Understanding Fertility: Hormones, AMH and Preparing for Pregnancy

An unfulfilled desire to have children affects many couples. Yet many people rarely speak openly about it. Feelings of shame, uncertainty, and conflicting information on the internet can lead women to feel alone with their desire to conceive.

Modern reproductive medicine has made significant progress over the past decades. At the same time, our understanding of how hormones, lifestyle, and metabolic health influence fertility continues to grow. In her book Your Fertility, Your Family, reproductive endocrinologist Dr. Lucky Sekhon explains how complex the interaction between these factors really is and why many common assumptions about fertility do not reflect reality [1].

Fertility and the Desire to Conceive: Why Reliable Knowledge Matters

In my practice, I often observe that many women begin to look more closely at their fertility only after pregnancy has not occurred for a longer period of time. However, early education about the menstrual cycle, hormonal balance, and ovarian reserve can help women better understand their bodies and make more informed decisions.

Information about fertility and family planning is widely accessible today. At the same time, this abundance of information often leads to confusion. Many online sources provide incomplete information or present medical topics without proper context. As a result, patients frequently encounter contradictory statements about fertility.

The role of medical counseling therefore increasingly involves helping patients interpret information and assess their individual situation. It is not only about providing knowledge but also about supporting patients through complex decisions. Women who understand their hormonal processes often experience the journey toward pregnancy less as a loss of control and more as a process they can actively participate in.

Fertility Challenges: Possible Causes of Infertility

Many women perceive infertility as a personal failure. This perception is often shaped by societal expectations or oversimplified portrayals of fertility in the media. From a medical perspective, however, infertility is rarely the result of a single decision or lifestyle factor.

In many cases, underlying causes exist that cannot be directly influenced. These may include genetic factors, age-related changes in egg cells, or medical conditions such as endometriosis. Hormonal disorders may also play a role. In addition, male factors are often overlooked, even though they account for a significant proportion of fertility problems.

Fertility and the AMH Level: What the Hormone Value Really Means

As part of fertility diagnostics, the Anti-Müllerian Hormone (AMH) is often measured. The AMH value provides information about the ovarian reserve. However, many women interpret this laboratory value as a direct measure of their fertility.

In reality, AMH primarily reflects the number of remaining egg cells. It does not reliably predict whether pregnancy can occur naturally. In clinical practice, spontaneous pregnancies can still occur even in women with very low AMH levels.

This hormone value is particularly relevant for assisted reproductive techniques such as IVF (in vitro fertilization) or when planning egg freezing. In this context, a low AMH level mainly indicates that fewer eggs may be retrieved during hormonal stimulation.

Improving Fertility: Preparing for Pregnancy

Fertility is influenced by many biological factors. At the same time, certain lifestyle choices can support the body’s readiness for pregnancy.

In my practice, I often recommend preparing the body several months before attempting to conceive.

Based on my experience, hormonal stabilization over a period of approximately nine months can be beneficial, especially when pregnancy or IVF treatment is planned. When steroid hormones such as estradiol, progesterone, and testosterone, as well as thyroid function, are well balanced, the body may respond more steadily to pregnancy.

Metabolic health also plays an important role. A balanced diet with sufficient protein and fiber supports stable blood sugar levels and may positively influence hormonal processes. Regular physical activity further improves circulation and metabolic function.

Supportive factors for fertility may include:

• regular physical activity
• a balanced, protein-rich diet
• stable blood sugar levels
• complete avoidance of smoking

Nicotine can negatively affect both egg quality and sperm quality. For this reason, I often advise patients and their partners to stop smoking completely several months before trying to conceive.

Fertility and Mental Health

The journey toward having a child can be emotionally challenging. During fertility treatment in particular, many women experience significant internal pressure. Fear of further disappointment or concerns about the body not functioning properly can be very distressing.

From a medical perspective, it is important to understand that fertility treatments often require time. Many treatments involve multiple steps and demand patience. Open communication with a partner and a supportive social environment can help couples navigate this phase more successfully.

For many couples, the path toward having a child is not a quick solution but a longer process.

Fertility and Hormones: The Importance of Hormonal Balance

Women and men generally produce the same hormones, although in different concentrations. While estradiol is more dominant in women, testosterone predominates in men. These hormonal differences influence many physical and psychological processes.

In my practice, I often see that a detailed analysis of hormonal balance can be very informative for women trying to conceive. Bioidentical hormones may be used individually to address hormonal imbalances and help prepare the body for pregnancy.

Dosage is not determined by a standardized protocol but is tailored individually based on laboratory results and a detailed medical history.

Preparing for Pregnancy with Bioidentical Hormone Therapy (BIHT)

In addition to lifestyle factors, hormonal preparation for pregnancy has become an increasingly important topic in reproductive medicine. One approach that is often discussed is bioidentical hormone therapy, commonly referred to as BIHT.

BIHT stands for Bioidentical Hormone Therapy and refers to the use of hormones whose molecular structure is identical to those naturally produced by the body.

Particularly important is the interaction between estradiol, progesterone, testosterone, and thyroid hormones. When these hormones are in stable balance, the body may be better prepared for pregnancy.

Treatment is always individualized and based on laboratory results and a comprehensive medical history, as each patient has a unique hormonal profile. The goal is to identify and address hormonal imbalances at an early stage.

Fertility and Premature Ovarian Insufficiency (POI)

One specific medical condition related to fertility is premature ovarian insufficiency (POI). In this condition, the ovaries lose their normal function before the age of 40.

POI can have several causes, including genetic changes, autoimmune processes, or the effects of cancer treatments.

The diagnosis can be emotionally challenging for affected women because it is often associated with reduced fertility. At the same time, early treatment can help minimize long-term health consequences.

Studies show that individualized hormone therapy can significantly improve symptoms and is often recommended until the natural age of menopause [2][3][4].

In my practice, I frequently treat women with POI using individualized bioidentical hormone therapy. Dosage is guided by regular hormone testing rather than a standardized protocol.

Viewing Fertility and Family Planning Realistically

Fertility is influenced by a complex interaction of factors. These include hormonal balance, metabolic health, lifestyle, environmental influences, and psychological well-being.

A healthy lifestyle can improve the conditions for pregnancy. At the same time, it is important to recognize that not all biological processes can be fully controlled.

Modern reproductive medicine offers many possibilities today. Equally important, however, are well-informed guidance, realistic expectations, and individualized medical care. The desire to have children is not only a medical issue but also a deeply personal life journey.