Egg Freezing and Your AMH Levels
If you’re thinking about freezing your eggs or have ever looked into assessing your fertility, you’ve probably heard about AMH (aka Anti-Müllerian Hormone). In simple terms, testing your AMH allows you to check your ovarian reserve (the quantity of eggs in your ovaries).
Finding out your AMH score gives you a better understanding of your reproductive health and can help you with your future family planning. If you decide to freeze your eggs, your EVOLVE team will use your AMH score to guide your treatment plan and tailor it to your unique needs.
Want to learn more about AMH? Read on to find out what it is and what it means for your egg freezing journey.
What is AMH?
AMH is a hormone that your follicles (the fluid-filled sacs in your ovaries that contain eggs) produce. Your AMH score can give us a good idea of the number of follicles (and therefore eggs) you have in your ovaries. A higher AMH level suggests a higher ovarian reserve.
Why Should I Test My AMH?
Testing your AMH will form part of your initial assessment before you freeze your eggs, as it tells us important information that helps us plan your treatment cycle. Alongside AMH, we will test the levels of other hormones (FSH, LH, and Estradiol) in your blood, and perform an ultrasound scan to check your antral follicle count (AFC). Together, these results paint a picture of the number of eggs you have in your ovaries. This helps us predict how your egg freezing cycle is likely to go and tells us which dosage of stimulatory drugs is most appropriate for you.
How is AMH Tested?
AMH is checked with a quick and simple blood test. Unlike the other hormones, AMH can be assessed at any point in your menstrual cycle. However, to make things easier for you, we will check your AMH at the start of your menstrual cycle, along with other tests. Once results are back, you’ll sit down with your EVOLVE team to plan your egg freezing cycle.
What is a ‘Normal’ AMH Score?
We don’t really like to use the word ‘normal’, because what is normal will be different for every person. However, as you can see in the table below, we do have some research available that tells us the average AMH scores based on age.
| Age-Appropriate AMH: Reference Ranges Age (yrs) | Median pMol/L AMH | 25th-75th percentile |
|---|---|---|
| ≤ 25 | 31.27 | (13.49-41.78) |
| 26-30 | 33.68 | (14.48-41.99) |
| 31-35 | 25.24 | (9.49-32.42) |
| 36-40 | 15.81 | (5.15-21.22) |
| ≥41 | 8.02 | (1.2-10.69) |
Source: TRIO Fertility, Inc. Calculated from 9170 samples. Last updated August 2021.
AMH and Age
You were born with all the eggs you will ever have, and as you get older, your ovarian reserve (and therefore AMH score) declines as some of your eggs are lost each menstrual cycle. Some people are born with fewer eggs or lose their eggs more quickly throughout their lives, which would be reflected as a lower AMH score.
If your AMH score is below the average for your age group, this doesn’t make you abnormal; it simply means your normal looks different from the average. If your AMH score is on the lower end of the scale, it just lets you know that you may want to think about making certain life decisions sooner rather than later (e.g., starting your family or freezing your eggs to use in the future).
How Will My AMH Score Affect My Treatment?
Your AMH score, along with the results of your other tests, will help your EVOLVE doctor decide which dosage of stimulatory drugs to give you. The role of this medication is to encourage your ovaries to produce multiple mature eggs. Without these stimulatory drugs, your body would naturally mature and ovulate just one egg each month.
For patients with a lower AMH score, we will generally give a higher dose of this medication, as their ovaries need more encouragement to produce multiple eggs. Even with this higher dose, however, people with a lower AMH score are likely to have fewer eggs retrieved at egg collection. Therefore, if your AMH score is on the lower side, you may need more treatment cycles to retrieve your desired number of eggs.
For patients with a higher AMH score, we may prescribe a lower dose of stimulatory drugs, as their ovaries don’t need as much encouragement. If your AMH is on the higher side, you’re likely to have more eggs collected per retrieval, which means you’ll probably need fewer cycles to collect your desired number of eggs. Unfortunately, patients with a higher AMH score are at an increased risk of developing a rare condition called (Ovarian Hyperstimulation Syndrome (OHSS), where the body ‘overreacts’ to stimulatory drugs. If you have a high AMH score, however, try not to worry as severe cases of OHSS only occur in around 1% of patients and we monitor you closely throughout your cycle and make adjustments as needed, to minimize any risk.
What Can’t AMH Tell Me?
Although AMH is a useful tool that lets you know your ovarian reserve, it can’t tell you everything. For example, this test can’t tell you anything about the genetic health of your eggs, which is an essential part of creating a healthy pregnancy.
Unfortunately, there isn’t currently a test that can check the genetic quality of your eggs. However, egg quality (like AMH) predictably declines with age, which is why it’s more difficult to achieve a healthy pregnancy the older you get.
To stay on the safe side, we often recommend that our older patients freeze more eggs. This way, there’s a higher chance of at least one of those eggs being genetically normal and resulting in a healthy pregnancy if/when they decide to use their eggs later down the line.
If you have any more questions about AMH and egg freezing, please don’t hesitate to get in touch. We will be happy to talk to you about the egg freezing process and what your AMH score means for you. Contact us today.
