What are the Anti-Mullerian Hormone (AMH) levels by age?

AMH (anti-Mullerian Hormone) is a glycoprotein (made up of glucose and proteins) hormone that has different roles in both males and females. It is a very crucial hormone related to reproductive health. Its levels vary with age as in males, its role is only at the time before birth. While for females, its continuous level (although in a negligible amount) is present throughout their reproductive life as it has an essential effect on the reproductive cycle. It gives an account of the fertility of females (ability to reproduce). 

What are the different AMH levels per age?

The answer to the query of what are the levels of AMH by age is that its level is related to the age of the ovaries as they will produce a lower quantity of the anti-Mullerian hormone over time. So it also indicates the decrease in fertility level with increasing age. AMH levels can be tested using an AMH blood test. Now we will discuss the exact mode of action of anti-Mullerian hormone and what proportion of its level decreases with age. 

According to Manchester Fertility, the below ranges are the most common found in apparently healthy women who are not using any contraceptive

Anti-Mullerian Hormone for Women by Age Group (units are in pmol/l)

• 20-29 years 13.1 - 53.8
• 30-34 years 6.8 - 47.8
• 35 - 39 years 5.5 - 37.4
• 40-44 years 0.7 - 21.2
• 45 - 50 years 0.3 - 14.7

Read more: What is a good AMH level?

Anti-Mullerian hormone significance in males

Anti-Mullerian Hormone has an essential role at the time of sex differentiation in the foetus (infant after eight weeks of conception). It is the Mullerian duct-inhibiting hormone which develops the female reproductive organs during early foetal development. If it is not regressed in males (in rare cases), it can lead to cryptorchidism (one or both testes fail to descend in the scrotum). Sometimes female organs also develop and descend along with the testis. Males are usually infertile if this regression of the Mullerian duct fails.

So, to cope with all these situations, foetal Sertoli cells (somatic cells of the testis) secrete anti-Mullerian Hormone, which leads to differentiation as a biological male. It has another role in regulating the level of FSH in males, which is, in turn, a regulator of Sertoli cell production during prenatal growth. 

Role of anti-Mullerian Hormone in females

During the postembryonic period, if the foetus is designated as female, the anti-Mullerian hormone is absent because it only releases from functional ovaries, but its level is not so noticeable. In adult females (after puberty), it is released in a negligible amount.

During pregnancy, the level gradually decreases, which indicates ovarian regression. Its level is such that during the first, second and third trimesters is 1.69 ng/ml, 0.8 ng/ml and 0.5 ng/ml, respectively. Before parturition, its level increased gradually to some extent. In women of more than 35 years of age, if pregnancy occurs, the level of AMH is even lower compared to the normal level during pregnancy in young females. It decreases due to the decreasing performance of ovaries in folliculogenesis.

Read more: What is AMH?

What is the level of anti-Mullerian Hormone with respect to age?

Anti-Mullerian hormone level is normally very low in the body, both in males and females. It is measured in nanograms per millilitre, and its quantity range from 1-3 ng/ml. If we generally talk about its level in the body, it has an inverse relationship with age. Its amount is about 3 ng/ml for up to 25 years of age. 

Then it starts decreasing, and by 30, its level is 2.5 ng/ml. At 35, 40 and 40 years of age, its level drops to 1.5, 1 and 0.5 ng/ml. It is an average estimate and can vary depending on the body's working conditions. This decrease is related to the fall in the functioning capacity of ovaries. With menopause, when ovaries are non-functional, AMH is undetectable. 

What is the test to check the level of AMH in the blood?

AMH test is done as a blood test which is done to determine if the hormone is present in the body or not. It is used to predict the onset of menopause, fertility, polycystic ovaries and granulose tumours. 

Read more: Why should I test my AMH levels?

Complications due to changes in the levels of AMH

In males, if AMH is not released, it leads to persistent Mullerian duct syndrome (PMDS). The male is usually sterile as it leads to the failure of descend of the testis in the scrotum, a situation known as cryptorchidism. Also, the chances of hernia and prostate cancer increase.

Female reproductive organs may also develop in them. In females, the increase in AMH leads to the development of polycystic ovaries. At the same time, a decrease is linked with non-functional ovaries because in this condition, AMH level increases which gives negative feedback to FSH. It leads to hyperandrogenism (increased release of androgens). Its elevated level can be linked with a tumour of granulosa cells of ovaries in which its level increase by about 76 to 93%.

Regulation of AMH secretion

AMH stimulates the release of FSH in the females, which then results in folliculogenesis (follicles formed on the ovaries that mature to make an egg). Then FSH will give negative feedback, decreasing its level in the body. So FSH causes the down-regulation of AMH. A study also checked the effect of GnRH on its level, which indicated that GnRH also leads to a decline in AMH level due to the negative feedback mechanism. In the case of males, testosterone also down-regulates the level of the anti-Mullerian Hormone. 

Conclusion: 

The level of anti-Mullerian Hormone is not independent of age and pregnancy. Its level decreases with the increase in age and pregnancy duration. If we test its level during pregnancy, it will not be a good and true indicator of fertility and ovarian health. New research and studies use it as a biomarker to study the ovaries' health and functioning. Its level is independent of the menstrual cycle; in serum, its quantity ranges from 2 to 6.8 ng/ml. Its amount in serum is related to age, and if menopause occurs or due to any complications in which ovariectomy is done, it can't be detected after 4-5 days, even if the female has a proper menstrual cycle.  

If you're looking to test your AMH levels, Welzo offers an AMH at-home Blood Test.