Can you improve AMH levels?
You can definitely make some changes to your diet and lifestyle that can be supportive of your fertility, but it’s worth asking if focusing on AMH is the best approach for your fertility journey. For many women trying to get pregnant, focusing on improving egg quality can be far more beneficial than focusing only on AMH levels. The good news is that you can actually improve egg quality over about three to four months. While AMH levels can give you an idea of the number of eggs you have left, it doesn’t highlight if those eggs can fertilise, develop properly, or lead to a successful pregnancy.
This article explains what AMH really measures, why looking at only your AMH levels in isolation might be misleading, and where to direct your efforts to boost your reproductive health instead of fixating on one measurement. If you’re worried about a recent AMH result and want to explore the bigger picture, Floralia offers fertility consultations with a naturopath who can work alongside your doctor or fertility specialist to focus on the lifestyle factors that can significantly impact your chances of conceiving.
The honest answer about raising AMH levels
Many articles claim to offer ways to boost Anti-Mullerian Hormone (AMH) levels, but these suggestions often oversimplify the facts. AMH levels indicate the quantity of small follicles present in your ovaries, and once these follicles are depleted, no diet, supplement, or lifestyle adjustment can restore them. Suggesting otherwise tends to exaggerate the findings of scientific studies.
There are steps you can take to improve your fertility, including correcting any lifestyle factors, nourishing the existing follicles, improving egg quality and seeking support for a holistic fertility practitioner who can look at your fertility with a broader perspective. The combined effect of these measures will have a much greater influence on your chances of conception than the number printed on your blood test.
Here, the framing is important, since women are frequently presented with a low AMH score and are told that their time frame for fertility is running out. This may not be the case at all, but the anxiety that such information generates frequently leads women to seek costly options prematurely.
Why AMH became the number women obsess over
Anti-Mullerian hormone (often referred to as AMH) is secreted by the tiny follicles in your ovaries. It has gained popularity as a fertility marker because its levels remain consistent throughout the menstrual cycle. Measuring AMH is straightforward, requiring just a simple blood test. Often, fertility clinics will rely on it to assess how well a woman might respond to in vitro fertilisation (IVF), especially during the egg retrieval process. Over time, its clinical significance extended into broader discussions about fertility, leading to AMH being promoted to women as an indicator of their overall reproductive health.
The issue is that AMH levels do not necessarily predict natural conception. AMH levels simply help fertility doctors determine how to proceed with fertility treatments.
What an AMH test actually measures
AMH testing measures the amount of the hormone secreted from the granulosa cells of your tiny antral follicles. This test typically yields results in ng/mL, which gives you an idea of your ovarian reserve, and this represents the number of eggs left in your ovaries. Normal levels of AMH fall within the range of 1.0 ng/mL to 3.0 ng/mL. Low AMH is less than 1.05 ng/mL, while undetectable AMH is less than 0.16 ng/mL.
For fertility specialists preparing IVF treatments, the test is a handy tool as it can forecast the number of eggs that could be collected in a stimulation cycle. Generally, a woman with a higher level of AMH tends to have a better response to fertility drugs and yields multiple eggs. Conversely, a woman with a low AMH might have a poor response and end up producing a limited number of eggs per cycle.
What AMH cannot tell you about your fertility?
AMH focuses on the quantity. It doesn’t reveal anything about the quality of your eggs. You can have great egg quality and get pregnant easily, even if your AMH levels are low. On the other hand, you can be having trouble getting pregnant or maintaining a pregnancy despite high AMH levels.
The AMH test is not capable of accurately predicting the age at which you will reach menopause, regardless of claims made to the contrary. Nor can it predict if you will conceive in this coming year or the next. What’s more, the AMH test does not replace a thorough evaluation of your ovulation, menstrual cycle, hormonal levels, partner’s fertility status, and other reproductive factors.
If you have received an AMH result indicating poor fertility prospects without other assessments being conducted, that is only half the story.
When low AMH levels are real, and when they are not
If you have received AMH testing with a low AMH result, it is worthwhile finding out why you have a suppressed AMH number. There could be several things that contribute to this.
Vitamin D deficiency and falsely low results
Vitamin D is an active participant in the formation of AMH. Women who lack vitamin D always have lower levels of AMH compared to those who have sufficient vitamin D levels, and it has even been proven that restoring vitamin D results in increased levels of AMH.
Vitamin D deficiency is surprisingly prevalent in Perth, despite the beautiful climate. If you have found out that your AMH levels are low, but haven’t had your vitamin D levels checked within the past six months, it is imperative to do so before making any judgments regarding your ovarian reserve. You must have these levels assessed by a practitioner who is measuring your results against what is optimal, not the threshold that is typically used, which can often be subpar.
Hormonal contraception and recent ovarian surgery
Your AMH level may be lower by between 20% and 30% if you have been using hormonal birth control, especially the oral pill. This suppression normally wears off after about three months of discontinuing birth control pills, but you should keep in mind that your AMH level will be higher than the current reading if you have recently used birth control pills.
Recent ovarian surgery (such as the surgical removal of an ovarian cyst or endometriosis) can also cause decreased levels of AMH. This is due to the physical destruction of follicles, and it is not necessarily reversible. If you have undergone any form of ovarian surgery, then you need to understand that your AMH levels must be evaluated in the proper context, not just against the general population norms.
Biotin supplements and falsely high results
Biotin supplements can disrupt the tests used to measure Anti-Mullerian Hormone (AMH) levels, potentially leading to falsely high results. This issue is particularly relevant since many women consume biotin (often found in hair, skin, and nail supplements) without being aware of its impact. If you've been using biotin in the weeks leading up to your test, your AMH levels might appear higher than they truly are, providing an inaccurate picture of your ovarian reserve. It's advisable to stop taking biotin at least 72 hours before retesting. Be sure to review the labels of any multivitamins or beauty supplements you use to ensure they don't contain biotin.
Factors that affect AMH levels
After ruling out the false suppressors, there is a smaller number of factors that can truly impact AMH values. Some are within your control, while others are not.
Age and the natural decline of ovarian reserve
Age is the most important factor that affects AMH levels. Women are born with all of their eggs, but their numbers reduce gradually from birth, and the reduction rate increases after age 35. Also, AMH is no longer detectable in women by the time menopause occurs because the ovarian follicles have all been depleted.
This is a natural process that occurs. So, whilst you can't change this, what you can do is to provide the best environment possible for the eggs you do have to thrive. It can be helpful to focus on what you can do in the coming months, rather than focusing on what you cannot change in the past.
PCOS and unusually high AMH
Women suffering from polycystic ovary syndrome tend to have higher levels of AMH, as characterised by the higher numbers of small antral follicles found in PCOS, compared to other women. The problem is that while this may seem like good news in terms of fertility, women with PCOS often experience anovulation, meaning the follicles are present but not maturing and releasing eggs reliably.
If you have polycystic ovarian syndrome and have been told that your AMH levels are high, it's important to work with a practitioner who can assist your body to regularly ovulate. Often this means making changes in your diet and managing your blood sugar levels, which can help tackle the insulin resistance often associated with the condition. Your eggs are present; the key lies in helping them to ovulate effectively.
Endometriosis, autoimmune conditions, and genetic factors
AMH levels are low in patients suffering from endometriosis due to the inflammatory environment in the pelvis and because endometriomas (ovarian cysts) cause an actual physical reduction of healthy ovarian follicles. Surgery for endometriosis may result in even lower AMH levels, which is why surgical intervention needs thoughtful consideration in women who wish to conceive.
Naturopathic care for endometriosis focuses on calming inflammation and addressing any underlying factors that may be contributing to the condition, as well as complementing any specialised medical treatments you may be receiving already.
Another factor linked to low AMH and premature ovarian failure is autoimmune disorders, especially autoimmune thyroid disease. Comprehensive thyroid testing can detect certain patterns that are often missed by standard screening procedures. Genetics also come into play; if your mother or sister had an early onset of menopause, you might experience a more rapid drop in AMH.
Smoking, alcohol, and environmental toxin exposure
Smoking and vaping cause damage to the ovarian follicles and increase follicular depletion. This is a dose-related phenomenon that cannot be reversed once it occurs. If you are a smoker and wish to become pregnant, then this should be the highest priority among the things you need to change.
Environmental toxins, especially endocrine disruptors such as BPA and pesticides, can also cause harm to your ovaries through repeated exposure over time. Although exposure is usually cumulative, it is never too late to start protecting yourself from toxins.
How to support your AMH levels naturally
While no diet or supplement can regenerate lost follicles, you can certainly take steps to nurture the ones you have and enhance your overall reproductive health. Interestingly, these steps also contribute to better egg quality, which presents a significant opportunity for improving fertility.
Correct a vitamin D deficiency first
First, get yourself tested for vitamin D deficiency and, if needed, start by correcting it by taking the appropriate supplements in order to raise your levels to at least the higher end of what is considered optimal. Depending on your individual levels, that requirement will vary, and that's why we always recommend working with a practitioner who can interpret your results and recommend appropriate supplementation to correct any deficiencies. However, most women would need a minimum of 2000 - 5000 IU daily for at least six months.
Eat for hormone regulation and antioxidant support
Eating a healthy diet high in antioxidants is essential for preventing oxidative stress that can be reflected in your egg quality. The basics matter more than any superfood. This includes eating colourful vegetables with each meal, consuming berries, getting your greens, having good-quality protein sources at each meal, and minimising ultra-processed foods where you can. Vitamins such as E, zinc, selenium, and folate have unique functions in egg production.
Eating a diet rich in whole foods significantly boosts fertility more effectively than focusing on one specific intervention. Consulting with a clinical nutritionist can provide personalised guidance, helping you identify and fill any nutritional gaps that may affect your fertility.
Include omega-3 fatty acids and fatty fish
Omega-3 fatty acids lower inflammation and help in hormone formation. Fatty fish (such as salmon, sardines, mackerel, and herring) should be eaten for the optimal intake of Omega-3 fatty acids, with two or three portions recommended every week to make a significant difference in most women. However, there are supplements made from fish oil or algae that you can take if these are deficient in your diet. Make sure you always purchase from a reputable and third-party tested brand to ensure the purity of the fish oil, as often brands found in the supermarket or chemist use cheap fish oils, which oxidise, therefore losing the therapeutic benefit.
Maintain a healthy weight without restriction
Maintaining a healthy weight is crucial for optimal ovarian function and AMH levels, whether you are underweight or overweight. However, resorting to a restrictive diet is not the solution. Such diets can put undue stress on the body and further disrupt reproductive hormones. Instead, aim for a weight that you can sustain with a balanced, nutritious diet and regular, moderate physical activity. For women dealing with polycystic ovary syndrome (PCOS), even a small amount of weight loss can help restore ovulation. However, the emphasis should be on improving metabolic health and managing blood sugar levels, rather than obsessing over the numbers on the scale.
Address chronic stress and prioritise adequate sleep
Chronic stress increases levels of cortisol, impacts hormonal communication between the brain and ovaries, and leads to inflammation, which may impact egg quality. Hormonal healing occurs primarily during sleep, and insufficient sleep can further exacerbate the negative impacts of stress.
Meditation, breathing techniques, mindfulness, and yoga are truly effective in these cases. In addition, sleeping for seven to nine hours during the night, exposing yourself to morning light, reducing screen time before bed, and having an early dinner will help immensely. It is not very exciting, but getting the basics right can really impact your hormone health.
Limit endocrine disruptors like BPA and pesticides
You can decrease your intake of BPA by staying away from plastic food containers (particularly when heated) and opting for glass or stainless steel water bottles, as well as reducing your consumption of canned goods. Opt for organic foods when possible, including lettuce, spinach, strawberries, cherries, and grapes. Try replacing any personal and household items with fragrance-free, non-toxic options when feasible, too. You don't have to overhaul everything overnight, but steadily reducing your exposure to these can definitely compound and make a profound difference.
Why egg quality matters more than AMH for natural conception
When discussions turn to AMH, a crucial aspect of fertility often fades into the background. For those trying to conceive naturally, the focus should be on the quality of the egg released each month, rather than the total number of eggs in the ovaries.
The difference between egg quantity and egg quality
Egg quantity is what AMH measures. It gives a rough idea of the total count of eggs stored within your body. Egg quality, on the other hand, is something completely different because it deals with how good each particular egg will do when it comes to being fertilised and developing into a foetus.
For example, a woman at age 38 who has low levels of AMH but good-quality eggs is more likely to conceive naturally compared to a woman at the same age who has high levels of AMH but poor-quality eggs.
The factors influencing egg quality are mitochondrial function, oxidative stress, hormones, ovarian blood flow, and the female metabolism. All these factors can be changed. These things are not detected by the AMH test.
How egg quality changes month to month (and why this is good news)
The maturation period of eggs is approximately 90-100 days before their release. Factors that happen during these three months (your nutritional levels, level of stress, quality of sleep, blood sugar level, inflammatory markers, toxins in your system) determine the quality of the egg you eventually release.
This is great news because it means that egg quality can be improved within a certain period of time. The egg that you will ovulate in four months is already being developed at present, meaning you can make changes today to affect your egg's development.
Targeted nutrients that support egg quality
There are specific nutrients that are crucial to the quality of eggs. Antioxidants such as vitamin C, vitamin E, selenium, and zinc prevent oxidation in eggs. CoQ10 helps provide mitochondria energy, which plays an important role in the development of eggs. Folate (preferably as methylfolate), B12, choline, and B6 all help in the methylation of eggs' DNA. Omega-3 fatty acids decrease inflammation around follicles.
A practitioner-grade prenatal multivitamin will satisfy most of these requirements, but it may be advisable to discuss the dosage of CoQ10 and other antioxidants with your naturopath, especially if you are experiencing difficulty conceiving, are older than 35 years of age or have specific risk factors.
Supplements and treatments worth discussing with a practitioner
Certain supplements and treatments are backed by more solid evidence than others. However, it's important to understand that none should be used without considering the broader picture, and it's always important to take supplements under the guidance of a qualified health practitioner. Let's explore a healthcare professional's perspective on which ones might be worthwhile.
CoQ10 and ubiquinol for women over 35
CoQ10 promotes the proper functioning of mitochondria in developing eggs, and mitochondrial dysfunction is one of the chief causes for deterioration of egg quality over time. The active form is ubiquinol (which is usually more easily absorbed), especially among women aged 35 years or above. Effects on egg quality take at least three months to develop because of the egg maturation timeline.
DHEA under medical supervision
DHEA helps improve AMH and antral follicle counts for women who have reduced ovarian reserve; however, it is a hormone that must be taken with caution. Factors such as dosage, length, monitoring, and timing become important when taking DHEA. DHEA should be taken in consultation with either a reproductive endocrinologist or a naturopath who specialises in fertility, and preferably with baselines and follow-ups. Women with polycystic ovary syndrome (PCOS) or increased androgens should avoid taking DHEA.
Prenatal vitamins and the case for practitioner-grade formulations
Standard over-the-counter prenatal vitamins are usually made with the least expensive form of ingredients. This means folic acid instead of methylfolate, cyanocobalamin instead of methylcobalamin, and iron in a form that can often cause constipation. Practitioner-level prenatal vitamins contain higher-quality ingredients that absorb well and in higher amounts. They also contain choline, which is critical for fetal development. The difference in price is significant, but for women preparing to conceive or already pregnant, the formulation matters.
Acupuncture and ovarian blood flow
Acupuncture can enhance ovarian blood flow and reduce elevated FSH levels in some women. Research shows significant benefits when combined with IVF treatments. However, many women trying to conceive naturally also report positive outcomes. They find it beneficial not only for its physical effects but also for its ability to help manage stress. If you decide to pursue acupuncture, it's important to consult a practitioner who specialises in fertility acupuncture to maximise these potential benefits.
When to involve a fertility specialist alongside naturopathic care
Combining naturopathic and fertility specialist care can greatly enhance your journey toward conception. These approaches aren't at odds but rather complement each other beautifully. Recognising when to consult a fertility specialist is crucial. If you're under 35 and have spent a year trying to conceive without success, a fertility evaluation is advised. For those over 35, this period is reduced to six months. Conditions such as endometriosis, polycystic ovary syndrome (PCOS) with anovulation, or notably low AMH levels suggest an even earlier specialist visit. It’s equally important to evaluate male fertility, as male factors contribute to about 40% of fertility challenges but are often missed.
Fertility specialists delve into areas that naturopaths might not cover, such as checking if your fallopian tubes are open, identifying structural issues, and thoroughly assessing hormonal and immune factors. They are equipped to offer advanced reproductive options like intrauterine insemination (IUI), in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and egg freezing when necessary.
Meanwhile, naturopathic care fills gaps by focusing on areas that fertility clinics might not prioritise. This includes enhancing nutritional levels, reducing inflammation, improving gut health, and balancing hormones throughout the menstrual cycle. Naturopaths also prepare the body for embryo transfer and support recovery between IVF cycles. Women who integrate both approaches often find the most success on their fertility journey.
Working with a Floralia naturopath on your fertility
Floralia adopts a root-cause analysis of fertility, which requires considering the whole picture instead of concentrating on one metric. The consultation process entails comprehensive history taking, evaluation of past tests conducted, and, in cases where it is necessary, further functional tests to understand what might be missing.
This allows your naturopath to develop a personalised program to meet your unique needs in terms of nutrition, hormone balance, preparation for pregnancy, and flexibility to make changes based on your response to treatment. The program is created to complement other programs currently being implemented by your family physician or infertility expert.
If you've recently learned that your AMH levels are low and you're uncertain about the next steps, or if you're gearing up for IVF and wish to optimise your chances, a Floralia fertility naturopath can guide you. We can help you understand your situation and provide the support you need.
