Ep 341 The Truth About AMH and FSH: What These Numbers Actually Mean
On today’s episode of The Wholesome Fertility Podcast, I’m breaking down the truth behind two of the most talked-about fertility hormones: AMH and FSH. Whether you're navigating IVF, trying to conceive naturally, or just beginning to explore your fertility, understanding what these numbers actually mean (and what they don’t) is essential.
In this solo episode, I share what AMH (Anti-Müllerian Hormone) and FSH (Follicle-Stimulating Hormone) reveal about your ovarian reserve, what doctors are looking for, and why these values are only one piece of the fertility puzzle. I also offer insights into how lifestyle, nutrition, and stress management can positively influence your hormonal health and egg quality.
Tune in for a science-meets-soul discussion that will empower you to move forward with more clarity, hope, and confidence on your fertility journey.
Key Takeaways:
AMH indicates the estimated quantity of follicles, while FSH reflects how well your ovaries respond to stimulation.
These values don’t measure egg quality—and they certainly don’t define your fertility potential.
Numbers like AMH and FSH are just a snapshot in time; they can change with the right support.
Egg quality can be supported through lifestyle shifts, acupuncture, and antioxidant-rich nutrition.
Natural conception is possible—even with “low” AMH or “high” FSH.
Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care.
For more information about Michelle, visit: www.michelleoravitz.com
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https://www.michelleoravitz.com/thewayoffertility
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FSH and AMH
[00:00:00] So first I am going to break down what they are. What, what is a MH and what is FSH and why that matters when you're trying to conceive. So a MH stands for anti malian hormone, and this is a hormone that is produced in the granulosa cells of your follicles in your ovaries. So it is one of the things that is measured by reproductive endocrinologists to see how many.
Eggs you have now, they can't tell you how many, but they can tell that the reserve is high the higher the A MH.
So generally speaking, many doctors would like to see over one and. And anything under that might be considered more diminishing reserves.[00:01:00]
Fun fact is that a MH is considered the embryonic police and it prevents males in utero from growing fallopi, from growing fallopian tubes and female reproductive organs.
Unlike many hormones, a MH does not fluctuate throughout the cycle, so you can actually take the blood work anytime, but most of the time they will take it and measure it at the same time that you're doing FSH, which is usually day three of your cycle. Now, FSH stands for follicular stimulating hormone.[00:02:00]
And this is a hormone that is released by your pituitary gland, and this hormone stimulates your ovaries to mature follicles.
So typically speaking, they would like the number to be eight or lower. And the reason why FSH is preferred to be lower is because a higher FSH means that the brain has to produce a higher number in order to. Impact your ovaries in order to help the follicles grow. Now, if the follicles are not responding, or it's taking a little longer, your pituitary gland has to increase the amount of FSH, which means that your body is not as responsive, where your ovaries are not as responsive, and ultimately that is why they want it to be eight or less, because then it [00:03:00] shows that that your body is responding faster and that your ovaries are functioning optimally.
And in men, FSH plays a key role in sperm production. So in this case, we're talking more about women because we're talking about specifically A MH and FSH and egg reserve.
So as a recap, a MH will be measuring. The quantity of small follicles. Now, it doesn't give you an exact number, but it gives you an estimated amount based on the number [00:04:00] while FSH is showing the effectiveness of how your ovaries are functioning.
So the reason this is such a big deal oftentimes, especially if you go to an REI, which is a reproductive endocrinologist, is because they wanna measure the amount of eggs a woman has because when they retrieve and when they give their. Medications, they are going to try to stimulate the egg quantity, so they wanna know that they have a big number to work with and then they give you certain medications and hormones to increase the follicles.
And typically what happens in a woman's cycle is that the FSH increases, and then there's always that one follicle that will take all of it and it will be kind of the queen bee of the follicles for that month. All the other follicles will not get it, and the one will increase to the point where it matures and [00:05:00]that one follicle every month will be the one to ovulate.
But when it comes to IVF, they increase the amount of FSH and they will inject you with that. And also work with other hormones so that what it does is it actually creates a situation in the ovaries where you get way more FS, H than you normally would, and then all of the eggs or a lot of the eggs will be able to benefit and grow.
And this is one of the reasons why, because all of these eggs grow at the same time. It creates almost like a heaviness in the ovaries. And this is one of the reasons why when a woman is going to do a retrieval, they say, don't exercise and don't use the abdomen because they're afraid of something called an ovarian torsion.
Um, this is a complete side note, but that's one of the reasons is because it creates more eggs and it grows more eggs than normal.[00:06:00]
So oftentimes when it really is a cycle that can be stimulated, such as when a person goes for egg retrieval, then this is a number that is very important for doctors because they wanna make sure that a woman has enough reserves so that the cycles work properly. However, in a natural cycle, even if a woman has low A MH, and that means that she does not have a huge reserve, it still only takes one egg to fertilize.
So if a woman has really good quality, even if it's a low number, she could still naturally conceive. This is where it gets really confusing because a lot of times women go to the REI and they get those numbers and it looks like it's a poor score, but it doesn't necessarily mean that she cannot conceive either through [00:07:00] IVF or naturally.
So here's what a MH and FSH do not tell you. They do not tell you information about the quality of the egg. So. When it comes to equality, actually something that is very hard to measure. The only way you can really kind of see possibly is when a woman goes through IVF and they can see how the eggs grow and how they fertilize.[00:08:00]
But they also can see how they test genetically. So if there's any issues with the. Genetics and the health of the embryos. That is one of the things that could be because of egg quality, but it can also be because of sperm quality.
And while a MH and FSH can tell you a lot about what's going on, pregnancy, generally speaking is multifactorial. It really depends on the sperm health. It depends on also the environment and the uterus. There's so many other things that can contribute to issues getting pregnant, that it really doesn't only come down to a MH and FSH.
As a matter of fact, I've had many patients myself who started out with really, really high FSH and very, very low A MH, and they have gone on to get pregnant [00:09:00] naturally, not just once, but multiple times.
So just because a woman has low a MH does not mean that she cannot get pregnant. And what it really comes down to at the end of the day is really getting the quality of the eggs as high as possible so that even if it's a low number, they can, they can conceive. And another fun fact, something that I've noticed, and it was more anecdotal in my office, I have seen women with high MH and also there is a correlation to really, really high A MH, and that is something that you can find often with conditions like PCOS.[00:10:00]
So what I was saying before is that I've had some patients that will go through a retrieval and get about 40 eggs, and then in the end, none of them, I. Up to be viable embryos. And then I've had other patients that have had only two extracted two eggs. And then from those two they fertilized and they ended up being two healthy embryos.
So you never really know what will happen. And the bottom line is if you really wanna focus on something, my suggestion is focus on egg quality.[00:11:00]
That being said, I also will say that I have found in my practice that after doing some work and making some changes, lifestyle changes, stress. Lowering stress, really creating an a lot more self-care and acupuncture and sometimes Chinese herbs and sometimes supplements. Depends on the person, 'cause each person is unique.
After many months I have seen FSH going down and a MH going up. So those numbers, while it seems like a MH should not go up because it's because reserve would usually be going down. I have actually seen that number increase. So also to keep in mind that those numbers are a snapshot in time. So imagine somebody kind of following you [00:12:00] around or a camera following you around and taking snapshots at different times of the day or different times in your life.
Say one time after you had a really stressful day, and then another time after you just got back from a vacation. How different will you look and how much of a conclusion can somebody come up with by just taking that little quick snapshot of you? And that is typically what the body is like. That is why it's important to do multiple tests and not just one time because you want a baseline, which is really the base that you're starting with.
And then other times as well, after implementing changes to see if your body's responding.
So couple of things that you could do. [00:13:00] Really to support yourself is stress reduction. I talk about that a lot because when you come up with tools that manage stress, then you'll be able to manage your sleep. When you manage your sleep, you're able to get into a more restorative state, and that is a state of growth.
And ultimately, I talk a lot about getting into the parasympathetic nervous system where you're able to feel more calm because when you're in that state, your body is not using up energy. On things that it doesn't really need. Ultimately, it's able to preserve that energy for your reproductive health.
And when it's able to do that, then you're able to think about growth and you're thinking about egg quality and egg growth, and also energy, because that is actually key. And this is going to dive into the next point that I wanna mention is that. One of the things that is really important for egg quality, and one of the ways that we can look at it is that a TP, [00:14:00] which is the energy unit that is produced by the mitochondria in the cells, ultimately over time, gets lower as we age, and as that.
Number gets lower, then the quality gets lower. So you want a lot of energy. Think about it. When you don't have a lot of energy, you can't function. So it's really important that the cells have a lot of energy and that the mitochondria is protected. And typically what happens as we get older is oxidation and oxidative stress increases in the body.
So what do we do to counter that? And that oxidative stress, by the way, is what causes the DNA in mitochondria, which are the powerhouses of your cell. And fun fact, your egg cells have hundreds of thousands of mitochondria, whereas a normal cell is a couple of thousand. So this is just an example of why it is so important for the mitochondria to be healthy.[00:15:00]
There's a reason why egg cells have so many. Have such a huge number of mitochondria. It's because it's necessary and needs to be there, and this is why a TP is so important because it takes a lot of energy to reproduce and for eggs to fertilize and become a human.
So the first thing you wanna do is really counter any kind of oxidative stress, and one of the things that you can do is have something called antioxidants, and that is where the name came from. It basically counteracts the effect of oxidative stress, and you will find antioxidants in supplements and in food.
But you can also find it in the sun. Yes. In the morning when you get sunlight, it actually increases melatonin, but it's not used in the same way as when it [00:16:00] is in your bloodstream at night, or if you're taking it as a supplement to go to sleep. It's actually called cellular melatonin, and it is the melatonin that is in your cells, and you can get that from sunlight also.
My suggestion is of course, do it in the morning because that is the best time to get the sunlight, and that is also a time where the sun is less dangerous and there's less UV rays.
Another thing that the sun can give us is vitamin D, and while vitamin D is a hormone, it actually exhibits antioxidant properties.
And then as far as food and supplements, some of the supplements, and I do wanna mention, do [00:17:00] not take any supplements without talking to your doctor first. But here are a few supplements that you can ask your doctor about and one of them being really, the top one is coq 10 or Ubiquinol. Um, there's Ubiquinone, so it comes in two forms and ubiquinol with an L is the more superior form.
That is something that a lot of people take when they want to support their egg quality. Another thing that you can consider is resveratrol, and that is another really amazing antioxidant that can also support equality.
And then you could think about the [00:18:00] very common vitamin C, vitamin E, and those are usually in a good prenatal, but sometimes you might have to supplement a little extra. And glutathione. Um, supporting glutathione is incredibly important. Now, glutathione is a very strong master antioxidant that is produced by the body, and it is actually a very hard thing to take 'cause the body just doesn't just take it, it produces it.
So N-Acetylcysteine is another supplement that you can take, and it's called NAC. You'll see that typically written down in the bottles. That is the precursor to glutathione, so it helps your body produce glutathione, so that is an amazing, amazing supplement to take as well.
And then as far as foods go, you want to consider, um, lots of dark leafy greens and also berries. [00:19:00] And that dark color that you'll see in blackberries that is from antioxidants. So it's really important to have lots of those natural occurring antioxidants.
In foods and fruits because that will support your egg quality.
And fun fact, dark chocolate when it's not processed and unhealthy is very high in antioxidants as well.
And matcha green tea is also very high in antioxidants.[00:20:00]
And lastly, you also would benefit from lowering inflammation, so working on gut health as well, because inflammation can impact the quality of your eggs. One of the things that I say is the most. Simple thing that you can do. And if you can do that every day, it would be amazing is grounding your feet on the earth, having some earth time where your feet are touching the earth.
And if you can't have that, you can look into buying a grounding mat. And I always say this because this is one of the things that I think about is the only time you don't wanna use a grounding mat is if it's lightning outside. And you also wanna make sure that whatever grounding mat you buy comes with a tester to use on your outlets to make sure that it's safe to use.
So that concludes today's episode.[00:21:00]
And really the bottom line is, is that those numbers, while they're important and they give you a lot of information, they are a snapshot in time. They can definitely change and they do not define your fertility journey. As long as you are getting your period and you are ovulating, you always have a chance to conceive.
And the true factor, really the big thing is you want to get the quality high. And if you think about quality, ultimately it's the eggs. But if you live a quality life, that is, you take care of yourself, you live stress free. You decrease the amount of stress or at least give yourself tools on how to handle stress
and you eat to nourish your [00:22:00] body and really, really,
and go to acupuncture. Of course I am biased, then that will help egg quality as well. So thank you so much for tuning in today, and I will see you next time. I'll say this for the podcast. Thank you so much for tuning in today, and I hope you have a beautiful day.