What does my low AMH level indicate?
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
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 lengths were 34 days, 28 days, 28 days, 28 days, 36 days, and 19 days respectively. My cycle statistics are as follows. The average cycle length is 29 days, the shorter cycle length is 19 days, and the longer cycle length is 36 days. Irregular cycles or cycles shorter than 21 days or longer than 35 make calendar prediction of ovulation unreliable? What is the effect of thyroid dysfunction by inflammatory conditions 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.
Hello,
Welcome to icliniq.com.
You are suffering from hyperprolactinemia and borderline subclinical hypothyroidism. Both of these can cause a delay in ovulation and hence irregularity in cycles. Ideally, menses between 23 to 35 days are considered normal as per the 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 the day of the test or any other hormone-like thyroid or prolactin. Your levels are way lower than 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 defects where progesterone is not produced due to the absence of the 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 ovary or not. This irregularity may indicate an early onset of menopause if the FSH and LH levels are higher than 30 IU.
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Obstetrics and Gynecology
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