Also a very good question. There is no normal because it depends on what exactly we are searching. If, for example, we are speaking about ovarian stimulation, it is good if a woman has more than 1 and less than 3 because more than 3, 3.5, she may have a very high response to stimulation and risk of ovarian hyperstimulation syndrome. Less than one, we will probably receive less than seven, eight eggs probably. If a woman has less than 0.3, 0.5 we will receive two, three eggs – it is not a lot and not good for stimulation. So, from the point of view of IVF treatment “good” it is from 1-3, more the risk of hyperstimulation, less it is not enough eggs. If we are speaking of age norm, at 40 years old to have 0.6-0.7 it is absolutely normal – if women will not have disease to do the IVF treatment or became pregnant because ovarian reserve, I repeat once more, does not mean that woman cannot became pregnant, it mean that she has much less time for that. At 25 – 30 years old, it is normal to have an AMH level like 2.5 – 3.5 even 4, at 40 it is around 1, at 45 zero point something like that.
Typical because it comes so like a test result will come back within a reference range. It’s not just about looking at a number, it’s about looking at absolutely everything else: her age, etc. It’s very very hard to define but obviously the higher the number, the better and the more optimistic about getting pregnant, the lower the number, the harder it is to get pregnant. Again, if you’ve got something like Polycystic Ovaries or PCOS, it doesn’t give you a true status because it’s going to be artificially high.
Normal ovarian reserve, it is a very difficult question because every woman is different in this aspect. What we see as a good or normal ovarian reserve is when we have women younger than 35 years old and who have a higher level of AMH than two 2.2 ng/ml – this would be the best scenario for IVF.
AMH level, age and the Antral Follicle Count are the three points that are going to tell us how good the ovarian reserve is and what to expect when you are beginning IVF on that particular patient.
Lots of studies have looked at this and they find that the AMH level varies significantly according to a woman’s age, In fact some graphs will show that from one to two picomoles per liter in a certain age group. Some women can have an AMH level as high as a 100 or more which is why on reports the reference ranges. What we do know for certain is that the older women get on average the ovarian reserve will drop.
