Q. What does my low AMH level indicate?

Answered by
Dr. Sameer Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 11, 2017

Hi doctor,

Last month on day 2 My TSH level was 4,9304 uIU/mL, free T4 was 102 ng/dL and prolactin was 30.63 ng/mL. My last six months menstrual cycle length were 34 days, 28 days, 28 days, 28 days, 36 days and 19 days respectively. My cycle statistics are as follows. Average cycle length 29 days, shorter cycle length 19 days and longer cycle length 36 days. Irregular cycles or cycles that are shorter than 21 days or longer than 35 make calendar prediction of ovulation unreliable? What is the effect of thyroid dysfunction by inflammatory condition on reproductive endocrinology? What is the effect of  thyroid dysfunction on anti-mullerian hormone concentration in a 44 year old? Do birth control pills suppress AMH levels? My anti-mullerian hormone (AMH) on day 4 was 0.01. Please explain.



Welcome to icliniq.com.

You are suffering from hyperprolactinemia and borderline subclinical hypothyroidism. Both of which can cause delay in ovulation and hence irregularity in cycles.

Ideally, menses between 23 to 35 days are considered normal as per definition.

In your case, the concern is AMH levels (anti-mullerian hormone), which are indicators of ovarian reserve for ovums. It is not affected by day of the test or any other hormone like thyroid or prolactin.

  • Your levels are way lower 0.01, which indicates a very poor ovarian reserve and likely that you are experiencing possibly anovulatory cycles.
  • Hence, menses are further shortened due to luteal phase defect where progesterone is not produced due to absence of corpus luteum after follicle rupture. Therefore, you experienced early shedding of unstabilized estrogenized endometrium.
  • It is suggested that you should get your FSH (follicle stimulating hormone), LH (Luteinizing hormone) plus serum progesterone on day 21 levels done.

Also, an ultrasound pelvis by mid-cycle to check the endometrial thickness and if any follicles are developing in either ovaries or not.

This irregularity may indicate towards an early onset of menopause if the FSH and LH levels are higher than 30 IU.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

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