Anti-Müller-Hormon (AMH) bei Kinderwunsch

Can I Still Get Pregnant? Understanding AMH Levels and Ovarian Reserve

In today's world, many women wonder, "Can I still get pregnant?" This question is particularly relevant for women who decide to have children later in life. One of the most important indicators in this context is the Anti-Müllerian Hormone (AMH) level. This value, determined by measuring the AMH level in the blood, serves as an indicator of a woman's ovarian reserve and can provide important information on whether a natural pregnancy is possible or if assisted reproductive techniques like in-vitro fertilization (IVF) should be considered.

Ovarian Reserve of a Woman

The ovarian reserve of a woman, which refers to the number of eggs available to her, is determined before birth.

Stages of life

Number of eggs

Conception (20th week of pregnancy)

Approx. 7 million eggs per ovary

Birth

1 - 2 Millionen eggs in total

Start of menstruation:

300.000 - 400.000 eggs in total.

 

From puberty onwards, up to 1,000 follicles mature each month, but only the largest and most dominant is released during ovulation. The remaining eggs degenerate. This process repeats about 300-500 times in a woman's life. Menopause begins when there is a very small number of non-viable eggs left, and menstruation stops.

Menopause occurs at varying ages for different women, usually around age 50, but sometimes as late as 60. If menopause begins before the age of 40, it is considered premature menopause (premature ovarian insufficiency).

What is the AMH Level and Why is it Important?

The Anti-Müllerian Hormone is produced by the ovaries and serves as a marker for the number of eggs remaining in a woman's ovaries. The AMH level is determined through a blood test that can be performed at any time during the menstrual cycle, as hormonal contraceptives do not affect the AMH level.

Age

Average AMH Levels (ng/ml):

25 - 29 years

3.2 - 5.5

30 - 34 years

2.4 - 4.7

35 - 39 years

1.5 - 3.8

40 - 44 years

0.7 - 2.9


An AMH level above 6 ng/ml may indicate polycystic ovary syndrome (PCOS). A low AMH level can suggest a reduced ovarian reserve, meaning fewer eggs are available, which can lower the chances of pregnancy.

Smokers generally have lower AMH levels compared to non-smokers.

Significance of AMH Levels for Fertility

A low AMH level can have various causes, including genetic factors, environmental influences, a woman's age, and certain medical treatments like chemotherapy. Endocrine disruptors such as phthalates and BPA can also negatively affect the ovarian reserve (Ding et al., 2022).

Women with a low AMH level often worry about their ability to conceive and seek ways to improve their chances.

Can the AMH Level be Improved?

The AMH level is largely stable and primarily influenced by genetic factors and age. Unfortunately, there are no specific methods to improve the AMH level. However, certain lifestyle changes and micronutrient intake can help improve overall fertility and egg quality.

Ways to Promote Fertility

For women with a low ovarian reserve, there are various steps they can take to improve their chances of pregnancy:

Healthy Lifestyle:

A healthy diet, regular exercise, and avoiding harmful habits like smoking and excessive alcohol consumption can help improve overall health and support fertility.

Micronutrients:

High-quality micronutrients such as Coenzyme Q10 in the form of Ubiquinol, DHA (Docosahexaenoic Acid) from Omega-3 fatty acids, and antioxidants like Alpha-Lipoic Acid, NAC (N-Acetyl-Cysteine), and Selenium have been shown in clinical studies to positively affect egg and embryo quality.

In-Vitro Fertilization (IVF):

Women with a low AMH level can benefit from fertility treatments such as in-vitro fertilization (IVF). During IVF, eggs are retrieved from the ovaries, fertilized outside the body, and then implanted into the uterus.

If the Anti-Müllerian Hormone level is very low (below 1.0 ng/ml), higher doses of hormones may be required during stimulation.

Egg Donation as an Option:

In some cases, egg donation may be an option, especially if the woman's own ovarian reserve is very low. In egg donation, eggs from another woman are used to achieve pregnancy.

AMH Level as an Important Indicator of Fertility

The AMH level is a crucial indicator of a woman's ovarian reserve and can provide important information to reproductive medicine on whether a natural pregnancy is possible or if assisted reproductive techniques should be considered. For women with a low AMH level, an appointment at a fertility clinic can be an important next step to identify suitable treatment options. Despite a low AMH level, there are ways to achieve the dream of having a family.