Does this sound familiar…you’re having trouble getting pregnant or have had a couple miscarriages (or more). Doc decides it’s a good idea to check your hormone levels. He rambles on about AMH, FSH, blah blah blah. You nervously await the results and finally they’re in. You walk into the docs office, heart beating a thousand beats a minute and…
You hear those dreaded words. You’re AMH levels aren’t normal and it looks like you’re running out of eggs. You better do IVF right away if you want a chance of having a baby.
This exact scenario happens way too often! And honestly, so often it’s complete BS!
So, today I want to talk about the two hormone levels that lead docs to having this conversation with you….AMH and FSH. And I want to clear up the misconceptions about what these hormones do and what it means when the levels are outside “normal limits”.
What is AMH?
AMH stands for anti-mullerian hormone and is often used by docs to give you a glimpse into your ovarian reserve (number and quality of eggs).
Each month your body prepares multiple eggs and chooses the “best” one to release for fertilization. These eggs live in fluid filled sacs, called follicles, within your ovaries. The follicles contain cells that produce hormones and support egg maturation. One of the hormones produced by these cells is AMH. This means the more follicles the more AMH.
That being said, there is a sweet spot. Too few follicles and your AMH is considered low and according to conventional fertility medicine this means you have low ovarian reserve. Too many follicles and your AMH is considered high and is an indication of polycystic ovarian syndrome (PCOS).
Sounds simple, right? Well…it’s not quite that easy.
Conventional medicine tends to look at hormone levels from a black and white viewpoint. Problem is, nothing with the human body (and especially fertility) is that black and white.
Causes of low AMH
Yes, low AMH can be a sign of diminished ovarian reserve. However, there are many other possible underlying causes as well. And, if you’re under the age of 40 and have low AMH, it’s more likely that there is a correctable underlying cause than that you actually have diminished ovarian reserve.
Some potential underlying causes of low AMH include:
- Birth control obviously affects hormone levels and basically “turns off” your reproductive system. It’s not abnormal to have a lower AMH level for a while after stopping birth control. The longer you were on birth control the longer it will take for your hormones to return to a normal level.
- Stress is a normal part of life. However, too much stress can play a big role in infertility and can result in low AMH. If your body is under excess stress (physical or emotional) it may respond by decreasing normal reproductive function. Bottom line, if you’re struggling to handle the physical and/or emotional load as is, your body is going to try and minimize added stressors – such as pregnancy. Want helpful tips to cope with stress? Click here
- Vitamin deficiency is another potential cause of low AMH. Vitamin D deficiency is the best studied and most recognized deficiencies resulting in low AMH levels.
- General hormone imbalance is often the underlying cause of many hormone level issues, AMH included. No hormone works independently of others. Therefore, if one hormone is off (even a little) it tends to be a cascade effect. Things such as diet, stress, and lifestyle can all impact your overall hormone health.
Causes of high AMH
The most common cause of high AMH is PCOS. Women with PCOS have a high level of antral follicles (remember, these follicles produce AMH), which results in a high AMH level. This can be a problem because high levels of AMH can stop ovulation. Obviously, that’s the last thing you want if you’re trying to get pregnant.
Now, it’s important to keep in mind that PCOS is a hormone imbalance. So, even if you’ve been diagnosed with PCOS it doesn’t mean it can’t be corrected and it is does not have to mean you won’t be able to get pregnant.
Can I get pregnant with low AMH?
The simple answer is YES!
I know, I know…that’s completely different then what your fertility doc is telling you. Just hear me out.
Your AMH level indicates how many eggs are being prepared each month. From those eggs your body picks the best one to release. If your AMH level is high you may have 10-12 follicles all containing an egg that is being matured for ovulation. If your AMH is low, you may only have a handful, or less, of follicles.
But, here’s the thing…you only need ONE good egg to get pregnant. So even if you only have a few follicles, as long as you’re still releasing an egg, you have a chance to get pregnant each month.
In fact, a well known study that tracked women trying to get pregnant over 12 months showed no difference in frequency of pregnancy for women with low AMH levels compared to women with normal AMH levels. Mind blown, right???
Can I raise my AMH?
AMH levels naturally decrease as we age, becoming virtually nonexistent at menopause. That being said, having a low AMH level prior to entering your 40’s isn’t normal. Meaning, if you aren’t at menopausal age and your AMH level is low there is likely an underlying cause. Raising your AMH involves correcting the underlying cause. As mentioned earlier, some of the most common are birth control (or synthetic hormone) use, hormone imbalance, stress, or vitamin deficiency.
Bottom line, all hope is not lost even if your AMH is low. You can still get pregnant naturally, even with low AMH. And on top of that, you can take back control of your hormones and start doing things that will bring that level up.