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Can I Conceive with low AMH ?

By Dr. Anupma Chopra ( M.D. (Obst & Gynae) Fertility Specialist )

Can I Conceive with low AMH ?

Jun 29, 2024

Can I Conceive with low AMH ?
Low anti-Müllerian hormone (AMH) levels can be concerning for women trying to conceive, as AMH is a marker of ovarian reserve, indicating the remaining quantity of eggs in the ovaries. But then AMH can define the quantity and not the quality and you can conceive even with low AMH

Understanding AMH

  • AMH Levels: AMH is produced by the granulosa cells in ovarian follicles. It helps estimate the number of viable eggs a woman has.
  • Normal Range: AMH levels typically range from 1.5to 4.0 ng/ mL. Levels below 1.0 ng/mL are considered low.

Implications for Pregnancy

  1. Fertility: Low AMH levels often indicate a reduced ovarian reserve, which can make it more challenging to conceive naturally. However, it does not entirely predict the ability to get pregnant.
  2. Age Factor: AMH levels naturally decline with age. Women over 35 are more likely to have lower AMH levels.
  3. IVF Success Rates: Lower AMH levels may reduce the success rates of in vitro fertilization (IVF) due to fewer eggs being retrievable during stimulation.

Pregnancy with Low AMH

  • Natural Conception: While low AMH can make conception harder, many women with low AMH still conceive naturally.
  • Assisted Reproductive Technologies: Treatments like IVF can be tailored to women with low AMH to improve chances of pregnancy. Techniques include using higher doses of ovarian stimulation drugs or opting for donor eggs.

Managing Low AMH

  • Consult a Specialist: A fertility specialist can provide a comprehensive evaluation and personalized treatment plan.
  • Lifestyle Changes: Maintaining a healthy weight, reducing stress, and avoiding smoking and excessive alcohol can support overall reproductive health.
  • Supplements and Medications: Some studies suggest that supplements like CoQ10 and DHEA might improve egg quality and ovarian function.

Diminished Ovarian Reserve in young patients is a condition where the ovaries have fewer eggs than expected for the woman's age. This can be particularly challenging and distressing for young women who are trying to conceive. 

Understanding Poor Ovarian Reserve

  • Definition: Poor ovarian reserve is typically indicated by low levels of anti-Müllerian hormone (AMH) and antral follicle count (AFC), often accompanied by elevated follicle-stimulating hormone (FSH) levels.
  • Age Factor: Although more common in older women, young women (under 35) can also experience POR due to various factors.

Causes of Poor Ovarian Reserve in Young Patients

  1. Genetic Factors: Conditions like Turner syndrome or fragile X syndrome can affect ovarian reserve.
  2. Autoimmune Disorders: Some autoimmune diseases can impact ovarian function.
  3. Medical Treatments: Chemotherapy, radiation, or ovarian surgery can reduce ovarian reserve.
  4. Endometriosis: This condition can affect ovarian function and reduce egg count.
  5. Lifestyle Factors: Smoking, obesity, and certain environmental toxins can contribute to reduced ovarian reserve.


  • Blood Tests: Measuring AMH, FSH, and estradiol levels.
  • Ultrasound: Antral follicle count (AFC) through transvaginal ultrasound helps assess the number of small follicles in the ovaries.

Implications for Fertility

  • Natural Conception: POR can make it harder to conceive naturally, but it doesn't mean pregnancy is impossible.
  • Assisted Reproductive Technology (ART): Treatments like IVF can be more challenging but not impossible. The response to ovarian stimulation may be lower, requiring tailored protocols.

Management and Treatment

  1. Fertility Preservation: For those not ready to conceive immediately, egg freezing can be an option.
  2. IVF Protocols: Using higher doses of stimulation drugs, antagonist protocols, or adding growth hormone can improve response.
  3. Donor Eggs: In cases where egg quality or quantity is significantly compromised, using donor eggs might be considered.
  4. Supplements and Medications: Some supplements, like CoQ10 and DHEA, may help improve egg quality.
  5. Lifestyle Changes: Healthy diet, regular exercise, stress reduction, and avoiding 

Psychological Support

  • Emotional Impact: The diagnosis of POR can be emotionally challenging but fertility consultant can help u deal with this.
  • Ongoing Research: Studies are exploring new treatments and interventions to improve outcomes for young women with POR, including stem cell therapy and novel medications.

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