ANTI MULLERIAN INHIBITING HORMONE (AMH)

The Anti Mullerian Hormone (AMH) test is a relatively straightforward blood test which, among other things, assesses a woman’s reproductive potential in terms of her ovarian reserve. AMH is secreted by the small, developing follicles (sacs containing eggs) located within the ovaries. The amount of AMH in the blood is directly proportionate to the number of follicles present and therefore the remaining egg supply. 

Here are a few reasons why it is crucial to know your AMH level:  

• Fertility Assessment: It is one of the parameters used by physicians to determine someone's as fertility and age-related features. 
• Family Planning: It can help inform decisions for the case for planning as when to begin the attempts to conceive, if there is a wish for postponing the pregnancy. 
• Guidance For Fertility Treatment: The Anti Mullerian Hormone (AMH) Test is important for any candidate that is undergoing some form of a fertility intervention like In Vitro Fertilization (IVF). It helps to estimate the ovarian response to the stimulation injections and aid in tailoring the dosage of drugs given. 
• Diagnosing Conditions: The level of AMH could also assist in diagnosing or monitoring the progress of some conditions like Polycystic Ovary Syndrome (PCOS) and Premature Ovarian Insufficiency (POI). 

We offer a dependable and precise AMH blood test service that enables you and your physician to make the right decisions concerning your reproductive functionality at Cadabam’s Diagnostics.  

The Anti Mullerian Hormone (AMH) Test runs a specific evaluation to measure the levels of AMH protein that is present in the blood. This hormone is made only by the granulosa cells of an ovarian follicle during some of the early developmental phases called preantral and small antral follicles. 

Let’s see what that measurement means:  

• Correlation with Follicle Pool: The level of AMH is higher in women with a larger follicle pool, which indicates a greater ovarian reserve, or remaining egg supply. In contrast, lower levels usually signal a smaller reserve. 
• Reflects Quantity, Not Quality: The Anti Mullerian Hormone (AMH) Test is not used to gauge the quality of the eggs. Moreover, it is important to note that the test significantly underestimates the quality of the eggs left as the female patient grows older and due to other aspects, AMH level is not going to determine egg quality. 
• Insight into Potential: Even though this is not a direct measurement, it is helpful to estimate the number of viable follicles. This information is useful in verifying the egg count blood test requirements. It enhances the assessment of a woman’s ovarian reserve potential during a given time. 

The measurements are most expressed as ng/mL or pmol/L. 

The Anti Mullerian Hormone (AMH Test) is suggested in a range of reproductive and fertility issues. You may be required to have this test done if:"  

• Evaluating Fertility Potential: You are concerned about your current ovarian reserve because you wish to postpone pregnancy or want to understand your reproductive health better.  
• Infertility Workup: This is normally one of the first tests done to a couple who has been trying to conceive without success.  
• Pre-Fertility Treatment: It's a routine test done prior to commencing treatment such as IVF or egg retrieval. The results assist in predicting the response to stimulation expectations and guiding expectations. This is a fundamental reserve test to fertility affording clinics.  
• Diagnosing Ovarian Diseases: For cases of Polycystic Ovary Syndrome (PCOS – often associated with high AMH) or Premature Ovarian Insuffyciency (POI – associated with very low AMH).  
• Ovarian Function Monitoring: It may assist in monitoring the possible effect of certain medical interventions such as chemotherapy or ovarian surgery on reserve. 

The Anti Mullerian Hormone (AMH) Test is one of the safest tests, however, it does have risks and limitations like any medical test.  

Risks 

Risks are minimal which come with the blood draw: 

• Pain or discomfort where the needle is inserted.  
• Light bleeding or bruising.  
• Rare blinding of eyes or feeling dizzy.  
• Very unlikely infection at the puncture site. 

Limitations 

Here are some limiting factors associated with the AMH blood test: 

• Low AMH Does Not Predict Natural Conception: Remember that a low AMH level does not mean you cannot conceive naturally, and neither does a high-level guaranteed pregnancy. It does add to considerations for the fertility range. 
• Egg Quality Not Verified: As said before, egg quantity considered, AMH does not reflect egg quality which greatly affects fertility, especially as one gets older. 
• Possibility of Fluctuation: Though not as much as other hormones do for FSH, AMH levels do experience some lesser fluctuations. Age (levels are on a natural decline) and some conditions or treatments are major influences. 
• Effect of Conditions/Medications: In PCOS, levels may be artificially elevated and hormonal contraceptives (for example, birth control pills may decrease levels for a short while) may cause temporary elevations. Some ovarian tumours may also cause levels to be extremely high. 
• Single Evaluation: The test captures the ovarian reserve on the date of testing. It does not predict how fast or how slow the ovarian reserve will decline in the future. 
• Lab Variability: References ranges and results may differ minimally from one laboratory to another due to the technology employed. 

Discuss the results with Cadabam’s Diagnostics and your health care provider or the doctor who referred you. 

In the Anti Mullerian Hormone (AMH) Test, the main parameter measured is the concentration of the AMH hormone in the serum and blood.  

• AMH Concentration: Core value reported is type AMH concentration in blood which is measured in ng/mL or pmol/L.  
• Reference Ranges: Usually, the laboratory provides stated ranges of normal values when interpreting the results. Most importantly, these ranges are not unchanging, often age-dependent since AMH values decline as a woman gets older. What’s deemed ’acceptable’ for a 25-year-old would differ for a 40-year-old. 

Cadabam’s Diagnostics guarantees accurate measurements and delivers test results with appropriate reference ranges for proper clinical evaluation.  

There are several reasons why someone might want to know their AMH levels. Here are a few reasons when you should bring up the Anti Mullerian Hormone (AMH) Test with your healthcare provider:  

• Women contemplating future childbearing and wanting to know about their ovarian reserve would be considering assisted reproduction in case of health issues.  
• Individuals or couples who have been trying to conceive (usually for 6-12 months depending on age) without success and need a medical evaluation.  
• Women seeking IVF, IUI, or oocyte cryopreservation. It helps tailor treatment protocols, so the patient doesn’t undergo needless procedures.  
• Women with clinical features or a past medical history suggestive of PCOS or those worried about Primary Ovarian Insufficiency (POI) due to family history or previous medical treatments.  
• Any woman wanting to know how her health impacts her family planning and wants information about her reproductive health. 

As a major test for ovarian reserve, this test supplies vital information for these discussions. 

Having an Anti-Mullerian Hormone (AMH) Test brings multiple noteworthy advantages: 

• Determines Ovarian Reserve: AMH Test is the most reliable in estimating your egg supply (quantity) and remaining resources. 
• Informs Treatment Options: Informs the predictions of your ovaries' responsiveness to stimulation medications used in IVF, allowing for more tailored and potentially successful treatment approaches. 
• Aids Diagnosis: Participates in diagnosing or evaluating some conditions with contributing information such as PCOS (often high AMH) and Diminished Ovarian Reserve (DOR) or Primary Ovarian Insufficiency (low AMH). 
• Family Planning Support: Can be used alongside other studies on reproductive health to provide objective data that help you, your partner, or your physician make decisions regarding family setting. 
• Estimates Reproductive Lifespan: Cannot estimate the age when a woman would attain menopause, but AMH levels can provide a rough indication of time left. 
• Reassurance or Guidance: The knowledge of one’s AMH level can either provide peace of mind or prompt timely fertility advice or treatments. 

The Anti Mullerian Hormone (AMH) Test does not diagnose diseases by itself; however, it plays an important role in the evaluation of several conditions relating to the ovarian modulars and a woman’s fertility:  

• Diminished Ovarian Reserve (DOR): In a woman’s DOR, lower than her age-related expectations of AMH levels indicate an egg reserve which is lesser than the anticipated ovarian reserve.  
• Premature Ovarian Insufficiency (POI): In women who fall under the age of 40, very low or absent levels of AMH can help make a strong case for diagnosing POI, a condition where the ovaries stop functioning at an early age.  
• Polycystic Ovary Syndrome (PCOS): High and very high levels of AMH are usually found in PCOS patients because of multitude of tiny follicles being present in the ovaries. It serves as one of the indicators for PCOS.  
• Granulosa Cell Tumours: Rare ovarian hormonally active tumours of this type may have extremely high AMH levels because of their secretory activity.  
• Assessment of Ovarian Damage: It is useful in estimating the effect of ovarian reserve and efficiency following treatment with chemotherapy or radiation. 

It is important to note that a diagnosis always includes an evaluation, a medical history, and quite often, other evaluations in addition to the AMH blood test.  

Preparing for Anti Mullerian Hormone (AMH) Test at Cadabam’s Diagnostics is easy. 

• Instructions: In general, no fasting is necessary for the AMH test. A major benefit is that the test can be conducted on any day of the menstrual cycle. This is because AMH levels do not change significantly throughout the month. However, confirm with Cadabam’s Diagnostics while making the appointment in case there are other specific instructions. 

Prerequisites:  

An AMH test usually requires a referral or an order from the physician. 

Eligibility 

Most women are eligible to take the test. However, it is important to disclose to the phlebotomist or clinic staff if you are currently pregnant, as AMH levels are volatile during this period. Also, inform them if you are using hormonal drugs, especially hormonal contraceptives like pills, patches, rings, implants, or injectables. These hormonal therapies might suppress AMH levels. Although testing can often still proceed with this information, it's critical for interpretation, and this information is essential regarding the result's validity. 

Procedure for Taking the Test 

The test is comprised of a simple and fast AMH blood test. At Cadabam’s Diagnostics, a certified phlebotomist will collect your blood through a venous puncture at the inner fold of your arm with a disposable syringe. The test can be performed within a short time frame. 

Cautions Before the Test 

While preparing for the test, inform the physician and laboratory personnel about any drugs or vitamins you are currently using. Certain high-dose biochemical compounds, including biotin (vitamin B7) which is occasionally included in hair, skin and nail vitamins, may interfere with several laboratory tests, including some AMH tests. Review this with your provider. 

Test Interpretations 

Interpreting the Results of Your AMH Test 

Receiving your Anti Mullerian Hormone (AMH) Test results is an important step. However, understanding the value of these results brings into perspective a further issue that must be discussed with your care doctor. AMH levels are part of your fertility assessment along with other variables. 

Important Factors that Assist in Interpretation: 

• Context is Crucial: Results should be discussed in combination with the patient’s age, clinical history, any presenting complaints, and other important workup like FSH, Oestradiol, Antral Follicle Count by ultrasound.  
• Age Specific Ranges: AMH levels naturally decline with age. A level considered “normal” for a 30-year-old might be low for a 25-year-old and high for a 40-year-old. Cadabam’s Diagnostics will supply age specific reference ranges where relevant. 
• Low AMH: Suggests a lower ovarian reserve (number of remaining follicles) than expected for your age which may mean a shorter time to conception or possibly bearing higher ovarx doses during stimulation with medications. 
• Normal AMH: Represents an average value within the population for your age group indicating an ovarian reserve. 
• High AMH: Suggests a high ovarian reserve or could be linked with conditions such as PCOS where a greater number of small follicles are present.