AMH (Anti-Mullerian Hormone) Test

AMH (anti-mullerian hormone) is a female hormone that is important for measuring fertility levels. AMH is a protein produced in women when eggs are developing in the ovaries. A simple blood test taken from your finger can measure your AMH levels, and your results will be given to you with free aftercare advice from our doctors.

The levels of AMH in your blood can give your doctor an idea of how many ovarian follicles you have remaining. Ovarian follicles are located in your ovaries and this is where your eggs develop before they are released. You are born with a certain number of ovarian follicles, which will decrease as you get older.

The AMH test works by taking a blood sample, which can be measured in a lab. You can take the test with a finger prick sample, which involves using a small device called a lancet. Using the lancet, prick your finger and collect a blood sample at any time during your menstrual cycle. Make sure to fill the blood sample bottle up to the line. You then send your AMH test to our lab, where it can be measured, and the results will be reviewed by our doctors.

The results will be provided to you through your online portal, and you can speak with our doctors about your results at any time, for free. We will give you free aftercare advice depending on your results. Although an AMH test can indicate your fertility, it cannot tell you how healthy your follicles are, or how many you have left exactly.

The higher your level of AMH, the more ovarian follicles you have, and the higher your chance of releasing an egg that can be fertilised. A normal level of AMH is between 1.0ng/ml to 5.4ng/ml but this will depend on your age. As you age, your AMH level will decrease naturally.

If your AMH levels are low, it could mean that you have low egg supply and potentially low fertility. Low fertility is common in the UK and around 1 in 7 couples can have difficulty getting pregnant. Low AMH levels do not mean you cannot get pregnant, but you may need some help from your doctor. AMH levels are often measured before a woman gets IVF (in vitro fertilisation), which is where the egg is fertilised outside the body and returned to the womb.

There are many causes of low fertility, including:

• low quality semen
• endometriosis, which is where the lining of the womb is not inside the womb, making it harder for fertilisation to occur
• damaged or blocked fallopian tubes
• lack of ovulation, meaning you are not releasing an egg each month
• age, as a male and female ages, the chance of pregnancy decreases naturally

In some cases, the cause of low fertility is not known.

Once you have your results, you can message one of our doctors for more information on what to do next, if you are unsure. If you have healthy levels of AMH but are struggling to get pregnant, you and your partner may need to visit your GP and have fertility testing. You may need to be referred to a fertility clinic who can help you increase your chances of getting pregnant through medical treatments.

If your AMH levels are higher than they should be for your age, you should visit your GP as you need to get checked for a condition called polycystic ovary syndrome (PCOS). If your levels are lower than what is expected for your age, you should visit your GP or a fertility clinic. They can discuss options with you and carry out other tests to find out the cause of your low fertility.

Having low fertility does not mean that you will not get pregnant. There are medical and non-medical ways to improve your chances of getting pregnant. You should always speak to your doctor, who can give you advice based on any conditions you and your partner have.

Surgical procedures

There are a few different surgical procedures that can help if you have low fertility.

1. Fallopian tube surgery: If you have blocked fallopian tubes, you can have surgery which can unblock them, meaning your eggs can pass through to become fertilised.
2. Epididymis tube surgery: Males can also have a blockage in the tube where their sperm leaves the testicles, which is known as the epididymis. They can also undergo surgery to unblock this, meaning their sperm can pass through when they ejaculate. Sperm can also be extracted this way and frozen for later use.
3. Laparoscopic surgery: This is a procedure which can be used to treat endometriosis, PCOS, and fibroids. It can involve removing cysts or fibroids (small growths) from the womb.

Medicine

There are a number of different medicines that can increase the chances of fertility.

These include:

• tamoxifen and clomifene (both help women to ovulate monthly)
• gonadotrophins (helps women to ovulate and can improve fertility rates in men)
• gonadotrophin-releasing hormone and dopamine agonists (alsos help ovulation in women)
• metformin (a medicine often used to help women who have PCOS and want to get pregnant)
• testosterone injections (for men with low levels of testosterone)

Speak to your doctor for more information on these medicines and which ones may be right for you., or your partner. This will depend on the reason for your low fertility.

Assisted conception

Assisted conception is a way to conceive when you cannot do so naturally.

There are a few types of assisted conception, which include:

• IVF (where the egg is fertilised outside the body and inserted back into the womb)
• Intrauterine insemination (where a sample of sperm is inserted into the womb through a tube)
• sperm or egg donation (if one partner is infertile)

You must have tried other ways of getting pregnant before using assisted conception on the NHS. You can choose to go private but the cost will depend on which treatment you have.

Risk factors

There are some risk factors that can affect your fertility.

These include:

• smoking
• your weight
• sexually transmitted infections (STIs)
• alcohol
• stress

Making lifestyle changes, like quitting smoking and reducing stress levels, may help to improve your fertility levels. But, you should still visit your GP or fertility clinic to get medical advice.