain egg count.
 
As we age the health of our eggs is affected by environmental toxins, poor food choices, circulation, free-radicals, stress, hormonal balance, illness, injury, genetic factors, autoimmune disorders, etc. It is very normal for the health of our cells to decline as we age, but we can also work to protect and support long-term health, which includes our egg health. During our pilot study, we noticed that 71.43% of female candidates (keeping in mind the study was on 20 women only - but it is very interesting). Get in touch or visit our site to find out more.
Fertility Specialist

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