Here’s what we know about AMH: It is secreted by primordial follicles in the ovaries. These are the tiny little follicles that are in their most early stage of development.
I don’t want to get too far off track here but, just in case you didn’t already know this, female humans are born with around 500,000 primordial follicles (aka little tiny eggs sleeping inside their little shells).
The current prevailing scientific theory is that the more of these primordial follicles you have, the higher your AMH. The fewer primordial follicles you have, the lower your AMH.
Therefore, it is thought that low AMH correlates to low ovarian reserve – meaning that there aren’t a lot of follicles left.
But, here’s the thing – while there may be some truth to this in certain cases (where AMH may correlate to an actual low egg count) – AMH is NOT a fertility test.
More importantly, it’s not a test of egg quality, either.
True, many of the people who show up in fertility clinics have low AMH because they’re either over 35 and are naturally starting to run a little low on follicles OR they are under 35 and may have started off with fewer follicles than average for their age.
I’ve also seen cases where AMH increases dramatically after some of the key lifestyle changes we recommend along with the treatments we do at the clinic. Which leads me to postulate that AMH may just be a snapshot in time of how active the ovaries are.
In other words, high AMH = the ovaries are more active. Low AMH = the ovaries are less active. Not “egg counts” per se, but simply how active the ovaries are in releasing those eggs into “production”.
Regardless, one thing I can tell you beyond any shadow of a doubt that low AMH does not equal low fertility.
Take the story of Jenny – one I’ve seen play out many, many times over the last decade plus.
A 39-year-old high-tech engineer, Jenny came to me after trying to conceive for almost two years. She already had a son that was almost 4 years old at the time. Initially, she wasn’t in a hurry because she conceived easily at the age of 35 and figured things would be fine.
After the first year of trying to get pregnant, yet not conceiving, Jenny thought because of her age, getting pregnant this time around was going to take a little longer. She was concerned but not freaked out.
After the second year of not conceiving, she started to worry quite a bit and went to see her OB/GYN who ran an AMH test.
It came back at less than 0.16 – which for all purposes is “undetectable”. Her antral follicle count (the count of follicles seen on ultrasound at the beginning of her cycle) was also low.
She was shocked as the OB/GYN told her it looked bleak and she should consult a specialist right away because she’d probably need IVF.
Jenny decided to come see me first. She’d heard about me through a friend. 3 months later, after getting on my program, she was pregnant. 9 months later she delivered a healthy baby girl at full term.
Why wasn’t she getting pregnant before? I have no idea, to be honest.
But I suspect based on what happened that her body was very, very close to conceiving – but her eggs were receiving just enough damage to be unviable.
However, with the simple things we did – including the lifestyle changes, easy dietary shifts, and key supplements – her body was able to make the extra little push it needed and a healthy egg, full of life, emerged.
So, while her AMH supposedly painted a bleak picture, the reality was anything but.