We know that AMH is a test that tells us more about the ovarian reserve and we also know that AMH declines as age advances, because it looks at the small follicles in the ovaries, but there are other factors which also have an impact on AMH.
When we come to the basics, the AMH is produced by granulosa cells, they are small cells of small and pre-antral follicles. The quantity of AMH also corresponds to the pool of these follicles. In a study published in the Reproductive Biology and Endocrinology in 2013, evaluated what happens to AMH during pregnancy; this was a study done on 554 women. What was noticed is that the AMH levels continued to drop during pregnancy and the levels significantly dropped as the pregnancies progressed. Once delivery took place there was a further drop to AMH. This was quite often age-related. Younger women saw a more dramatic drop, while older women did not see a much more dramatic drop, which is probably due to them having a low AMH.
When you look at the implication of this treatment it is important to realise that women who come in for treatment for their second baby just after they have had a delivery should be asked to wait for a couple of months until their egg reserve starts recovering, and this is something we learn from the study, not to rush into another treatment.