How Does Low AMH Affect Fertility?
When woman enters puberty, her eggs begin to decline. Beginning with millions of egg cells (oocytes), each period and other factors lead to a gradual fall in this “ovarian reserve.” Usually, most women see a significant decline in the mid to late 30s.
One marker of this change in fertility is anti-mullerian hormone (AMH). It naturally decreases with age and is an indicator of the ovarian reserve. The higher AMH levels are, generally speaking, the more eggs remain.
So, what is low AMH? How are low AMH and fertility linked? And what are the low AMH treatment options? We answer your questions below.
What is Low AMH?
Anti-Mullerian hormone, or AMH, isn’t as commonly known as other hormones like oestrogen or insulin. But, in the context of reproductive health, it’s incredibly important.
AMH is directly produced by granulosa cells in your ovarian follicles. Each follicle only produces a certain amount, and so the concentration of AMH is directly linked to the number of follicles. We call the number of follicles, or egg cells, the ovarian reserve.
Your ovaries begin with a certain number of egg cells. This supply begins to diminish over your lifetime, leading to a continually declining AMH level. A lower AMH level often indicates a reduced egg supply, which can impact fertility.
What Causes Low AMH?
A low AMH is relatively normal in your 40s. After all, most of your ovarian reserve will have been depleted. That being said, several factors can lead to a low AMH earlier in life. A low AMH isn’t always a direct test of fertility; however, it is a helpful indicator of what’s going on.
Some potential causes of low AMH include:
- Age: As mentioned, AMH naturally declines with age as the egg cells deplete. This is due to fewer follicles being stimulated as women get older.
- Stress: The more stressed a person is, the more ovarian function can decline. However, the stress must be persistent and continuous.
- Diet and Lifestyle: Factors such as smoking, obesity, low vitamin D levels, and environmental pollution can all lower AMH levels. Adopting a healthier lifestyle may help mitigate some of these effects.
- Birth Control: As birth control alters your menstrual cycle, it naturally lowers AMH levels. This effect is usually reversible once the contraceptive is discontinued.
- Endometriosis: Analysis of patients with endometriosis-related infertility found lower levels of AMH. This decrease in AMH can be attributed to the damage and inflammation caused to the ovaries by endometrial tissue.
According to Traditional Chinese Medicine (TCM), kidney deficiency, liver Qi stagnation, spleen Qi deficiency, and dampness and phlegm accumulation can all lower AMH levels. Here’s why:
- Kidney Deficiency: In TCM, weakened kidneys impair reproductive capabilities, lowering AMH levels due to reduced egg quality and quantity.
- Liver Qi Stagnation: Impeded liver function disrupts hormonal and ovarian activity, leading to decreased AMH levels.
- Spleen Qi Deficiency: A weakened spleen affects blood production essential for ovarian nourishment, thereby reducing AMH levels.
- Dampness and Phlegm Accumulation: Excessive dampness and phlegm obstruct reproductive channels, impairing ovarian function and lowering AMH levels.
4 Ways How Low AMH Affects Fertility
Reduced Egg Quantity – Kidney Yin Deficiency
The most obvious was that low AMH and fertility are linked to egg quantity. The fewer eggs there are, the lower the AMH concentrations. However, it’s not quite this simple. It’s all about the number of follicles that are being stimulated for ovulation. You can still ovulate as your egg quantity declines, but the chances gradually decrease.
Egg quantity declines in part due to Kidney Yin Deficiency. This causes follicles to become dry, alter reproductive cycles, and lower egg quality. On the other hand, Kidney Yang Deficiency causes a cold uterus, weak ovulation, and implantation failure. Only in balance is reproduction successful.
Affect IVF Success – Kidney & Spleen Deficiency
IVF is one treatment for low AMH and fertility issues. However, low AMH means that there are fewer egg cells available for ovarian stimulation during IVF. Fewer retrieved eggs directly affect the number of embryos available for transfer.
The Spleen (Pi) governs this process, including digestion and Blood production. This is essential for nourishing the ovaries. A weakened spleen, therefore, impairs follicle development, leading to lower-quality embryos that struggle to survive pregnancy.
Shortened Timeframe for Pregnancy
A low AMH means that time is ticking. Your ovarian reserve is beginning to dwindle. That’s not to say pregnancy is impossible; far from it. But it does mean there is a shortened timeframe when you can become pregnant. Part of this is due to more irregular menstrual cycles. However, there is still the possibility of ovarian-inducing treatments such as Clomid and Letrozole.
Egg Quality
Egg quality is crucial to a successful pregnancy. The healthier the egg, the lower the risk of complications. It must be said that fewer eggs don’t necessarily mean poorer quality. However, an early low AMH level could indicate the eggs have been affected by factors such as stress, inflammation, or metabolic imbalances.
Can You Still Get Pregnant with Low AMH?
Yes, although a low AMH can make conception more challenging, it is not synonymous with infertility. With treatments like acupuncture and Chinese supplements and herbs, you can significantly boost your chances of conception.
It should be noted that AMH isn’t the only measure of fertility. FSH levels also play a key role. As a general rule, a higher FSH means a low ovarian reserve, whereas a lower AMH indicates the same. If your AMH levels are low and your cycle is irregular – between 21 to 35 days long – there’s a high chance you’re going through ovulation. That’s when it’s possible to get pregnant.
Can I still get pregnant if I have low AMH but regular periods?
- Many women with low AMH still ovulate and have regular cycles.
- AMH reflects ovarian reserve, not ovulation quality.
- Other fertility factors like egg quality, uterine health, and hormonal balance play a crucial role.
- Many women with low AMH who conceived naturally or with treatment.
Low AMH Treatment
Acupuncture is the primary TCM treatment for low AMH-related infertility. It gives you the best chance of conceiving by supporting ovarian function and restoring any imbalances in your body.
In one case study, a woman with ovarian cysts (which are linked to low AMH) underwent a successful pregnancy after just seven treatments. It’s believed that inserting needles at certain points in the body activates the nervous system, triggering the release of neuropeptides. These neuropeptides influence certain hormones related to the menstrual cycle, helping to regulate it and relieve other bodily imbalances.
A 2022 systematic review confirmed these results. The analysis of 27 studies found that women who underwent acupuncture had a better live birth rate than the control group. This was true for the number of eggs retrieved and embryo quality.
For more information about how Chinese Medicine can help you with low AMH, book your free consultation with our Chinese Medicine experts today
* These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. We can’t guarantee the treatment result, as the symptoms of conditions are unpredictable and vary greatly from person to person. The treatment length and recovery time also varies for individual. Please visit our clinics website: GinSen where a specialists will discuss your care and provide a consultation, and the treatment will be designed to meet your individual needs.
