AMH and ovarian reserve

Each woman is born with her lifetime supply of eggs (oocytes) and these gradually decrease in both quality and quantity with age. Declined fertility is caused by “ageing” of ovaries. OVARIAN RESERVE starts to decline at the age of 25 and at the age of 30 it declines significantly.

After birth each girl has about 1 million eggs in her ovaries and until her puberty approximately 300,000 remain.  Within reproductive period about 300 eggs are released during ovulation. Remaining eggs disintegrate.  The process of egg decline is set in each woman and is not affected by using contraception, infertility treatment, or the number of deliveries. However, there is evidence that tobacco smoking may precipitate egg disintegration and the onset of menopause.

In girls ANTI-MÜLLERIAN HORMONE (AMH) starts to be produced only in puberty and is produced by granulose cells of follicles in the ovaries.

An important role of AMH in women is regulation of follicular maturation. Thus it allows follicles to mature gradually and not a great number of them at once, so the reserve of eggs is not used up too early.

AMH is an indicator of ovarian function and is appropriate for assessing the condition in the presence of polycystic ovaries and also premature failure of ovarian function.  After menopause AMH is undetectable in blood.

AMH level does not change during your menstrual cycle, so the blood sample can be taken at any time of the cycle – even while you are using hormonal drugs. The test is performed from a blood sample and AMH level is determined and assessed. Thus, “follicular reserve” is monitored.

You do not need to come for taking the blood on the empty stomach.

Using AMH in diagnosis:

monitoring polycystic ovaries (PCO)

monitoring “follicular” reserve, particularly prior to IVF – it is shown, that women with higher AMH concentration have a better chance to get pregnant after stimulation.

AMH level does not tell us much about the quality of eggs.