Understanding Your AMH Levels
What your ovarian reserve test really means for your fertility.
AMH Quick Facts
- What it measures: Ovarian reserve (egg quantity, NOT quality)
- Normal range: 1.0 - 3.5 ng/mL (varies by lab and age)
- When to test: Any day of your cycle
- Key limitation: AMH doesn't predict natural conception chances
What Is AMH?
Anti-Müllerian Hormone (AMH) is a hormone produced by the small follicles in your ovaries. The level of AMH in your blood correlates with the number of eggs remaining in your ovaries—your ovarian reserve.
Think of it as a rough estimate of your remaining egg supply. Higher AMH generally means more eggs; lower AMH means fewer eggs.
🔬 Why AMH Matters
AMH is useful because it:
• Predicts response to IVF stimulation (how many eggs you'll likely retrieve)
• Gives insight into time until menopause
• Can indicate conditions like PCOS (often high AMH)
However, it does NOT predict your ability to get pregnant naturally.
AMH Levels by Category
AMH is measured in ng/mL (nanograms per milliliter). Here's how results are typically interpreted:
Above 3.5 ng/mL
What it means: High ovarian reserve. May indicate PCOS if combined with other symptoms. Generally good for IVF response.
Note: Very high levels (>5.0) often seen in PCOS and may require careful medication dosing during fertility treatment to avoid ovarian hyperstimulation.
1.0 - 3.5 ng/mL
What it means: Normal ovarian reserve for reproductive age. Expected to respond well to fertility treatments if needed.
Note: "Normal" varies by age. A 1.5 ng/mL is great at 38 but on the lower end at 28.
0.5 - 1.0 ng/mL
What it means: Diminished ovarian reserve. Fewer eggs remaining than average for age. May need higher medication doses for IVF and may retrieve fewer eggs.
Important: Low AMH doesn't mean you can't conceive—it means you may have less time and fewer eggs for treatments.
Below 0.5 ng/mL
What it means: Significantly diminished ovarian reserve. May be approaching menopause or experiencing premature ovarian insufficiency.
Important: Pregnancy is still possible but may be more difficult. Time-sensitive decision-making about family planning is recommended.
⚠️ Lab Variation
Different labs may report different ranges and use different assays. Always interpret your results with your specific lab's reference ranges and discuss with your doctor.
AMH by Age: What's Normal?
AMH naturally declines with age. Here are typical ranges:
| Age | Low | Normal | High |
|---|---|---|---|
| 25-29 | <1.5 ng/mL | 1.5 - 4.0 ng/mL | >4.0 ng/mL |
| 30-34 | <1.2 ng/mL | 1.2 - 3.5 ng/mL | >3.5 ng/mL |
| 35-37 | <0.8 ng/mL | 0.8 - 2.5 ng/mL | >2.5 ng/mL |
| 38-40 | <0.5 ng/mL | 0.5 - 2.0 ng/mL | >2.0 ng/mL |
| 41-43 | <0.3 ng/mL | 0.3 - 1.5 ng/mL | >1.5 ng/mL |
| 44+ | <0.2 ng/mL | 0.2 - 1.0 ng/mL | >1.0 ng/mL |
Note: These are general guidelines. Individual variation is significant.
What AMH Does NOT Tell You
This is crucial to understand:
AMH Does NOT Measure Egg Quality
You could have high AMH (lots of eggs) but poor egg quality, or low AMH (few eggs) with excellent egg quality. Egg quality is primarily determined by age and isn't reflected in AMH.
AMH Does NOT Predict Natural Conception
Multiple studies have shown that AMH does not predict the likelihood of natural conception in women trying on their own. A woman with low AMH can conceive just as quickly as someone with normal AMH—she just has less time before menopause.
AMH Does NOT Predict IVF Success
AMH predicts how many eggs you'll likely retrieve, but not pregnancy rates. A woman who retrieves 6 eggs may have the same success rate as one who retrieves 20—if her eggs are good quality.
💡 The Real Value of AMH
AMH is most useful for:
• Planning IVF protocols (medication dosing)
• Family planning timelines (how much time you might have)
• Diagnosing PCOS (when combined with other factors)
• Detecting early menopause
Low AMH: What Are Your Options?
If your AMH is lower than expected for your age:
Don't Panic
Low AMH doesn't mean you can't get pregnant. Many women with low AMH conceive naturally. It does mean time may be more critical.
Consider Your Timeline
If you want children, low AMH is a signal to prioritize. This might mean trying sooner rather than later, or considering egg freezing if you're not ready yet.
Explore Treatment Options
- Natural conception: Still very possible, especially under 40
- IUI: Less dependent on ovarian reserve since you only need 1-2 eggs
- IVF: May retrieve fewer eggs but can still be successful
- Mini IVF: Lower-dose protocol that works with (not against) diminished reserve
- Egg freezing: Preserve current eggs for future use
Lifestyle Factors
While you can't increase your egg count, you may support egg quality through:
- CoQ10 supplementation (200-600mg daily)
- DHEA (under doctor supervision only)
- Antioxidant-rich diet
- Avoiding smoking and excessive alcohol
- Managing stress and sleep
High AMH: What Does It Mean?
High AMH (above 3.5-4.0 ng/mL) can indicate:
PCOS
Polycystic ovary syndrome often causes elevated AMH because of the many small follicles on the ovaries. High AMH alone doesn't diagnose PCOS—it must be combined with other criteria.
Excellent Ovarian Reserve
Some women simply have more eggs than average, which is generally good news for fertility.
Implications for Treatment
If undergoing IVF with high AMH, your doctor will likely use lower medication doses to avoid ovarian hyperstimulation syndrome (OHSS), a potentially dangerous overresponse to fertility drugs.
Getting Your AMH Tested
When to Test
AMH can be tested on any day of your cycle—it doesn't fluctuate significantly like FSH or estrogen.
Where to Get Tested
- Your OB/GYN or RE: Standard blood test
- At-home tests: Services like Modern Fertility offer finger-prick tests you can do at home
- Direct-to-consumer labs: LabCorp, Quest, etc.
Cost
AMH testing typically costs $50-150 without insurance. Some fertility benefits cover it. At-home tests range from $100-200 for a panel including AMH.
Should Everyone Get Tested?
There's debate about routine AMH testing. Arguments for: better family planning information. Arguments against: may cause unnecessary anxiety without changing outcomes for natural conception. Discuss with your doctor.
Frequently Asked Questions
Can AMH levels improve?
Generally no—AMH reflects your remaining egg count, which only decreases over time. However, levels can fluctuate slightly month to month, and some studies suggest DHEA supplementation may modestly increase AMH in some women.
How fast does AMH decline?
AMH typically declines about 5-7% per year, accelerating after age 35. A significant drop (>50%) in a year warrants investigation.
Can you have low AMH and still have regular periods?
Yes. AMH measures quantity of eggs remaining, not whether you're currently ovulating. Many women with low AMH have perfectly regular cycles until closer to menopause.
Does birth control affect AMH?
Hormonal birth control may temporarily suppress AMH by 20-30%. Test a few months after stopping for accurate results, or understand your result may be slightly lower than true baseline.
The Bottom Line
AMH is a useful piece of the fertility puzzle, but it's just one piece. It tells you about egg quantity, not quality, and doesn't predict your ability to conceive naturally.
If your AMH is lower than expected, don't despair—but do consider your timeline. If it's higher than expected, you may have PCOS worth investigating. Either way, work with your doctor to understand what your specific results mean for your specific situation. 💚