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How to increase Anti-Müllerian (AMH) Levels

On this page

  1. Overview
  2. Symptoms
  3. Testing
  4. Age
  5. Causes
  6. Treatment

1. Overview

Anti-Müllerian (AMH) is a measure of egg reserve. It is not a measure of egg quality! A low AMH level is considered to be below 9 pmol/L (4 ng/mL), although this various from country to country. Some women with a low AMH level can still produce a good egg, conceive and have a healthy pregnancy, with the right treatment, as good fertility is about the quality of the egg and not how many eggs you have.

As a general rule, a woman’s AMH level starts to decrease from the age of 35. However, it varies from woman to woman. Some women can still have a good AMH level at 40 and others it starts to drop from 30. It varies and is based upon genetics, lifestyle, diet and if you’ve done IVF before. Women with PCOS will tend to have higher levels of AMH and they don’t ovulate, which consumes AMH.

In my experience, a woman with an AMH of 1 pmol/L can still get pregnant naturally if they improve their egg quality. Women with an AMH below 1 pmol/L will need to have extensive treatment and may need advanced fertility treatments such as ovarian rejuvenation, which involves injecting platelet rich plasma (PRP) into the ovaries.

2. Symptoms

Having a low AMH level will increase the likelihood or having an early miscarriage due to defective chromosomes within the egg. There is also an increased possibility of the baby having a birth defect, i.e. Downs syndrome or them having impaired fertility later in life. However, this risk can be reduced by improving egg quality through treatment.

3. AMH test

A blood test can be taken at any time in the menstrual cycle to measure AMH levels. However, levels tend to be higher in the first part (follicular) phase of your menstrual cycle.

Your AMH test result will look something like this:

Level ng/mL pmol/L
Optimal fertility 12.7–21.6 28.6–48.5
Satisfactory fertility 7–12.7 15.7–28.5
Low fertility 1–6.9 2.2–15.6
Very low fertility <1 <2.2

4. Age

A woman’s AMH level decreases with age. The rough AMH level for your age in shown in the table below. This isn’t a definitive rule, as this study of woman was conducted in the USA. In other countries, such as India, the AMH decline with age may well be different.

Age ng/mL pmol/L
26 4.2 30
27 3.7 26.4
28 3.8 27.1
29 3.5 25
30 3.2 22.8
31 3.1 22.1
32 2.5 17.9
33 2.6 18.6
34 2.3 16.4
35 2.1 15
36 1.8 12.9
37 1.6 1.4
38 1.4 10
39 1.3 9.3
40 1.1 7.9
41 1 7.1
42 0.9 6.4
43 0.7 5
44 0.6 4.3
45 0.5 3.6
46 0.4 2.9
47 0.4 2.9
48 0.2 1.4
49 0.1 0.7

5. Causes

In western medicine, it’s often related to age or having underdone chemotherapy or repeated IVF cycles. Chemotherapy and IVF greatly damages yin and blood leading to a jing deficiency, which relates to AMH. The causes of a low anti mullerian hormone level in Chinese medicine are outlined below:

  1. Genetics (jing deficiency)
  2. Excessive conceptions (jing deficiency)
  3. Overwork (yin deficiency)
  4. Poor diet (qi and blood deficiency)
  5. Excessive exercising or physical work (yang deficiency)

As we get older, we become more and more deficient. Life wears us out. It is therefore important to maintain a healthy lifestyle throughout our life. Maintaining an optimal diet and lifestyle together with supplements and Chinese herbs can help to replace deficiencies in the body.

6. How to increase AMH levels

Most fertility clinics do not recommend anything to increase AMH levels. In women with a low AMH level, doctors often recommend either a soft/natural IVF cycle that was invented in Japan or a donor cycle. This can be hard on some couples. However, in my clinic, in some women it is still possible to treat their AMH level enough for them to fall pregnant naturally. However, it can take several months of treatment using a combination of acupuncture, Chinese herbs, dietary, lifestyle advice and certain supplements.

It takes 120 days for an egg to grow from start to finish. Over this time, the quality of the egg will be based upon the woman’s underlying health. By improving the woman’s health during this period, it is possible to improve egg quality. Some of my patients have seen their AMH increase over time.

Supplements

There are several supplements that you can take to help increase your egg quality, including:

Acupuncture

Research has shown that acupuncture is able to increase AMH levels in women, improve their ovarian reserve and chances of getting pregnant. Women with PCOS will naturally have higher than normal levels due to multiple follicles being present. Acupuncture is able to normalise AMH levels in women with PCOS.

Chinese herbs

Chinese herbs in conjunction with supplements and acupuncture can help AMH levels and improve egg quality.

Moxibustion

Research has shown how the use of the traditional Chinese medicine technique called moxibustion can increase AMH levels. This is a technique that can be performed by me in clinic or at home.

References

Wang Y, et al. (2016) Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study. Acupunct Med; 0:1–6. doi:10.1136/acupmed-2015-011014.
Seifer, David, Baker, Valerie and Leader, Benjamin. Age-specific serum anti-Müllerian hormone values for 17,120 women presenting to fertility centers within the United States. 2, s.l. : Fertility and Sterility, 2011, Vol. 95.
Jin X, Cheng J, Shen J, Lv X, Li Q, Mu Y, Bai H, Liu Y, Xia Y. Moxibustion improves ovarian function based on the regulation of the androgen balance. Exp Ther Med. 2021 Nov;22(5):1230. doi:10.3892/etm.2021.10664. Epub 2021 Aug 30. Erratum in: Exp Ther Med. 2022 Mar;23(3):190. PMID: 34539826; PMCID: PMC8438671.

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