AMH

Anti-Mullerian Hormone:

Anti-Mullerian Hormone (AMH) is secreted from the Sertoli cells in the testes in men and is secreted throughout life and ensures normal development of the sexual organ in the early period. In women, it starts to be secreted from the granulosa cells in the ovaries after birth, increases during the fertility period, decreases towards menopause, and reaches undetectable levels with menopause.

AMH plays a very important role in tissue development and differentiation in the fetus. In the male fetus, it facilitates the regression of the Mullerian duct, which forms the fallopian tubes and upper vagina sections, and provides the formation of male genital organs and the regulation of spermatogenesis, i.e. sperm production. In women, it also plays a role in regulating folliculogenesis, or which oocyte will develop.

What is the AMH test?

Anti-Müllerian Hormone test is a blood test to measure the ovarian reserve in women. AMH, which is found in both men and women, starts to be secreted in the mother's womb, and is secreted until menopause. With menopause, it is reduced to undetectable levels.

AMH is a hormone secreted from the granulosa cells of small oocytes that begin to grow in women. AMH determines which egg will develop at what rate. AMH test is a very important test that gives information about the ovarian reserve, as it is secreted from small cells that cannot be seen even in ultrasound. AMH level is directly correlated to the number of eggs in the ovaries.

FSH hormone test, the predecessor of the AMH test, could be misleading because FSH could only be measured in certain periods of menstruation and its levels varied greatly from month to month. However, since AMH is directly secreted from ovaries and does not vary during the cycle, AMH test consistently gives accurate information about the ovarian reserve.

As a woman gets older, the AMH value decreases along with the number of eggs. AMH reaching very low levels is an indication that menopause is approaching. A low AMH level at a younger age is an indication that a patient should hurry. A low AMH level, especially under the age of 35, indicates that attention should be paid to `early menopause`. We recommend our patients wishing for a child in this situation to get pregnant as soon as possible or if they don’t want to at the moment, have their eggs frozen.

Sometimes, AMH can be detected in very high levels in patients with polycystic ovary syndrome (PCOS).

In IVF treatment applications, AMH is an important marker showing the response to treatment. It guides the hormone levels to be used before treatment. The information that a low number of eggs can be collected at low AMH levels is shared with the patient before the treatment. It is necessary to adjust the drug doses more carefully, as although a lot of eggs can be collected at very high AMH levels, high AMH levels risks overstimulation of the ovaries (Ovarian Hyperstimulation Syndrome, OHSS).

How is the AMH test done?

AMH test, similar to other hormone tests, is a blood test. AMH is a test done with blood taken from a vein. The AMH test can be performed at any time of the menstrual cycle. For the AMH test, it is not necessary for the patient to have menstruation or to be on a certain day after menstruation similar to FSH hormone tests. You can have the AMH test done in our clinic at any time by giving blood.

Why is an AMH test requested?

The most common use of the AMH test is to determine the ovarian reserve in women. AMH is the most important marker in the determination of ovarian reserve today.
It is used in diagnosis and follow-up of granulosa cell tumors (ovarian cancer).
It is used to determine the risk of poor response or hyperstimulation (OHSS) in IVF treatment.
It is used for differential diagnosis in patients with genital anomalies.
It is a test applied in the detection of menopause.
It is a recommended test for the diagnosis of Polycystic Ovary Syndrome (PCOS).

What are the normal AMH levels?

AMH is at a level of 1.5-4 ng/ml during puberty. It decreases with age and reaches undetectable levels during menopause. Your AMH value must be evaluated by our doctors. Since low AMH value indicates early menopause under 35 years of age, our patient should hurry to have a child. Each patient should be evaluated separately, and personalized treatment should be applied.

High (AMH > 4 ng/ml)
Normal (AMH 1.5-4 ng/ml)
Low (AMH < 1.5 ng/ml)
Very low (AMH <0.5 ng/ml)

What is the difference between FSH test and AMH test?

FSH hormone is secreted from the pituitary gland in the brain, while AMH is secreted directly from the granulosa cells in the ovary.
FSH can be done at a certain time of the menstrual cycle, whereas AMH can be done at any time of the cycle.
FSH varies a lot during menstrual cycle periods and menopause periods. The AMH value is always constant.
AMH is not affected by birth control drugs.
AMH is a direct test that shows the ovarian reserve in a woman.
For the AMH test, hunger does not make a difference.

How is the AMH test evaluated?

Your AMH result should be evaluated together with the rest of your examination findings during your meeting with our physician.

You should remember that the AMH value gives information about the number of eggs in your ovary, not about your egg quality. In very low AMH values, you should not worry immediately but make good use of the remaining time. With a very low AMH value, you should not forget that good quality eggs can still develop, even if they are few in number, and pregnancy is still possible. In our embryology laboratory we are accustomed to working with a small number of eggs, and we will obtain the best quality embryos for you.

On the other hand, patients with high AMH levels may develop OHSS during IVF treatment. In that case, we adjust the treatment process to account for that risk factor.

What is the treatment for low AMH values?

While men can produce sperm every day throughout life, women are born with a limited ovarian reserve. Women use a certain number of eggs from this reserve every month. The AMH value indicates the remaining number of eggs in the ovary, and since new eggs cannot be produced in women, it is not possible to treat a low AMH value. We recommend our patients with low AMH value to hurry if they want to have a child, since AMH value cannot be increased.

For detailed information or to make an appointment, you can call us at any time on +90 224 251 50 00 or reach us via WhatsApp on +90 530 886 52 63.