Has the idea of having kids started to linger at the back of your mind?
Although not everyone wants children, if you do (or have contemplated the idea), you might have come across a marketing term of a ‘biological clock’.
The reason it persists, has many reasons, but regardless of its connotation and inappropriateness, the notion helps with urging mums-to-be to start on a good foot with a proper health check.
AMH stands for Anti-Müllerian hormone and refers to a substance produced by your ovarian follicle which contains your eggs.
Recently, this has been used as a reliable medical tool for predicting ovarian reserve.
Women are born with a certain number of eggs, which declines as we age until we stop ovulating. Hence, AMH is shows the rate at which your eggs are declining and measures a protein which is found in the follicles (that house the eggs within the ovaries). In short, the more there is protein the higher the amount of eggs.
There are so many reasons why people delay having a family, but while some women can afford to delay, others might struggle with the cost of fertility treatments if they put it off too long (too long in this case means to their 40s).
Many assume that their ability to conceive is solely linked to their age, when in reality your ‘ovarian age’ can differ greatly from your biological age.
Often, many women wish they were more aware of their egg reserve earlier than having to deal with the heart-breaking ordeal of knowing the result of their AMH later in life.
However, having a low AMH level doesn’t necessarily mean you can’t have a baby. Remember that low ovarian reserve doesn’t always affect your natural fertility, especially in your younger years (up to 35).
Having a low AMH level typically means you don’t have many available eggs, however, low egg reserve should always be confirmed by other tests such as ultrasound scans.
There is not much evidence to suggest those with low AMH would have more difficulty conceiving at the time they are diagnosed with it than your average person (don’t you only need one egg?). And of course it works both ways, having an optimum egg supply won’t help much if you are not ovulating.
Hence, your potential for conceiving is influenced by a number of factors and the AMH assessment is only a part of it. You have to consider your age, fertility history, and any previous treatments.
In essence, you cannot improve your AMH as you cannot make more eggs for yourself; however, you can work on your egg quality and boosting your chances in several other ways.
According to Professor Geeta Nargund, MBBS FRCOG in London, you can get tested with a quick, simple and cost-effective blood test that detects the level of AMH. This is a good indication of your egg reserve, but be aware that you need to look out for two different readings of this test.
A low AMH reading indicates you have a low egg reserve and in many cases you will have to consider trying for a baby earlier than originally planned, or if you are already trying to conceive, it will give you an idea of how quickly you need to seek treatment (usually IVF treatment) as well as indicate your potential chances of success.
The test can also determine how well you may respond to hormone stimulation drugs, with those showing a very low AMH reading being unlikely to benefit from conventional IVF, which uses high doses of stimulation drugs.
Women with low AMH levels may choose options such as natural IVF in order to have a baby using their own eggs.
An AMH test can also detect early warning signs of current or future fertility issues you may face. A very high AMH result indicates that you may have PCOS (Polycystic Ovary Syndrome) or polycystic ovaries.
This likely means you will need expert advice on your fertility options. The AMH blood test is quick and easy to carry out as it can be undertaken on any day of your menstrual cycle, and results are typically available within 24 hours.
Overall, AMH testing empowers women, enabling them to make informed decisions on their future family plans.
If you’re having trouble conceiving or simply want to be more informed, it is definitely worth considering.
If you have a family history of early menopause, or if you suffer from an under active thyroid, an early AMH test could help to reassure you that your egg reserve is not adversely affected.
Professor Geeta Nargund believes that all too often she deals with couples who have been told that they are unable to conceive naturally and suddenly need to consider IVF treatment.
This is common in the UK, where one in six couples now needs specialist help to conceive. There is clearly a gap in understanding when it comes to knowing how to monitor, protect and act on your fertility health. And this is where AMH test can make a world of difference.
Once you have your AMH results, it is recommended to have an ovarian scan in order to see what options are available to help you get pregnant.
As you can’t reverse or improve a low AMH score, so there are different approaches to consider when trying to conceive.
You may want to consider egg freezing, if you are not ready to start a family yet.
Egg donation is often the last resort and there are some people with very low AMH levels who have gone down this route when traditional IVF was unsuccessful.
It is costly but it does allow those with the levels of AMH that are undetectable to still have the chance to carry a child by using eggs from a donor.
Although there is nothing you can do to reverse low AMH, but there are things you can do to increase your egg quality and fertility in general.
You may find it useful to complete some research about fertility and conceiving, even talking to a specialist for guidance.
There are many different supplement to try. Many people swear DHEA (Dehydroepiandrosterone) has massively improved their egg quality, and yet there is not much evidence to back this up.
Coenzyme Q10 and DHA (different to DHEA) which consists of fish oil, also believed to provide some benefits to some couples trying to conceive. Fish oil can help things like inflammation which can sometimes prevent conceiving.
It’s important to note that this test is not an accurate test of your current fertility, and there is not much evidence that those with low AMH would have trouble conceiving. This makes AMH more useful as a precaution measure: if you were thinking of having a baby later in life and aren’t sure how much time you would start trying.
If AMH test results have smacked you in the face making you feel hopeless and devastated, consider putting things into perspective and trust yourself to find the right way forward for you and your partner.