AMH and Vitamin D: What Can Affect These Hormone Levels and How Are They Linked? A Fertility Specialist Explains
Novalynn Fertility CEO and Emmy-winning journalist Katie Krause Mork emailed questions about anti-müllerian hormone (AMH) levels and vitamin D to Dr. Sharon Moayeri, MD, MPH, MS, FACOG. She is an expert fertility specialist and gynecologist with over 15 years of experience. You can read more about her and her practice in her bio below.
For awareness, a woman’s AMH level is an indication of her ovarian reserve. There are various factors that can affect these levels, including ethnicity, vitamin deficiency, oral contraception, chemotherapy and more.
AMH and vitamin D: What can affect these hormone levels and are they linked?
Vitamin D can interfere with assays that measure AMH.
As a woman gets older her AMH level decreases. Why is this?
Anti-mullerian Hormone (AMH) is released from the active ovarian follicle pool and as these are depleted with age, so too is AMH.
How does vitamin D affect fertility?
Vitamin D receptors are noted in ovarian granulosa cells and theca cells, as well as the endometrium. In women with vitamin D deficiency there may be detrimental effects on fertility at the cellular level, similar to how other tissues rely on adequate nutritional support to function properly.
Various studies have said different things about the link between vitamin D and AMH. In my personal experience, taking vitamin D supplements greatly increased my AMH level. I went from 0.3 to 2.1 in approximately a year. Why is this? How are the two possibly linked?
In women with vitamin D insufficiency, AMH and ovarian reserve may be affected. However, AMH assays may be influenced by Vitamin D blood concentrations so it’s important to correlate AMH values with other clinical findings, such as antral follicle measurements on pelvic ultrasound especially when the clinical story does not align.
I have heard so many incredible stories about how women with extremely low AMH levels got pregnant naturally and quickly. Why is there so much fear around a low AMH level? How can we improve the messaging?
AMH is only one aspect of fertility assessment.
First, reproductive history is key - age and history of prior pregnancy.
Second, hormone levels in the context of their respective age group. In this case, AMH and FSH can be valuable to understand if a person’s fertility is in line with others of similar matched age-group.
I wouldn’t compare an AMH for a woman in her 40s to a woman in her 20s - just as I wouldn’t compare wrinkles or graying hair. As women are born with all the eggs they will ever have and AMH resides in the resting egg pool, the more eggs one has, the higher the AMH; and conversely, the fewer eggs one has, the lower the AMH. It is a marker of ovarian reserve and does not reflect egg health. It is true that with age both egg count and egg quality declines.
Why do some studies differ on the link between vitamin D and AMH levels?
Studies differ on the link between vitamin D and AMH levels because of the variability in the study designs, including: assays to measure AMH, ethnicity studied, whether or not vitamin D was deficient or sufficient, and whether the women were fertile or infertile. Finally, studies often don’t evaluate for other reproductive markers of fertility aside from AMH to understand if the changes related to AMH are from the assay or related to real changes in fertility potential.
Do women with higher vitamin D concentrations maintain their ovarian reserve for longer?
Women with higher vitamin D concentrations do not necessarily maintain their ovarian reserve longer, but having vitamin D deficiency may be related to overall poorer health and consequently poorer fertility and/or earlier menopause.
Can too high a level of vitamin D be dangerous?
Having too much vitamin D may be detrimental to health as well.
Can increasing vitamin D give a falsely higher AMH level?
Yes, it can interfere with the assay.
Novalynn Fertility is the only company to offer an AMH + Vitamin D at-home ovarian reserve test kit. You can order yours here.
About Dr. Sharon Moayeri
Sharon Moayeri, MD, MPH, MS, FACOG, is an expert fertility specialist and gynecologist with over 15 years of experience. As the founder and medical director of OC Fertility® in Newport Beach, California, she is board certified in both obstetrics and gynecology and reproductive endocrinology and infertility by the American Board of Obstetrics and Gynecology.
She received her Bachelor of Science in biological science and Bachelor of Arts in cognitive science from the University of California, Irvine (UCI) before heading to the University of California, Los Angeles (UCLA) for her Master of Public Health in health policy. She completed her Doctor of Medicine at the UCI School of Medicine, where she also finished her internship and residency in obstetrics and gynecology, serving as administrative chief resident.
She then completed her Agency for Health Research and Quality (AHRQ) and National Institutes of Health (NIH) post-doctoral research fellowship in health services at the prestigious Stanford University Center for Health Research and Policy in Stanford, California. She also finished her fellowship in reproductive endocrinology and infertility at the Stanford University Department of Obstetrics and Gynecology.
In 2009, she founded OC Fertility®, a culmination of her goals to provide personalized, patient-focused fertility services in my hometown. All treatments use the most cutting-edge technologies while creating a comfortable and communicative environment.
She is a reviewer for the renowned American Journal of Obstetrics and Gynecology (AJOG) and Fertility and Sterility®, and has given lectures and been published multiple times on topics like blastocyst IVF embryo transfer, oncofertility, CCS/PGS, endometriosis, and affordable fertility treatments. She is a member of multiple organizations, including the American Society of Reproductive Medicine (ASRM), Society for Assisted Reproductive Technologies (SART), Society for Reproductive Endocrinology and Infertility (SREI), Alpha Omega Alpha National Honor Medical Society (AOA), the American Association of Gynecologic Laparoscopists (AAGL), and a fellow of the American College of Obstetrics and Gynecology.
Please visit https://www.ocfertility.com to learn more.