Low AMH and Chinese Medicine: What Your Result Is Really Telling You

You get the result back.

The number is low. Or high. Or "within range but on the lower end." And suddenly you are reading everything you can find at 11pm.

I see this in clinic all the time. Someone walks in holding their AMH result like it is a verdict on their fertility. Sometimes they are devastated. Sometimes they have already been told to move straight to IVF. Sometimes they just need someone to sit with them and explain what they are actually looking at.

Photo by Ben Moreland on Unsplash

What AMH actually is

AMH stands for Anti-Müllerian Hormone. It is produced by the small follicles in your ovaries. The follicles that are active and growing in your current cycle are the ones producing this hormone.

Your AMH level reflects current follicular activity. How many follicles are being recruited right now. Not the total number of eggs you have left. Not your long-term fertility outlook. Not whether you will or will not conceive naturally.

In practice, AMH is tested on Day 3 of your cycle alongside your other reproductive hormones. FSH, LH, and oestradiol are all taken at the same time, giving a full hormonal snapshot in one go. Progesterone is the exception. That one is tested around 7 days past ovulation, to assess how well your luteal phase is being supported.

What AMH is actually used for

The main clinical use of AMH is in IVF. That is where this test earns its place.

If your AMH is low, a specialist will plan higher doses of stimulation medication to encourage more follicles to respond. If your AMH is high, they will use a gentler approach to reduce the risk of overstimulation.

Calibrating medication. That is the job of this test.

It is not a diagnosis. It is not a prognosis. It is not a fertility sentence.

Research published in JAMA found no significant association between AMH levels and time to natural pregnancy in women trying to conceive. The number that feels so heavy right now does not determine whether you will fall pregnant naturally. Your body is doing so much more than this one test can capture.

What low AMH looks like through a Chinese medicine lens

In Chinese medicine, I see low AMH as a picture of Blood deficiency, often alongside Kidney Yin or Kidney Jing deficiency.

Blood, in Chinese medicine, nourishes and supports tissue. Including the ovarian environment. When Blood is deficient, there is less nourishment available to bring follicles through each cycle. Fewer follicles being recruited means less AMH being produced. The number is reflecting something that is happening in the body as a whole.

Kidney Yin and Jing sit deeper. Jing is our constitutional essence. Our long-game resource. When these reserves are depleted, it often shows in reproductive function and in the broader picture of how someone feels day to day.

Blood deficiency has its own pattern of signs. Fatigue that rest does not fully fix. Lighter periods. Dizziness. Poor sleep. Cold hands and feet. Hair coming out more than usual. A pale or dull complexion.

These are the things I am looking at alongside the number on the page. And they tell me far more.

I treat the person in front of me. Always. Not the result.

Photo by Ben Moreland on Unsplash

What high AMH can mean

High AMH is associated with lots of follicular activity. And while a high number might sound like good news, it comes with its own picture.

In my clinical experience, high AMH is often connected to Dampness and Stagnation patterns. This is very common in PMOS (previously called PCOS). There are heaps of follicles, but the environment is sluggish. Things are not moving as freely as they could be.

In a PMOS picture, high AMH often comes with cycles that are long and irregular, making it genuinely difficult to identify when ovulation is occurring. Or whether it is occurring consistently at all. The challenge is not a lack of follicles. It is getting the system moving.

People with this presentation often describe themselves as heavy. Hard to get going in the morning. Brain fog. Low libido. Sometimes oedema. Sometimes night sweats. The energy is there. It is just not flowing.

High AMH in an IVF context also means the ovaries are more sensitive to stimulation, which is why protocols need to be carefully managed.

Treatment is always about the individual pattern presenting. Not the category.

AMH does not equal how fertile you are

This is what I wish every person was told before they left the room with their results.

AMH is one piece of information. An important piece if you are heading into IVF, because it helps calibrate medication. But it is not the whole picture. It is not a countdown. It is not a measure of what is possible for you.

Chinese medicine does not see you as a number on a lab sheet. It looks at your cycle, your sleep, your digestion, your energy, your tongue, your pulse. The pattern running underneath everything. And from there, we work out what your body actually needs.

If you would like to look at your results with someone who will take the whole picture into account, that is exactly what a Fertility Clarity Session is for.

Much love, Zoe x

Reference

Steiner, A. Z., Pritchard, D., Stanczyk, F. Z., Kesner, J. S., Meadows, J. W., Herring, A. H., & Baird, D. D. (2017). Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA, 318(14), 1367–1376. https://doi.org/10.1001/jama.2017.14588

Educational information only. Not medical advice.