Low AMH - don't panic
I am seeing more and more women attending me concerned about their AMH reserve. AMH, is the short name for Anti-Mullerian Hormone. It is a substance produced by the granulosa cells in the ovarian follicles. It is a routine test carried out in fertility clinics. It may be interpreted as an indicator of low ovarian reserve, in other words a reduced supply of eggs in the ovaries. However women are born with lots of eggs approximately 1-2 million follicles (immature eggs). This is their complete supply and they don’t make any more. At puberty the number of eggs has dropped by over half down to 400,000-500,000. With each menstrual cycle up to 1000 follicles begin getting ready for ovulation. Only one becomes mature enough to do so. The other 999 or so are lost. After the onset of puberty and regular menstrual cycles, eggs are lost on a monthly basis. This is part of the reproduction cycle and is nothing to unnecessarily worry about.
The level or measurement of Anti Mullerian Hormone in a woman is simply a response to a number of things going on in the ovaries and is not static. Primarily it is indicative of just how aggressive the follicles are being recruited from their dormant state into maturation. This process is very active and eggs are being recruited to start their journey into maturation. Levels of AMH go up and its job is to hold back immature follicles for future recruitment. This is not a perfect predictor of a women's fertility potential. It simply gives a rough idea as to how many eggs may be present. This is only a general indicator used to ascertain levels for possible retrieval if IVF is being considered.
Sometimes when women hear their results they may engage in catastrophic thinking and raise their stress levels. This kind of thinking should be avoided. It is often interpreted as a sign of premature ovarian ageing. Many, women conceive with undetectable levels of AMH. It should be simply viewed as a rough approximation.
The most important thing to remember is that you only need one egg that is of good quality and strong enough to fully mature. Egg quality is far more important. This is where the environment within the female body is so important. Nutrients are crucial at this stage. Focus on meal planning ensuring that you eat a diverse array of good quality proteins and healthy fats. Ensuring that you are getting your full complement of egg supporting nutrients is vital.
Nutrients in food do have the ability to affect our genetic material. This is called our DNA or otherwise known as our blue print. Egg quality refers to whether an egg is genetically normal or has abnormalities. The primary cause of damage to an egg is the ageing process. As women age, so too do the eggs. If they are bathed in a body that is exposed to excess alcohol, smoking, chemicals, inflammation from fat cells, poor diet and stress, the egg quality starts to become affected. When the damage goes to a genetic level, it is very difficult to reverse it. Thankfully, each month many follicles are produced and with natural selection a healthy body releases the best egg.
Taking pre conception supplements daily will confer many benefits to the internal workings of the female body while trying to conceive.
Gaye Godkin, MPH Nutrition (Hons) DipNT cNLP