How to Increase AMH Levels

As a fertility dietitian, I often get asked about ways to increase Anti-Müllerian Hormone (AMH) levels naturally. AMH is an important indicator of ovarian reserve and fertility potential, but many women are surprised to learn that diet and lifestyle factors can influence these levels. While there’s no magic food that will dramatically increase AMH overnight, research shows that certain nutritional strategies may help support healthy AMH levels over time. In this post, I’ll break down the science behind AMH and share evidence-based dietary tips to optimize your reproductive health and potentially improve this key fertility marker. Is it possible to increase AMH levels and will increasing your levels increase your chance of falling pregnant? Let’s find out!

WHAT IS AMH?

Anti-Müllerian Hormone (AMH) is a hormone produced by the small immature eggs in the ovary that have not yet begun to develop into mature eggs. AMH serves as an overall indicator of ovarian reserve, which refers to a woman’s remaining egg supply in her ovaries. It is also a useful tool for doctors to assess a woman’s response to ovarian stimulation through hormone therapy during in vitro fertilization (IVF). AMH levels can provide insight into the timing of menopause, as research suggests that AMH becomes very low or undetectable approximately five years before menopause.

It’s crucial to understand that while AMH serves as a valuable indicator of ovarian reserve, it doesn’t definitively determine fertility or predict pregnancy rates. This distinction is often misunderstood, leading to unnecessary anxiety. In reality, as long as a woman is still ovulating, the possibility of conception remains, regardless of AMH levels. Many women with low AMH have successfully conceived and carried healthy pregnancies to term. AMH is just one piece of the complex fertility puzzle, and should be considered alongside other factors such as overall health, age, and partner fertility. Remember, AMH results provide insight into egg quantity, not necessarily egg quality or a woman’s ability to become pregnant. Therefore, while AMH is a useful tool in fertility assessment, it shouldn’t be viewed as the sole determinant of one’s reproductive potential.

HOW TO CHECK AMH

Typically, AMH levels are tested using a blood sample. Unlike other tests, AMH can be checked at any day of a woman’s cycle. If you’re getting a full fertility workup, it’s likely that you will also be tested for estradiol and FSH levels, two other hormones that aid in reproduction. It’s important to understand that AMH levels can fluctuate due to many different factors, with some months showing higher levels of AMH than others. Women with Polycystic Ovarian Syndrome (PCOS) may have elevated AMH levels, making it less reliable as a predictor of ovarian reserve.

According to the AJOG low AMH levels and lower limits of normal are determined by age. In general, normal levels are as follows:

Very Low: AMH <0.5 ng/mL
Low: AMH <1.0 ng/mL
Normal: AMH >1.0 ng/mL but <3.5 ng/mL
High Normal: AMH >3.5 ng/mL

Based on Age levels are as follows:

25 years old: 3.0 ng/mL.
30 years old: 2.5 ng/mL.
35 years old: 1.5 ng/ mL.
40 years old: 1 ng/mL.
45 years old: 0.5 ng/mL

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WHAT DOES THIS MEAN IN TERMS OF FERTILITY?

A woman is born with about a million immature eggs, which is the maximum number of egg cells that she’ll ever have in her whole entire life. By the time she hits puberty, the number has dropped to around 300,000. From that point on, egg supply will continue to decline. Rates of decline can vary from woman to woman with the rate of decline increasing with age and can vary based on factors such as genetics, lifestyle, and environmental exposures. Although AMH level strongly correlates with ovarian reserve, it is a poor predictor of pregnancy rate, infertility, or fertility. This means that if a woman has a low AMH, it does NOT mean she has a lower chance of getting pregnant (JAMA, 2017). All it takes is ONE egg.

Data has shown that AMH levels are a poor predictor of pregnancy and live birth. This would support the fact that AMH best predicts egg quantity, but not the quality of eggs (Iliodromiti, 2014) (Reshef Tal M.D, Ph.D, 205).

Dietary Recommendations to Increase AMH Levels

1- Increase Vitamin D

Recent research has unveiled a compelling link between vitamin D levels and Anti-Müllerian Hormone (AMH), a key indicator of ovarian reserve. Studies demonstrate that women with sufficient vitamin D levels tend to have higher AMH levels compared to those with vitamin D deficiency. This correlation is particularly significant because vitamin D plays a crucial role in egg survival and growth (Xu, 2018).While sunlight remains the primary natural source of vitamin D, relying solely on sun exposure can be challenging. Factors such as geographical location, seasonal changes, and cultural clothing practices can limit one’s ability to synthesize adequate vitamin D. Given these constraints, it’s essential to:

Regularly monitor your blood vitamin D levels
Consult with a fertility dietitian about potential vitamin D supplementation
Incorporate vitamin D-rich foods into your diet

Dietary Sources of Vitamin D:

Fatty fish (salmon, mackerel, sardines)
Egg yolks
Fortified dairy products
Mushrooms exposed to UV light
Fortified plant-based milk alternatives

2- Maintain a Healthy Weight

Maintaining a healthy weight appears to play a crucial role in optimizing AMH levels and overall reproductive health. While the relationship between body mass index (BMI) and AMH is complex, several studies suggest that obesity may negatively impact AMH production, particularly in cases of severe obesity. Achieving and maintaining a healthy weight through balanced nutrition and regular exercise can potentially improve AMH levels, especially in women with higher BMIs.

However, it’s important to note that weight loss should be approached carefully, as extreme or rapid weight loss may temporarily decrease AMH levels despite improving overall fertility outcomes. For women trying to conceive, working with a fertility specialist or dietitian to develop a personalized plan for gradual, sustainable weight management is recommended to support optimal AMH levels and reproductive function.

3- Increase Fish Intake

Research has uncovered a fascinating link between fish consumption and AMH. A landmark study found that women who incorporated fish into their daily diet experienced a significant three-year delay in the onset of menopause. This finding suggests that regular fish consumption may have a positive impact on ovarian function and, by extension, AMH levels.

The Omega-3 Connection

The beneficial effects of fish on reproductive health are largely attributed to their rich omega-3 fatty acid content. Omega-3s, particularly EPA and DHA, have been shown to:

Support overall hormonal balance
Reduce inflammation in the body, which can negatively impact fertility
Improve egg quality and embryo development

4- Increase Intake of Yellow & Green Veggies

Research has indicated that increasing consumption of green and yellow vegetables may have a positive impact on ovarian reserve and the timing of menopause. A systematic review found that higher intake of these nutrient-dense vegetables was associated with a delay in the onset of natural menopause. While the exact mechanisms are not fully understood, it’s believed that the high antioxidant content and beneficial phytonutrients in green and yellow vegetables may help protect ovarian follicles and potentially support AMH production, thus contributing to the maintenance of ovarian function for a longer period.

5- Increase CoQ10

Coenzyme Q10 (CoQ10) is a powerful antioxidant that plays a crucial role in cellular energy production, particularly in the mitochondria. While our bodies naturally produce CoQ10, this production declines significantly with age, potentially impacting egg quality and AMH levels. Research suggests that supplementing with CoQ10 may help preserve egg quality and potentially support AMH levels, especially in women of advanced reproductive age.

Food sources are varied but include red meat, fish and avocado. Dosing varies person to person so it’s important to speak with a fertility dietitian before initiating CoQ10 supplementation.

6- Increase Zinc Intake

A recent study demonstrated that dietary zinc deficiency in mice led to a reduction in the total number of follicles and mature follicles, which correlated with decreased levels of AMH. This suggests zinc deficiency may indirectly lower AMH levels by impacting follicle development.

BOTTOM LINE

While AMH serves as a valuable indicator of ovarian reserve, it’s important to understand that it doesn’t directly predict pregnancy outcomes. Although we can’t increase egg count or stop the natural aging process, adopting specific dietary and lifestyle changes may help support egg quality and overall fertility. Focusing on nutrient-dense foods rich in essential vitamins and minerals can potentially improve reproductive health. Additionally, maintaining a healthy weight is crucial not only for fertility but also for overall well-being. By taking a holistic approach to health that includes a balanced diet, regular exercise, and stress management, individuals can create an optimal environment for conception, regardless of their AMH levels.