I. Introduction

In adults, the amount of anti-mullerian hormone in the blood can help diagnose menopause, polycystic ovary syndrome, and infertility. Menopause is not a disease; it’s a natural state that occurs when a woman stops having her menstrual period each month. According to the National Center for Biotechnology Information, the median age for menopause is 51. Polycystic ovary syndrome (PCOS) affects about 5% to 10% of all childbearing women. Approximately 10% of American women of childbearing age have difficulty conceiving or staying pregnant.

This guide explains why the anti-mullerian hormone test is ordered and how the results are used to diagnose PCOS, menopause, and infertility. It also provides more information on these conditions, including the symptoms and treatment options.

II. Overview of the Anti-Mullerian Hormone Test

Why should I get tested?

The purpose of the anti-mullerian hormone test is to determine if an individual has an abnormal amount of AMH in the blood. This information can be helpful for determining if a woman is going to enter menopause soon, diagnosing conditions that can cause a woman to stop having her menstrual period, and estimating how many eggs a woman has left in her ovarian reserve. The AMH test is also used to diagnose PCOS.

When should I get tested?

According to MedlinePlus, the anti-mullerian hormone test should be ordered when a woman is having trouble conceiving, or if a woman has signs of PCOS. Potential signs of PCOS include thinning hair, an irregular menstrual cycle, and difficulty losing weight.

What is required for the test?

A small sample of blood is required to measure a person’s anti-mullerian hormone level.

What do I need to do to prepare for the test?

No special preparation is required for this test.

III. The Basics of Menopause, Polycystic Ovary Syndrome, and Fertility Problems

Menopause

Menopause is not a disease that can be cured; it’s a natural part of a woman’s life. A woman is considered to be in menopause if it’s been 12 months since she had her last menstrual period. Before menopause occurs, a woman typically goes through a transition period that can last as long as 14 years. It’s during this transition period that many women experience symptoms such as hot flashes, night sweats, vaginal dryness, heavy vaginal bleeding, and spotting between periods.

Menopause doesn’t just cause changes in the reproductive system; because estrogen and progesterone levels decline in the transition phase, changes also occur elsewhere in the body. For example, menopausal women have a higher risk of fractures because their bones aren’t as dense as the bones of younger women. Once menopause occurs, it’s also easier for a woman to gain weight due to changes in the way the body uses fat.

Polycystic Ovary Syndrome

In a woman with normal ovarian function, eggs are released from the ovaries during ovulation. PCOS interferes with this process by causing small cysts to form on the ovaries, which prevents immature egg follicles from releasing eggs each month. The lack of ovulation can make it more difficult for a woman to conceive a child.

Researchers don’t know exactly why some women develop PCOS; however, it may be due to high levels of insulin or high levels of androgens. Insulin is a hormone that helps carry glucose (blood sugar) from the bloodstream into the cells. If the body doesn’t respond normally to insulin, more insulin is released, leading to elevated insulin levels. Many women with PCOS have this problem. Androgens are responsible for the development of traits associated with men, such as baldness. Some women produce more of these hormones than needed, which can prevent ovulation and interfere with fertility.

The symptoms of PCOS vary from woman to woman, but some of the most common symptoms include thinning hair, skin tags, darkened areas of the skin, irregular menstrual periods, acne, and the growth of unwanted hair on the chin, chest, and other parts of the body. Women with PCOS may also find it difficult to lose weight.

Fertility Problems

Women who can’t conceive after trying for at least 12 months are considered to have infertility. In women over the age of 35, the time frame is shortened to six months. Infertility develops for many reasons, including a lack of ovulation, problems with the structure of the uterus, and failure of a fertilized egg to attach itself to the lining of the uterus. Infertility can also be due to a problem with the man’s sperm.

For conception to take place, a woman’s egg must join with a man’s sperm. When a woman does not ovulate normally, there are no eggs for the sperm to fertilize, which makes it difficult to get pregnant. In some women, ovulation problems are caused by PCOS. Women with a history of endometriosis or pelvic inflammatory disease may have trouble conceiving due to scarring of the fallopian tubes, which are the tubes that carry eggs from the ovaries to the uterus. Fibroids can also interfere with a woman’s ability to conceive. These abnormal growths are non-cancerous, but they attach to the uterus, interfering with a woman’s ability to carry a pregnancy.

Certain risk factors increase a woman’s likelihood of having trouble conceiving. Age is one of the most significant factors, as women over the age of 35 are more likely to deal with infertility than younger women. Smoking, not getting enough nutritious foods, and a lack of exercise can also make it difficult for a woman to get pregnant.

IV. How an Anti-Mullerian Hormone Test Works

An individual who needs the anti-mullerian hormone test must have a blood sample drawn by a medical technician. During a blood draw, the technician inserts a needle into one of the individual’s veins and allows blood to drain into a collection tube. This tube contains substances that prevent the blood from clotting before it can be analyzed. When the sample reaches the laboratory, it is put through a process called chemiluminescent immunoassay, which allows laboratory personnel to determine how much anti-mullerian hormone is present.

V. Treatment for Menopause, Polycystic Ovary Syndrome, and Fertility Problems

Menopause

If a woman finds menopausal symptoms bothersome, oral contraceptives and hormone-replacement therapy can be used to increase estrogen and progesterone levels, relieving hot flashes, night sweats, and insomnia. Some women use vaginal lubricants and other over-the-counter remedies to relieve dryness and irritation.

PCOS

The right treatment for PCOS depends on several factors, including a woman’s age and medical history. Women who are overweight or obese are usually advised to lose excess weight by following a nutritious diet and getting plenty of physical activity. Some women also take medications to help control the symptoms of PCOS. Women whose bodies don’t respond to insulin properly may need to take medicine to make the body more responsive to this important hormone. Anti-androgens and hormonal contraceptives can be used to correct the hormonal imbalances that can occur in women with PCOS.

Fertility Problems

Lifestyle changes, medications, and surgery are some of the treatment options for women with infertility. For women who are overweight or have other risk factors associated with lifestyle, certain changes can increase the chances of getting pregnant. These changes include following a healthy diet, finding a healthy way to manage stress, and losing any excess weight.

Medications are used to stimulate ovulation, correct hormonal imbalances, and treat other problems that could be interfering with a woman’s ability to conceive. Ovulation stimulation is typically used when a woman doesn’t ovulate at all, or when she ovulates so irregularly that it’s difficult to anticipate when ovulation will occur. Gonadotropins are also used to stimulate ovulation, but they’re usually used when other treatments have failed. A woman taking gonadotropins must take shots early in her menstrual cycle and then have an ultrasound and other tests to determine how her egg follicles are developing.

Surgery can be used to treat some of the conditions that can contribute to infertility in women. For example, a woman with a blocked fallopian tube may have surgery to open up the blockage. Surgery is also used to remove fibroids and treat endometriosis, both of which can cause infertility.

If these treatments don’t work, a woman may decide to undergo intrauterine insemination or in vitro fertilization. IUI is a procedure in which a man’s sperm are placed inside the woman’s uterus near the time of ovulation. IVF involves fertilizing an egg and then implanting it in the woman’s uterus. During this process, the woman usually takes gonadotropins to stimulate ovulation. When she ovulates, a doctor uses a needle to retrieve multiple eggs from the ovaries. If one of the fertilized eggs turns into an embryo, the healthy embryo is then implanted in the uterus.

VI. FAQs

What is a normal anti-mullerian hormone level?

A normal anti-mullerian hormone level depends on a woman’s age; younger women naturally have higher levels of this hormone than older women. The normal levels by age range are as follows:

  • Age 25: 5.4 nanograms per milliliter (ng/mL)
  • Age 30: 3.5 ng/mL
  • Age 35: 2.3 ng/mL
  • Age 40: 1.3 ng/mL
  • Older than 43: 0.07 ng/mL

Do all women with low AMH levels have fertility problems?

No. It’s possible to have a lower-than-normal AMH level and still be able to get pregnant.

What are some other uses for this test?

In some cases, the anti-mullerian hormone test is used to monitor people with ovarian cancer. The results of this test can help determine if the cancer treatment is working.

I am trying to get pregnant. Is it good if my AMH level is higher than last time?

Yes. Lower-than-normal levels of AMH are associated with difficulty getting pregnant. A higher level is associated with better chances of conceiving.

What does it mean if a young boy's AMH level is abnormal?

In young boys, a low level of anti-mullerian hormone could indicate the presence of a genetic disorder that causes abnormal development of the genitals.

VII. Additional Resources

For more information about menopause, PCOS, and fertility problems, along with information on the lab tests used to diagnose and monitor people with these conditions, visit these online resources.

NameWebSummary
Office on Women’s Healthwww.womenshealth.govThe U.S. Office on Women’s Health provides information on a variety of medical conditions that affect women and girls.
The American College of Obstetricians and Gynecologistswww.acog.orgThe ACOG offers educational resources on conditions such as menopause and PCOS.
National Institute on Agingwww.nia.nih.govLearn more about menopause and other conditions that affect women as they age.
EndocrineWebwww.endocrineweb.comAccess tips on managing PCOS and other endocrine disorders.
American Society for Reproductive Medicinewww.reproductivefacts.orgFind more information on the fertility problems that can be caused by PCOS.

VIII. Sources Used in This Article