At Ioannis Raptis’ clinic, infertility issues are managed in accordance with the guidelines of the “Frankfurter Hormonschule” and the International Society of Gynecological Endocrinology (ISGE).
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The anti-Müllerian hormone (AMH) has emerged as a key indicator for the assessment of women’s fertility. It is a hormone that is primarily quantitatively, but also to some extent qualitatively, associated with the available reserve of oocytes in the ovaries, also known as ovarian reserve. Although it is not a predictive tool for conception, its importance in assisted reproduction and in the planning of motherhood is significant.
Anti-Müllerian hormone is produced by the granulosa cells of small developing follicles in the ovaries. Its concentration in the blood reflects the number of these follicles, providing an indirect estimate of the total egg reserve in the ovaries. Its level naturally declines with age, especially after 35, and reaches zero at menopause.
AMH has the advantage of not being affected by the menstrual cycle. Unlike other hormonal tests, it can be performed on any day of the cycle. Fasting is not required, and its interpretation is independent of temporary hormonal fluctuations in the body.
AMH testing is particularly useful for women who wish to assess their fertility, for patients with menstrual cycle disorders, and for those planning to undergo assisted reproductive procedures.
More specifically, AMH measurement is of particular value in the following cases:
Women who wish to delay motherhood and want to know their available ovarian reserve.
Women with a family history of premature menopause or with hormonal disorders that cause cycle irregularities.
Patients prior to initiating in vitro fertilization or egg freezing procedures, in order to select the appropriate treatment protocol.
Knowledge of AMH levels plays a decisive role in planning a woman’s overall reproductive strategy.
The interpretation of AMH depends on the woman’s age and on other factors related to her reproductive history. High levels are associated with an adequate number of follicles, whereas low levels may indicate a reduced reserve.
However, low AMH does not automatically mean infertility. Many women with low levels are able to conceive naturally without any problem, especially if they are of a young age. This is because during natural conception, only one egg per month is needed to achieve pregnancy.
Similarly, high AMH levels do not automatically mean ease of conception, as this is also determined by other factors (hormonal status, tubal function, sperm quality, etc.).
In any case, AMH serves as a predictive tool for ovarian response to assisted reproduction treatments. The final interpretation is always made in combination with the patient’s history and the remaining clinical, laboratory (e.g., FSH, LH, and estradiol), and ultrasound evaluation.
AMH testing has been established as an integral part of the initial assessment in assisted reproduction treatments.
In in vitro fertilization (IVF), and in combination with age, AMH is useful for:
AMH can completely differentiate the approach to an IVF cycle, tailoring it precisely to the needs of each woman.
Although AMH is a reliable indicator of ovarian reserve, there are clear limitations to its diagnostic capacity. It does not provide specific information about the quality of the oocytes, the probability of natural conception, or the condition of the rest of the reproductive system (uterus, fallopian tubes).
AMH levels alone cannot predict or exclude the success of any attempt to conceive. For this reason, it should be included within a comprehensive fertility assessment and in determining the appropriate assisted reproduction strategy.
As more and more women choose to postpone motherhood for personal, professional, or social reasons, AMH measurement plays a decisive role in decision-making. Through this simple test, and in combination with individualized fertility counseling by a gynecologist, each woman has the opportunity to understand her reproductive potential, plan her next steps in a timely manner, and possibly make decisions regarding pregnancy or oocyte cryopreservation.
For specialized guidance and support in every fertility assessment, Obstetrician – Gynecologist Ioannis Raptis and his team are at your disposal. Contact us.
