AMH and Egg Retrieval Outcomes

One of the key factors in determining whether egg freezing is a viable option is the level of a hormone marker for ovarian reserve, called Anti-Mullerian Hormone (AMH). In this article, we will discuss what AMH is and how (if at all) it is correlated with the number of eggs you can expect to have retrieved during egg freezing.

First off, what is AMH?

Anti-Müllerian Hormone (AMH) is a hormone that is produced by the granulosa cells in the ovarian follicles. The level of AMH in your blood is used as an indicator of your ovarian reserve, or the number of eggs remaining in your ovaries. Generally, the higher the level of AMH, the greater the number of eggs you have in your ovaries. Conversely, a lower level of AMH suggests a lower ovarian reserve. Since females are born with a fixed number of eggs, this number naturally declines over time. 

Does AMH tell you how many eggs you have?

Your AMH level corresponds to how many eggs you have (your ovarian reserve), but it can’t tell you the exact number of eggs. That being said, AMH levels have been shown to be a good predictor of ovarian reserve and response to fertility treatment. There are other factors such as age, overall health, and genetics that can also affect the number and quality of eggs. So while AMH can be a useful tool in assessing your fertility, it should not be the only factor considered when making decisions about fertility treatment.

Does AMH predict the number of eggs you will retrieve?

The overall success of an egg freezing cycle largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments. 

But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the fertility doctor performing the procedure.

When eggs are retrieved, only a portion of those eggs will be mature. A mature egg is one that’s ready and able to be fertilized. At most clinics, any non-mature eggs are discarded, though you can talk to your clinic about whether they’re open to freezing those too. 

Is AMH correlated with the number of eggs retrieved during egg freezing?

Multiple studies have shown a strong correlation between AMH levels and mature eggs retrieved during egg freezing or IVF.

Let’s look at a few of the studies:

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The study: Correlation between anti-Müllerian hormone, age, and number of oocytes [1]

Who: 1500 patients in Brazil between July 2012 and April 2019

The findings: “A positive correlation was found between serum AMH levels and total number of retrieved and mature oocytes from stimulated cycles”

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The study: Different anti‐Műllerian hormone (AMH) levels respond to distinct ovarian stimulation methods in assisted reproductive technology (ART) [2]

Who: 1,112 patients undergoing an egg retrieval as part of ART

The findings: “AMH showed a stronger correlation with egg number compared with age over a wide age range”

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The study: Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy [3]

Who: 314 infertility patients with an average age of 31.0 ± 4.5 years

The findings: “the AMH level of women of all ages was positively correlated with the number of retrieved oocytes “

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The study: Antimullerian hormone (AMH) is a predictor of the number of eggs retrieved and D3 embryos in women with fluctuating and persistently elevated FSH levels [4]

Who: 58 women with fluctuating and persistently high serum day 3 (D3) FSH.

The findings: “These data demonstrate for the first time that serum AMH is a prognostic indicator independent of age and FSH of the number of eggs retrieved”

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The study: Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels [5]

Who: 73 women undergoing ART with elevated early follicular FSH levels

The findings: “Random AMH levels were strongly correlated with the number of oocytes retrieved during an ART cycle among women with elevated FSH”

AMH and egg freezing

As we’ve covered, AMH can be used as an indicator of ovarian reserve and response to fertility treatments like egg freezing. While AMH cannot tell you the exact number of eggs you have, studies have shown that it can be used as a predictor of egg quantity, which is crucial for the success of egg freezing. 

The relationship between AMH levels and the number of eggs retrieved during egg freezing is positive, with higher AMH levels generally indicating more eggs retrieved. However, there are other factors that can affect the number and quality of eggs produced, including age, overall health, and genetics. Thus, while AMH can be a useful tool in assessing fertility, it should not be the only factor considered when making decisions about fertility treatment. 

Freeze your eggs with Cofertility

Regardless of your AMH level, we’d love the opportunity to support you on your egg freezing journey. 

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive. 

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other. 

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

If you don’t know your AMH and you’re interested in getting it tested as a baseline assessment, reach out and we’ll share next steps. 

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Read more:

• Which Matters More for Fertility: AMH or age?
• What AMH Level Do I Need to Freeze My Eggs?
• Do’s and Don’ts During Egg Freezing: Alcohol, Baths, Exercise, and More

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Sources:

1. Kozlowski IF, Carneiro MC, Rosa VBD, Schuffner A. Correlation between anti-Müllerian hormone, age, and number of oocytes: A retrospective study in a Brazilian in vitro fertilization center. JBRA Assist Reprod. 2022;26(2):214-221. Published 2022 Apr 17. doi:10.5935/1518-0557.20210083
2. Ishii R, Tachibana N, Okawa R, et al. Different anti-Műllerian hormone (AMH) levels respond to distinct ovarian stimulation methods in assisted reproductive technology (ART): Clues to better ART outcomes. Reprod Med Biol. 2019;18(3):263-272. Published 2019 Apr 4. doi:10.1002/rmb2.12270
3. Sun XY, Lan YZ, Liu S, Long XP, Mao XG, Liu L. Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy. Front Endocrinol (Lausanne). 2020;11:595448. Published 2020 Dec 4. doi:10.3389/fendo.2020.595448
4. Buyuk E, Seifer DB, Grazi R, Lieman H. Antimullerian hormone (AMH) is a predictor of the number of eggs retrieved and D3 embryos in women with fluctuating and persistently elevated fsh levels. Fertility and Sterility. Published 2010 Sep. doi.org/10.1016/j.fertnstert.2010.07.417 
5. Buyuk E, Seifer DB, Younger J, Grazi RV, Lieman H. Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels. Fertil Steril. 2011;95(7):2369-2372. doi:10.1016/j.fertnstert.2011.03.071