Anti-Mullerian Hormone

Anti-Müllerian Hormone (AMH) is a glycoprotein hormone produced by the granulosa cells of ovarian follicles. It acts as a marker of ovarian reserve, providing an estimate of the number of eggs a woman still has.

AMH levels rise during adolescence, peak in early adulthood, and gradually decline with age, becoming nearly undetectable at menopause. Unlike other reproductive hormones such as FSH or LH, AMH remains relatively stable throughout the menstrual cycle, making it a more reliable and consistent measure of ovarian function.

Clinically, AMH is used to:

• Assess fertility potential and ovarian reserve.

• Predict ovarian response to fertility treatments such as IVF.

• Support the diagnosis of polycystic ovary syndrome (PCOS).

• Estimate the timing of menopause.

AMH is one of the most valuable tools in reproductive and fertility medicine. It provides key insights into how the ovaries are functioning and helps tailor fertility, contraceptive, and lifestyle decisions.

• Low AMH indicates a reduced number of remaining follicles, suggesting a lower ovarian reserve. This may mean fewer eggs available for conception or a shorter reproductive window.

• High AMH is often seen in women with PCOS, reflecting an excess of immature follicles.
  

AMH is also a better predictor of ovarian response to stimulation than traditional hormones such as FSH or estradiol, and it is not significantly influenced by the day of the menstrual cycle, stress, or minor hormone fluctuations.

Tracking AMH over time gives a window into how reproductive potential may change — whether planning for pregnancy, egg freezing, or simply understanding reproductive longevity.

AMH levels change slowly over years, but certain factors can influence them:

• Age: Levels peak in early adulthood and decline steadily, becoming undetectable at menopause.

• Hormonal contraceptives: Long-term use may temporarily lower AMH, often reversible after stopping.

• PCOS: Women with PCOS typically have higher AMH due to an increased number of small antral follicles.

• Lifestyle factors: Smoking and obesity can reduce AMH, while regular physical activity may support healthier levels.

• Medical treatments: Chemotherapy, radiation, or ovarian surgery can significantly reduce AMH by damaging follicles.

• Stress and inflammation: Chronic stress or systemic inflammation may impact ovarian hormone regulation indirectly.

While AMH largely reflects natural ovarian biology, certain lifestyle and medical factors can help protect or optimise ovarian function:

Prioritise reproductive health early

• If planning to conceive later in life or undergoing fertility treatment, consider AMH testing in your 20s–30s to establish a personal baseline.
  

Optimise lifestyle factors

• Avoid smoking and limit alcohol intake.

• Maintain a healthy weight through balanced nutrition and regular exercise.

• Reduce chronic stress, which can influence hormonal balance and ovarian function.
  

Protect ovarian health during medical treatments

• Before chemotherapy, pelvic radiation, or ovarian surgery, discuss fertility preservation options such as egg or embryo freezing with your healthcare provider.
  

Monitor changes over time

• AMH naturally declines with age, but large or sudden drops may signal other underlying issues.

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