What is AMH and how does it Affect Fertility?
- nataliagardneracup
- 12 minutes ago
- 2 min read

AMH is Anti Mullerian Hormone, a hormone produced by the granulosa cells in the antral follicles.
The granulosa cells are the cells surrounding the egg in the follicles. Antral follicles are the small follicles which will ideally develop into larger follicles and release an egg at different stages.
AMH therefore measures ovarian reserve, meaning the amount of eggs remaining in the follicles. The main purpose of testing AMH is to estimate how many follicles remain within the ovary as it grows older and the reference range is between 0-48.5 pmol/l. As the numbers of follicles decline with age, so too does the measurement of AMH, reaching a low level after menopause.
How do Eggs Mature?
Eggs go through a long process of maturation, beginning as primordial follicles when the women was a foetus in her Mother’s womb.
During reproductive life, the primordial follicles are recruited and undergo changes from a primary follicle to a secondary follicle, until they become an antral follicle. This process takes at least three months.
An antral follicle is a resting follicle or small follicle. Women usually have between 8-15 antral follicles at the start of each cycle. This will vary due to age, or conditions such as PCOS. One of these (usually) develops into a dominant follicle during the follicular phase and produces an egg at ovulation.
AMH and Egg Quality
As eggs take at least three months to mature from primordial follicles to antral follicles, we also want to work for three months to effectively improve egg quality.
You can have a low AMH and still improve the egg quality of the eggs that you do have.
In acupuncture, we improve egg quality by strengthening the kidney energy. We also recommend supplements and help to reduce stress.
AMH and PCOS
PCOS women have more than the average number of follicles, so the concentration of AMH in circulation is often raised considerably.
Women with PCOS often respond quickly to IVF stimulation and produce a large number of follicles and eggs. PCOS is an oestrogen dominant condition and additional oestrogen is produced by the increased number of follicles. There is a risk of hyper-stimulation so frozen transfers are often preferred.
AMH and AFC
AFC is the antral follicle count. This will be measured on a cycle to cycle basis or before IVF via an ultrasound transvaginal scan. It shows how many antral follicles there are within the ovary at the start of a cycle. This is usually performed between days 2-5 of the menstrual cycle. Combined with AMH or on its own, AFC gives a good indication of a fertility prognosis. Antral follicle count of less than 5 each side indicates diminished egg reserve.
What can you do to improve egg quality:
Acupuncture
COQ-10 600mg
If you have PCOS myo-inositol works well.
Folic acid, zinc, omega 3
Selenium - 3 Brazil nuts daily
Reduce stress through meditation, walks in nature and exercise.
Avoid smoking and alcohol
Maintain a healthy weight
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