Anti-Müllerian Hormone (AMH) is a protein produced by the ovaries that indicates a woman’s ovarian reserve, or the remaining quantity of eggs. Many people wonder if this measured number is fixed, especially after receiving a low result. While a true, sustained increase in ovarian reserve is biologically improbable, the measured AMH value can fluctuate. These changes usually reflect temporary biological effects, laboratory variations, or the optimization of existing follicular function, not a regeneration of the egg supply.
Understanding AMH and Ovarian Reserve
AMH is secreted by the granulosa cells surrounding the eggs within the small, growing follicles in the ovary. The level of AMH in the bloodstream is directly proportional to the size of this pool of pre-antral and small antral follicles. Because these follicles are continuously recruited from the finite supply of primordial follicles, AMH serves as a proxy for the remaining egg count.
This finite supply is established before birth and naturally diminishes over a woman’s reproductive lifespan until menopause. The age-related decline in AMH reflects this continuous depletion of the ovarian follicle pool. Therefore, a significant, long-term increase in AMH that indicates a true reversal of ovarian aging is not expected.
Causes of Testing Fluctuation
Apparent increases in AMH levels are most often due to temporary suppression of the hormone or testing inaccuracies. A common cause of a measured rise is the recent discontinuation of hormonal contraceptives, such as the combined oral contraceptive pill. These contraceptives temporarily suppress ovarian activity, which can lead to measured AMH levels lower than the baseline value.
After stopping the pill, AMH levels typically rebound to their true baseline within two to three menstrual cycles. This change is not an actual increase in ovarian reserve but the unmasking of the woman’s actual hormone production.
Similarly, a severe deficiency in Vitamin D has been linked to lower AMH readings. Correcting this deficiency through supplementation may result in a measured increase, suggesting that optimal Vitamin D levels are needed for granulosa cell function.
Furthermore, variability between different laboratory assays and testing platforms can cause the same blood sample to yield slightly different results. If a woman is tested years apart using different assay generations, the change in the number may reflect technological improvements more than a biological shift.
Non-Hormonal Influences on Ovarian Function
While no supplement or lifestyle change can create new eggs, certain non-hormonal strategies can optimize the environment for the remaining follicles, potentially stabilizing or modestly improving AMH readings.
Dehydroepiandrosterone (DHEA), a mild androgen, is studied in women with diminished ovarian reserve. DHEA supplementation creates a more favorable androgen microenvironment in the ovary, supporting follicular health. This optimization can lead to an improved response to fertility treatments, including an increase in oocytes retrieved. Coenzyme Q10 (CoQ10) is another compound used, functioning as a powerful antioxidant that supports mitochondrial energy production. CoQ10 is theorized to improve the energy status of the egg, promoting better egg quality and follicular health.
For women with Polycystic Ovary Syndrome (PCOS), Myo-Inositol is often used to improve insulin sensitivity. However, women with low AMH should note that Myo-Inositol can potentially suppress androgen levels, which may be counterproductive to follicular health.
Adopting an anti-inflammatory diet, improving sleep hygiene, and managing chronic stress are also important. Systemic inflammation and cortisol imbalances can negatively affect the complex endocrine signaling required for optimal ovarian function.
Why the AMH Number Isn’t the Only Metric
The AMH value is a reliable indicator of the quantity of eggs remaining, but it is not a perfect predictor of fertility success. AMH is not able to measure egg quality, which is the most important factor for achieving a healthy pregnancy. Even a low AMH reading, if paired with good egg quality, can lead to a successful outcome.
Fertility specialists rely on other metrics to form a comprehensive picture of reproductive potential. The Antral Follicle Count (AFC), determined by transvaginal ultrasound, is a direct count of the small follicles visible in the ovaries. This count is often strongly correlated with AMH and provides immediate, complementary information about the current functional reserve. Follicle-Stimulating Hormone (FSH) levels, typically measured early in the menstrual cycle, also offer insight into the communication between the brain and the ovaries. While AMH is relatively stable throughout the cycle, FSH fluctuates and is a measure of the ovary’s responsiveness. Treatment decisions are rarely based on AMH alone; instead, a patient’s age, AFC, and FSH levels are all considered together to guide the most appropriate course of action.