The AMH test’s full form is Anti-Mullerian Hormone. It measures the amount of AMH in the blood, providing insights into reproductive health. Both males and females produce this hormone, but it is mainly used to assess ovarian reserve, which refers to the number of eggs remaining in the ovaries in women. AMH is produced in the ovaries by small follicles housing immature eggs. Higher AMH levels typically indicate a larger number of growing follicles, suggesting a greater ovarian reserve. As women age, AMH levels decrease, reflecting the natural decline in egg quantity, with levels dropping to zero after menopause.

In conditions like polycystic ovary syndrome (PCOS), AMH levels can be elevated because of a higher number of small follicles present in the ovaries.

Low AMH levels can occur due to ageing, illness, chemotherapy, or surgical procedures, potentially affecting fertility. The AMH test is often used to predict ovarian response during fertility treatments like in vitro fertilization (IVF), helping to tailor hormone treatment protocols.

The AMH test price ranges from Rs. 2000/- . Our AMH test cost includes home sample collection within 60 minutes of booking. Orange Health Labs offers this test at competitive rates, with the added convenience of home-based testing. While you can enjoy the ease of testing from home, please be aware that prices may vary based on your location and the laboratory you choose. The AMH test cost in other cities is as given below:

Here’s what you should know before the AMH test:

Pre-requisites : Fasting is not required before an AMH test, and you can eat and drink as usual prior to the test.

Precautions Before the Test: You do not need any special preparations for an AMH test. The test can be taken at any time during your menstrual cycle, as it is not affected by the timing of your period. Typically, one test is sufficient, but if there has been a long delay (over a year) since your last test, it may be recommended to repeat it. This is because AMH levels can change over time.

The AMH blood test requires a simple blood sample. Once you schedule the test with Orange Health Labs, a trained eMedic will come to your location for home sample collection. The process includes the following steps:

• Preparation : The eMedic will explain the procedure to you and answer any questions you may have. You will be asked to sit comfortably for the test.

• Site Selection : The eMedic will select a vein, usually in the inner elbow area, and clean the area with an antiseptic wipe.

• Needle Insertion : A needle will be inserted into the vein to draw blood, and you may experience a mild pinch or sting at this point.

• Blood Collection : The necessary amount of blood will be drawn into a vial.

• Needle Removal : After the blood is collected, the needle will be removed, and the eMedic will apply pressure with a gauze pad to stop any bleeding.

• Bandaging : A small bandage will be placed over the puncture site for protection.

The sample collection process usually takes around just a few minutes. AMH test results are typically available within 7 hours after the sample is collected.

The AMH test is used in females for various purposes, such as:

• Primarily used to assess the ovarian reserve, helping to determine how many eggs remain in the ovaries. Although AMH can indicate the number of eggs, it doesn’t predict egg quality or the likelihood of pregnancy.

• Indicate if you are approaching menopause or are in early or premature menopause phase. AMH levels decrease as you age, and testing can help monitor this process.

• Diagnose and monitor conditions like PCOS or certain types of ovarian cancer, both of which can lead to elevated AMH levels.

• Help in fertility planning by determining if a woman has a normal egg supply for her age, which is vital, especially when considering IVF. Higher AMH levels are generally associated with a more favourable response to fertility medications, while lower levels may require higher doses to stimulate the ovaries effectively.

For male babies and children, AMH testing can:

• Check for healthy testicles in individuals with undescended testicles, as healthy testicles produce AMH.

• Help diagnose conditions in babies born with atypical genitalia (formerly called ambiguous genitalia or intersex), as AMH levels can provide information about the presence of testicular tissue and assist in determining the cause of the condition.

AMH testing is a key tool for evaluating fertility potential, diagnosing hormonal disorders, and monitoring ovarian health.

You may need an AMH blood test if you:

• Experience fertility problems and want to assess your egg supply.

• To determine appropriate treatment with fertility medications for IVF treatment.

• Have symptoms of PCOS, such as irregular or absent periods, acne, excess body hair, hair loss on the head, weight gain, or dark skin patches.

• Want to monitor treatment progress of ovarian cancer or detect its recurrence.

• Would like to assess internal testicular health in a male baby or child with undescended testicles.

• Have a baby with ambiguous genitalia requiring AMH testing to help confirm the sex and diagnose the cause of ambiguous genitalia.

• Are undergoing fertility treatment, particularly if you have had a previous poor response to it, are over 35 years of age, have high FSH or E blood results, or have polycystic ovaries.

You may need an AMH test if you experience any of the following:

• Fertility problems : If you are struggling to get pregnant, the AMH test can help assess your ovarian reserve and provide insights into your chances of conceiving.

• IVF treatment : The test helps determine how well you may respond to fertility medications used during IVF.

• Irregular menstrual cycles : If you have irregular or absent periods, the AMH test can help diagnose conditions like PCOS..

• Symptoms of PCOS : These include excess body hair (e.g., on the face, chest, or thighs), acne, male-pattern baldness, weight gain, and dark patches of skin.

• Age-related concerns : If you are over 35 and concerned about your fertility or approaching menopause, the AMH test can help estimate your reproductive window..

• Previous poor response to fertility treatments : If you have had difficulty responding to fertility medications in the past, the AMH test can guide adjustments in treatment.

• Monitoring ovarian health : AMH levels can help assess conditions like ovarian cancer or assess the effectiveness of treatment.

• Undescended testicles in male babies : An AMH test can help assess testicular health in babies with undescended testicles.

• Ambiguous genitalia in babies : If a baby is born with ambiguous genitalia, an AMH test can provide important information about the presence of testicular tissue and aid in diagnosis.

The results of an AMH test can vary depending on the reason for testing. Here is what the results might indicate in women:

The reference range for serum AMH concentrations in adult men is as follows:

• Age 20-39 years – 18. to 90. pmol/L

• Over 39 years – 12. to 87. pmol/L.

This information summarises what the AMH levels generally mean; however, their interpretation can vary depending on individual circumstances, so it is important to discuss results with your doctor.-

The AMH test measures the AMH levels in the blood.

In women, AMH is produced by small ovarian follicles, which are sacs containing immature eggs. The amount of AMH in blood reflects the number of developing follicles, providing an estimate of a woman's ovarian reserve, or the number of eggs remaining in the ovaries. AMH levels decrease with age as the egg supply decreases, and AMH levels drop significantly at menopause when no eggs are left. Higher AMH levels typically signify a greater ovarian reserve, while lower levels indicate fewer remaining eggs.

In men, AMH is produced by the testicles and plays a role in the development of male reproductive organs during foetal development. In both males and females, AMH levels can help diagnose certain reproductive health conditions.

AMH levels may change depending on age and individual factors. In men, AMH levels rise rapidly in the first month of life, peak around months, and then decline, reaching low levels by puberty.

In healthy women, AMH levels typically follow this pattern:

• Age 20 years to early 30s : AMH levels are at their highest, reflecting a good ovarian reserve.

• Mid to late 30s : AMH levels begin to decline gradually as the number of eggs decreases.

• 40s : AMH levels progressively decline, reflecting a reduced ovarian reserve.

• Post-menopausal women : AMH levels drop to very low or undetectable levels, as the ovaries no longer produce eggs.

It is important to note that AMH levels vary from person to person, and factors like health conditions (e.g., PCOS) or fertility treatments may also influence AMH test results.

Several factors can interfere with the accuracy of AMH test results, including:

• Age : AMH levels naturally decline with age, reflecting a decrease in ovarian reserve.

• Health Conditions : Conditions like PCOS can lead to elevated AMH levels.

• Fertility Treatments : IVF or other fertility treatments can influence AMH levels depending on ovarian response.

• Ovarian Surgery : Previous surgery on the ovaries can impact AMH levels by reducing ovarian reserve.

• Pregnancy : A full-term pregnancy may lead to temporary suppression of ovarian activity, causing a significant decrease in AMH levels during pregnancy. This reduction can lead to misinterpretation of a woman’s actual ovarian reserve. After childbirth, AMH levels quickly rise again, which can further complicate the interpretation of ovarian reserve during the postpartum period. Therefore, AMH should not be used as a sole parameter for assessing ovarian reserve during pregnancy or immediately after childbirth.

• Reproductive issues : In boys, measurable AMH levels may suggest undescended testes, while undetectable levels suggest the absence of testicles. Additionally, elevated AMH levels in prepubertal boys with varicocele may indicate early abnormalities in seminiferous epithelial function.

When to Seek Medical Advice Based on AMH Test Results

Abnormal AMH test results may indicate underlying health problems that require additional evaluation and treatment.

• Consulting a Doctor for High/Abnormal AMH Levels : If your AMH levels are higher than expected, particularly if you have symptoms of PCOS or other conditions, it is important to consult a doctor for further evaluation and management.

• Addressing Abnormal AMH Results : If your AMH levels are unusually low, it could indicate a reduced ovarian reserve or early menopause. It is crucial to speak to your doctor to explore potential fertility treatment options or investigate the underlying causes.

• Medication Adjustments Based on AMH Levels : If you are undergoing fertility treatments or other medical procedures, your doctor may adjust medication doses (such as fertility drugs) based on your AMH levels to optimise your treatment plan and improve the chances of success.

Advantages of Early AMH Testing

The AMH test offers valuable insights into reproductive health and can be used to guide various medical decisions, including fertility treatment and diagnosis. Here are some key benefits:

• Assess Ovarian Reserve : Helps evaluate the number of eggs remaining in the ovaries, giving a clear picture of fertility potential, especially in women trying to conceive.

• Predict Fertility Treatment Response : AMH levels can guide doctors in determining how well a patient may respond to fertility treatments like IVF, allowing for personalised treatment plans.

• Monitor Reproductive Health : It helps detect conditions such as PCOS and primary ovarian insufficiency, both of which can impact fertility.

• Detect Early Menopause : Low AMH levels can indicate the onset of menopause or premature ovarian failure.

• Guide Cancer Treatment Decisions : For women undergoing cancer treatment, AMH levels can be used to assess the impact of chemotherapy on ovarian function and fertility.

• Assess Testicular Health in Male Children : In male infants, AMH levels can help diagnose conditions like undescended testicles or other reproductive health issues.

• Cost-Effectiveness : Provides a stable and reliable measure of ovarian reserve, helping guide fertility decisions and reduce unnecessary treatments.

The AMH test can help diagnose a variety of reproductive health conditions, particularly those related to fertility. Common diseases and conditions identified through AMH testing include:

• PCOS

• Primary ovarian insufficiency

• Early menopause

• Ovarian cancer

• Undescended testicles in male infants

• Atypical genitalia (ambiguous genitalia)

Risk Factors for Elevated AMH Levels

Certain factors may increase the likelihood of developing conditions that affect AMH levels. These include:

• History of ovarian surgery

• Oral contraceptives

• Chemotherapy

• BRCA mutations

• Obesity

• Vitamin D deficiency

Complications From Untreated Elevated AMH Levels

Untreated abnormal AMH levels in women are associated with significant complications, such as:

• Infertility or difficulty getting pregnant : Low AMH levels indicate a reduced ovarian reserve, making it harder to conceive naturally

• Premature ovarian failure or early menopause : Very low AMH levels may indicate primary ovarian failure, leading to early menopause and an earlier end to fertility

• Irregular menstrual cycles : High AMH levels, often associated with PCOS, can cause irregular periods, complicating a woman’s fertility journey

• Increased risk of miscarriage : Low AMH levels can indicate poor egg quality, increasing the likelihood of miscarriage during pregnancy

• Difficulty in responding to fertility treatments (IVF): Low AMH may lead to a poor response to fertility medications, while high AMH may lead to ovarian overstimulation during IVF

• Hormonal imbalances : High AMH levels in conditions like PCOS can cause an imbalance in hormones, leading to symptoms like acne, hair growth, and irregular menstrual cycles

• Development of ovarian cysts or polycystic ovaries : Elevated AMH levels are often associated with PCOS, where multiple small cysts develop in the ovaries, affecting fertility

• Impact on the success of assisted reproductive technologies (ART) : Low AMH levels may reduce the number of eggs retrieved during IVF, affecting the success of the procedure

Although there is no correlation between AMH levels and lifestyle factors, maintaining a healthy lifestyle supports fertility in the following ways:

• Exercise Regularly : Engage in moderate physical activity to promote overall health and fertility.

• Maintain a Healthy BMI : Achieve a balanced weight, as both obesity and being underweight can affect reproductive function.

• Eat a Balanced Diet : Focus on eating a variety of whole foods, including fruits, vegetables, and plant-based proteins, while limiting unhealthy fats.

• Avoid Smoking : Smoking can reduce ovarian reserve, negatively impacting fertility.

• Manage Sleep : Aim to get quality sleep each night to support hormonal balance and overall health.

• Monitor and Manage Stress : Practice relaxation techniques, such as meditation or yoga, to reduce stress, which can disrupt fertility and hormonal levels.

Besides the AMH test, other tests used to assess ovarian reserve and fertility include the following:

• Antral Follicle Count (AFC) uses ultrasound to count the visible follicles in the ovaries.

• FSH and oestradiol tests assess hormone levels that regulate follicle growth and menstrual cycles. Elevated FSH or abnormal oestradiol levels can suggest reduced ovarian reserve.

• The Progesterone test helps confirm ovulation, while the LH test assesses ovulation and hormonal imbalances.

• Thyroid function tests are important to check for thyroid imbalance as it can affect fertility.

• The Prolactin test checks for hormone levels that may disrupt ovulation.

• The Testosterone test checks for testosterone levels in women. Elevated levels can indicate conditions like PCOS.

These tests together provide a comprehensive understanding of a woman's reproductive health.

AMH testing provides a reliable and consistent measure of ovarian reserve, as its levels remain stable throughout the menstrual cycle. In contrast, tests like FSH, LH, and oestradiol fluctuate during the cycle and are more affected by the timing of the test. While the AFC also assesses ovarian reserve, it requires ultrasound and does not provide as consistent a value as AMH. Overall, the AMH test is a more reliable marker for ovarian reserve, while other hormone tests primarily assess ovarian function and cycle regulation.