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Low AMH levels causes are hormonal imbalance, increasing age, genetic factors, and Endometriosis. Symptoms of low AMH are irregular periods and lack of conception from a long period time. You can take measures to increase AMH levels. IVF with donor eggs is the best treatment for low AMH.
Let’s Discuss in More Details About Low AMH Treatment:
- AMH Levels for the Women Under 35 Years of Age?
- Who Needs to Opt for Anti Mullerian Hormone (AMH) Test?
- Causes of Low Anti Mullerian Hormone (AMH)?
- Symptoms of low Anti-Mullerian Hormone?
- What is the treatment for Low Anti Mullerian Hormone (AMH)?
The Anti-Mullerian hormone is a vital hormone released from the developing follicles in the ovaries. These follicles are egg sacs, which contain immature eggs in them. The state of ovarian reserve can be easily determined with AMH levels in a woman. AMH levels can be determined easily with a regular blood test. AMH levels also provide information about the number of eggs left in the ovaries. Always remember that AMH is a measure to check the number of eggs and not the quality. In simple terms, we can say that AMH is a hormone and hormones should always be balanced for their proper functioning in the body. If any of the hormone levels are too high or too low, it indicates problems in the functionality of the associated organ. (1) (2) (3)
1. Higher levels of AMH
If AMH levels are higher than 4.0 ng/ml, then it suggests that the woman can have PCOS. In such cases, egg reserve is very high but the egg good quality is poor which makes it difficult to conceive. To treat such cases, ovarian stimulation or IVF is required. Some people can conceive naturally too with higher AMH. But if you are trying to conceive for a long time and have very high AMH, probably you need fertility treatment to conceive a baby. (4)
2. Normal Levels of AMH
AMH levels between 1.5 to 4.0 ng/ml are considered normal. If someone has normal AMH values, then her egg reserve is good.
3. Low Levels of AMH
Low AMH levels fall between 1.0 to 1.5 ng/ml. If someone has low AMH levels, it means the woman has poor egg reserve and she needs fertility treatment to conceive. Women with low AMH responds well to ovulation-inducing medications and can conceive with the help of assisted reproductive technology. IVF is the recommended treatment with low levels of AMH. (5)
4. Very Low Levels of AMH
AMH levels are considered to be very low if it is lesser than 1.0 ng/ml. In such cases, female responds poorly to fertility medications and IVF with donor egg is the best-suited choice for the successful conception.
Functions of Anti Mullerian Hormone
- Anti-Mullerian hormone is one of the prime markers to know the number of eggs developing in the ovary of a woman. If AMH levels are low, it indicates that the woman has a poor number of mature follicles in the ovaries.
- Anti Mullerian hormone plays a crucial role in the success of the cases of in vitro fertilization treatment. If AMH levels of the woman are normal, then there are higher chances of IVF success. But if AMH levels are higher than the normal levels, then such a woman has higher chances of developing ovarian hyperstimulation syndrome (OHSS) while taking fertility medications. In such cases, the dosage of the medicine administered is controlled, so that the woman does not suffer from OHSS and has higher chances of getting pregnant. It is very necessary to know AMH levels before starting the treatment so that proper precautions can be taken beforehand. (6)
Anti-Mullerian hormone test is a crucial test for women in case of the following conditions (7):
- Not able to conceive: If a woman is trying to conceive for more than 6 months and is facing several failures in conceiving a baby naturally, then the gynecologist may suggest her to go for AMH test to know her egg reserve along with other fertility tests. The test helps to know the ovarian reserve at that particular stage of life. AMH levels decrease significantly with age.
- Ovarian Surgery: Some of the women have ovarian surgeries at a younger age due to the disorders in the reproductive system. With the help of the AMH test, it can be known whether ovarian surgery has impacted the AMH levels or not. It is checked to know the capability of conceiving in the future with self-egg. (8)
- Ovarian Tumor: Ovarian tumors can also occur in some women at a very early stage of life. This can hamper the chances of pregnancy in the later stages of life. AMH level is the best way to know the ovarian reserve after the treatment of ovarian tumors.
- Before starting IVF treatment:If you are planning to opt for IVF treatment in the near future for conceiving a baby, your gynecologist will advise you to get the AMH test done as soon as possible. Knowing AMH levels help in knowing the chances of the success of the treatment.
- To know ovarian reserve: Finally, if you just want to know the status of your ovarian reserve levels, you can do it with the help of AMH test.
Also, get to know more about Anti-Mullerian Hormone or AMH
Some of the major causes of lower levels of AMH include
- Increasing age
- Hormonal imbalance
- Genetic factors
- Increased stress levels
- Environmental Causes
- Unknown causes in some cases
- Irregular periods stopping of the bleeding are the common symptoms of the low Anti Mullerian Hormone.
- Apart from this, if someone is trying to conceive for more than a year, but still unable to conceive provided everything else is normal, then low AMH values can be the reason for the same.
Low AMH needs to be treated well in time if you want to get pregnant without any delay. You can utilize the best available treatments for curing the low levels of the antimullerian hormone. There are various types of fertility treatment available to help the couples conceive. It is important to focus on the treatments, which provide high success rates for the women who are detected with the low AMH.
IVF and IVF with donor eggs are used successfully for treating women with different infertility issues especially to manage lower AMH values. With the help of these treatments, many women are enjoying the happiness of motherhood.
In vitro fertilization:
In Vitro Fertilization techniques have proved to be a successful option for treating women with low AMH levels. Women with low AMH levels can conceive successfully if they consult an infertility specialist at the right time. This helps a woman to have a baby with artificial reproductive techniques like IVF.
Based on the levels of AMH of the woman, the infertility specialist utilizes stimulants and medications in the procedure. This helps in improving the response of the woman to in vitro fertilization treatment. Also, it is essential that you understand & discuss the case with your doctor clearly before starting the treatment. Women with low AMH need to receive required medical attention as soon as possible so that the doctors are able to treat them with a proper treatment protocol to achieve the desired results. (9)
In vitro fertilization comprises a series of steps as mentioned below:
- Ovaries are stimulated with hormonal drugs to ensure the growth of multiple eggs. Stimulation depends upon the AMH values. If AMH values are high, then stimulated is controlled, so that the woman does not suffer from Ovarian Hyper Stimulation Syndrome (OHSS).
- Egg retrieval process is carried out.
- Sperm and eggs are then combined for fertilization in the IVF lab.
- The Embryo is allowed to develop for the next 3-4 days in the lab.
- The embryo is then implanted into the uterus of the woman.
- This completes in vitro fertilization technique in the women. The specialist then waits for 2 weeks before taking the pregnancy test.
- In some of the patients if the chances of getting pregnant with IVF are very poor, then priming with DHEA and testosterone is recommended.
IVF with Donor eggs
IVF with donor egg is one of the most successful fertility treatment options, which is responsible for attaining pregnancy with very low AMH levels. During this procedure, an egg donor helps out another couple by donating her eggs for their IVF either for a monetary or social purpose. The entire process takes around 3-6 weeks of the time period. This process is technique sensitive and requires a skillful specialist to carry it out. (10)
- Firstly, the IVF specialist or gynecologist checks and finalizes the donor individual after screening her for various diseases.
- If she is eligible for egg donation, then the specialist takes out the donor eggs from the egg donor. Afterward, the donor eggs are combined with sperms of the male partner in the lab.
- Thus embryo formed is implanted into the uterus of the woman. This completes the entire procedure of donor egg implantation.
- Use of donor egg infertility treatments has provided excellent results for the women who have extremely low AMH levels in the body.
If you are trying to conceive from a long time but not able to get pregnant, then you should get some basic fertility tests done along with AMH test. Males should also undergo semen analysis test because 30% of the infertility issues are reported in male partners.
SOURCES AND REFERENCES:
- ^ The Role of Anti-Mllerian Hormone in Female Fertility | NCBI Ncbi.nlm.nih.gov, 07 August 2019
- ^ Anti-Mullerian Hormone | Lab Tests Online Labtestsonline.org, 07 August 2019
- ^ Anti-Mullerian hormone | MedlinePlus Lab Test Information Medlineplus.gov, 07 August 2019
- ^ Higher levels of High Amh Levels in Women Under Age 35 Fertstert.org, 07 August 2019
- ^ Low AMH Levels: What Patients Should Know | Fertility and Sterility Fertstert.org, 07 August 2019
- ^ Functions of Anti Mullerian Hormone Longdom.org, 07 August 2019
- ^ Anti Mullerian Hormone During Natural Cycle Frontiersin.org, 07 August 2019
- ^ Oophorectomy (Ovary Removal Surgery) | Mayo Clinic Mayoclinic.org, 07 August 2019
- ^ In vitro fertilization (IVF) | Mayo Clinic Mayoclinic.org, 07 August 2019
- ^ Why Should You Use an Egg Donor? Webmd.com, 07 August 2019
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