When it comes to fertility, there are a lot of acronyms out there — from DPO (days post-ovulation) to IVF (in vitro fertilization), and so many more. But there’s one acronym that’s incredibly important, yet not often considered until people are deep into the processing of TTC (trying to conceive).
That acronym is AMH, which stands for antimullerian hormone. Essentially, this hormone is used as a marker of egg quantity. It plays a major role in overall fertility: A 2019 study dubbed AMH the most reliable indicator of ovarian reserve, and one of the most powerful indicators of a person’s reproductive potential.
AMH is an easy way to gauge a bit about a person’s fertility, as it simply involves a blood test — which means if you have any concerns about your overall fertility, that’s one of the first data points to consider.
If you’ve been told you have low AMH, you may be wondering if that number is fixed or if there’s anything you can do to raise those levels. Boosting fertility is, after all, something many of us think a lot about — we’re willing to do anything to improve our odds of building our families, and in addition to medical intervention, we also seek out lifestyle modifications to do so.
So is there anything we can do to boost AMH levels, whether we’ve been told our levels are low or just in the name of improving fertility? Jessica Ryniec, MD, a reproductive endocrinologist, weighs in.
First of all: What does AMH measure?
“Antimullerian hormone is a hormone that is made by granulosa cells in the ovary which are cells that help support the resting follicles that contain eggs,” says Dr. Ryniec. “AMH is used as a marker of the number of eggs someone has remaining [AKA] ‘ovarian reserve’. People with many follicles (such as with polycystic ovarian syndrome) would be expected to have high AMH levels, whereas people with few remaining follicles (like in diminished ovarian reserve) would be expected to have low AMH.”
As we’ve previously shared, diminished ovarian reserve impacts up to 30 percent of women who struggle to conceive. AMH relates to the number of eggs: Women are born with all the eggs they’ll have throughout their lifetime, and that number dwindles with age. AMH is an indicator of egg quantity, but not an indicator of egg quality.
What are some causes of low AMH?
Egg quantity declines over time, so age is a major factor when it comes to AMH — but it’s not the only factor.
According to Dr. Ryniec, life events like perimenopause or menopause, hormonal suppression (like with birth control), pregnancy and breastfeeding, can all affect AMH.
Additionally, medical conditions like endometriosis, autoimmune diseases, and certain genetic conditions can also play a role.
Health interventions like ovarian surgeries, chemotherapy or other ovarian-toxic medical therapies can also affect AMH levels. As far as lifestyle factors go, smoking can diminish AMH.
Speaking of lifestyle factors — are there any that can raise AMH levels?
You may have heard that things like diet, exercise, supplement use, stress reduction, or other lifestyle modifications can help boost your AMH levels. The reality? It’s likely not worth overhauling your lifestyle with this goal in mind.
“While AMH levels may appear lower or higher at different times or at different labs, there is no way to actually raise your egg count even if the AMH level looks better,” says Dr. Ryniec.
“This is because people born with ovaries are also born with all the eggs they are going to have and diet, lifestyle factors, medications, supplements etc cannot increase that as we do not make new eggs,” she explains.
With that being said, there are things that can help us not lose eggs faster than is typical.
“That would be a better thing to focus on: Overall healthy diet and lifestyle, hydration, sleep, exercise, avoiding smoking and endocrine disruptors for example,” advises Dr. Ryniec. “If the AMH appears to be lower than anticipated for age, [we] can look at history and current lifestyle factors to see if it could be suppressed or if it appears to be true low ovarian reserve."
Let’s address common misconceptions where AMH levels are concerned
When it comes to health — especially women’s health — there are a lot of conflicting messages and bold claims that aren’t actually grounded in science. That leaves women stressed and expending energy on things that won’t really make a difference.
“There is a lot of misinformation and to me what seems to be targeting a vulnerable population with supplements and therapies that are proposed to increase AMH levels and thereby possibly improving outcomes and I encourage people to be wary of things that seem too good to be true,” says Dr. Ryniec. “While some studies do show blood hormone levels may increase in response to different therapies, these studies have NOT shown that this has translated to improved eggs retrieved, embryos created, or resulting pregnancies in an IVF setting.”
So what’s a better evidence-based approach?
“Unfortunately right now there are no evidence-based options, however this is definitely an area of exciting research that I am very hopeful will change over the course of my career,” says Dr. Ryniec.
But for people who’ve been told they have low AMH, there’s some good news
Dr. Ryniec clears up another common misconception regarding low AMH levels.
“A low AMH does not cause infertility unless it is so low that someone is no longer ovulating,” she says. “Since we only ovulate one egg a month, it does not matter how many eggs we have in the bank, everything relies on that one egg.”
“What AMH is more helpful for is predicting a response to IVF which is a treatment that relies on the ability to get more eggs than we are able to make on our own, she adds.
If you have low AMH, here’s what you can do
If you’ve been told your AMH levels are low, it’s probably not a good idea to try and get these levels up on your own. When it comes to fertility, time is often of the essence, and it makes more sense to work with a doctor instead of wasting time attempting to “raise your ovarian reserve” at home. Ultimately, there’s no proven way to really do that.
“Anyone at any age with a low AMH should be seeing a fertility doctor from the beginning to understand the nuances of what AMH levels actually mean and what the best next steps are for them (it's not necessarily fertility treatment!),” say Dr. Ryniec. “They need to understand a low AMH alone doesn't necessarily mean they are going to have difficulty getting pregnant if they haven't already been trying to conceive. If they find a low AMH and they HAVE been already trying to conceive- then they should see a fertility doctor to discuss the best strategies to help them conceive.”
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.