Endocrine Disorders

Low ovarian reserve (low AMH)

What is ovarian reserve?

Women are born with all the eggs they will ever have, and the quantity and quality of these eggs deteriorate with age. Ovarian reserve refers to the number of eggs that are left within a woman’s ovaries.

Testing ovarian reserve

Anti-Mullerian Hormone (AMH) is a hormone that is produced by the follicles in your ovaries, which contain the eggs. The level of this hormone in your blood gives an indication of your ovarian reserve i.e. how many eggs you have available. This blood test can be done at any point during the menstrual cycle. Please note though, that contraception medications can affect AMH levels.

Who should be tested?

From the age of 35, your ovarian reserve declines at a faster rate until menopause. You might consider having an AMH blood test if you:

• Have been trying to fall pregnant for over six months;
• Are worried about your future fertility and want to check your ovarian reserve is at a healthy level for your age. In these cases, elective egg freezing or embryo freezing are treatment options to consider;
• Have had chemotherapy or surgery and want to know if it has affected your future fertility; or
• Are considering fertility treatment and your fertility doctor needs to determine a medication dosage.

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Low ovarian reserve and fertility

Women with low ovarian reserve have reduced fertility due to a decrease in the number of eggs available. There is also a small amount of evidence to suggest an increased risk of miscarriage.

The most effective therapy available for low ovarian reserve is to consider starting a family sooner. While you may not have thought about this as part of your life plan yet, these decisions can allow you to have more options later on. Depending on your situation, fertility treatment is also an option, which can also allow you to freeze eggs or embryos for the future when you are ready to start a family.

Your fertility doctor will take into consideration your individual circumstances and talk you through what options you have available. You can arrange to have an AMH test done with your fertility doctor as part of your initial investigations.