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What your AMH level really means

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What your AMH level really means

May 21, 2019 in Studies Say, The Real Deal

If you’ve ever looked into getting fertility testing, you might be familiar with AMH. AMH, or anti-Müllerian hormone, is a hormone secreted by the ovarian follicles, so the higher your level, the more follicles (potential eggs) you’re expected to have. AMH testing is typically used as an indicator of your egg count.

But if you’re like many women, you might get the results of your AMH test and feel like, what now? It’s super important to look at that number in context, to understand whether it’s high or low (compared to the average) and what it really means for your chances of getting pregnant or the effectiveness of egg freezing or IVF.

Want to learn more about egg freezing with Extend Fertility?

What your AMH level can and can’t tell you

First things first: let’s clear up any misconceptions about the AMH test being a “holy grail” fertility test. It’s not—it’s just one piece of data among the many that a doctor will use to gauge your fertility health. Your AMH level isn’t a test of whether or not you can get pregnant right now. First of all, your AMH level tells you only how many eggs you have left—and nothing about the quality (or genetic health) of those eggs, which is actually much more important when it comes to getting pregnant. There’s no test for egg quality, but it declines with age in a predictable way. Learn more about egg quality.

AMH levels can’t tell us if you have fibroids, uterine scarring, or another condition that might make it harder to conceive. An AMH test also can’t tell us how quickly your egg count is decreasing, since it’s just a snapshot of your levels at one specific point in time.

Learn more about what ovarian reserve testing can really tell us.

But, that doesn’t mean it’s not useful. A particularly low AMH for your age can point to the possibility of early menopause, while an abnormally high AMH level may indicate polycystic ovary syndrome (PCOS), a hormone imbalance that can make it harder to get pregnant. And in the world of egg freezing, AMH offers us one critical piece of information: how many eggs you’ll be likely to freeze in one cycle.

Understanding the “average” AMH

Many women want to understand whether their AMH levels are higher or lower than average. When it comes to AMH, what’s really “average”? Because AMH has only been routinely tested in women who visit a doctor after having difficulty conceiving, past averages have been based on a population that includes many women with fertility problems. In order to truly understand where your AMH level falls on the spectrum, you’ll need to compare it to a population of women without known fertility issues. We performed just such a study through the Center for Fertility Research & Education (CFRE).

In our research, presented at the ACOG Annual Meeting earlier this month, we looked at the results of over 2,600 AMH tests among non-infertile women who had come to Extend Fertility for a fertility assessment. As expected, AMH was negatively associated with age—meaning as age increased, AMH levels decreased, generally speaking.

Average AMH levels by age:

Age

Median AMH levels

Under 30

2.91

30–34

2.42

35–37

2.03

38–40

1.50

41–42

.92

Over 42

.59


What your AMH levels mean for your egg freezing cycle

As we mentioned above, AMH testing is an invaluable tool for women considering egg freezing (and their doctors). AMH levels are closely correlated with the number of eggs you’ll be able to retrieve in one cycle of egg freezing or IVF.

Here at Extend Fertility, we use a proprietary algorithm based on your AMH level and age to predict—with 90% confidence—how many eggs you’ll be able to freeze in one cycle. Our past research has determined that while women age 34 or younger are able to freeze, on average, 17 eggs per cycle, that drops to under 10 eggs per cycle for women over 41.

Age

Mean number of eggs frozen per cycle

34 or younger

17.2

35–37

15.48

38–40

12.87

41 or older

9.67


This is where egg quality comes back into play. Because older women have a lower percentage of genetically healthy eggs, they actually have to freeze more eggs than younger women, despite the fact that they typically are able to freeze fewer eggs per cycle. According to a model published in Human Reproduction in 2017:

Age

Number of frozen eggs needed for a 50% chance of a live birth with those eggs later on

34 or younger

7

35–37

9

38–40

11

41 or older

20


New research from CFRE uses the results of over 1,300 cycles right here at Extend Fertility to determine the AMH level that represents a “cutoff”—as in, those with higher AMH levels will likely reach their 50% chance target in one cycle, while those with lower levels may need multiple cycles to reach that target.

Age

Number of frozen eggs needed for a 50% chance of a live birth with those eggs later on

AMH level necessary to achieve a 50% chance of a live birth in one cycle

34 or younger

7

1.25

35–37

9

1.5

38–40

11

1.75

41 or older

20

2.25


So what does all this mean for women who are actually considering egg freezing? It can help you figure out how many cycles you might need to plan for, or what your real chances of pregnancy later on will be if you only do one cycle. For example, if you’re 39 and you have an AMH level under 1.75, you’ll know that you might need to plan for multiple cycles to get a 50% chance of pregnancy with your frozen eggs later.

If this feels like a lot of data, don’t worry. A fertility assessment at Extend Fertility comes with a physician consultation, so that your doctor can interpret your AMH results in context and let you know what that means for your fertility health and your egg freezing plans.

Contact us to learn more or call us at 212-810-2828 to schedule an assessment!


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