Anti-Mullerian Hormone (AMH)

check icon Optimal Result: 5.5 - 37.4 pmol/L, or 0.77 - 5.24 ng/mL.

Anti-Müllerian Hormone (AMH) is a hormone produced by granulosa cells in ovarian follicles and plays a vital role in reproductive health. It is commonly used as a marker to assess ovarian reserve—the number of viable eggs a woman has left. This test is frequently ordered as part of fertility evaluations, to monitor ovarian function, or to predict menopause onset. In men, AMH is secreted by Sertoli cells in the testes and plays a role in early sexual differentiation, although clinical testing in adult males is rare.


Why the AMH Test Is Important

AMH levels provide insight into a woman’s fertility potential because they reflect the number of small, developing follicles in the ovaries. Unlike other reproductive hormones such as FSH (follicle-stimulating hormone), AMH levels remain relatively stable throughout the menstrual cycle, making it a reliable measure of ovarian reserve at any time of the month. The test is often used in:

  • Evaluating fertility and guiding assisted reproductive technologies (ART), like IVF

  • Diagnosing or monitoring polycystic ovary syndrome (PCOS)

  • Assessing risk of early menopause or diminished ovarian reserve

  • Monitoring ovarian function in women undergoing chemotherapy or other treatments that affect fertility

  • Diagnosing certain ovarian tumors that may produce AMH


What Do AMH Results Mean?

Low AMH Levels
Low AMH levels may suggest a reduced ovarian reserve. This can occur naturally with age, especially as a woman approaches perimenopause or menopause, but may also result from genetic factors, autoimmune diseases, surgical removal of part of the ovary, or exposure to chemotherapy or radiation. Low AMH doesn’t necessarily mean infertility, but it may indicate a lower chance of success with fertility treatments, particularly IVF.

Causes of Low AMH:

  • Advancing age

  • Premature ovarian insufficiency (POI)

  • Certain genetic conditions (e.g., Turner syndrome)

  • Previous ovarian surgery

  • Chemotherapy or radiation therapy

  • Autoimmune ovarian damage

High AMH Levels
Elevated AMH levels can suggest a high number of antral follicles and are often seen in women with PCOS, a hormonal disorder characterized by irregular periods, cystic ovaries, and excess androgen levels. High AMH in this context may be associated with anovulation (lack of ovulation), which can impair fertility despite a high ovarian reserve.

Causes of High AMH:

  • Polycystic ovary syndrome (PCOS)

  • Granulosa cell tumors of the ovary

  • Use of certain fertility medications that stimulate follicular growth


Normal AMH Levels by Age (General Guidelines)

Age Range (Years) Expected AMH Level (ng/mL)
20–24 1.9 – 6.7
25–29 1.5 – 5.4
30–34 1.2 – 4.1
35–39 0.5 – 3.1
40–44 0.2 – 2.2
45–50 < 1.0

Note: Reference ranges can vary between laboratories.


AMH and Fertility Planning

Understanding your AMH levels can help guide decisions about when to try to conceive, whether to consider egg freezing, or whether assisted reproductive technologies may be needed. However, AMH is not a direct predictor of the ability to get pregnant—it provides a snapshot of egg quantity, not egg quality.

Women with normal or even high AMH can still face fertility challenges due to egg quality, ovulation disorders, or uterine conditions. Conversely, women with low AMH may still conceive naturally, especially if they are younger and ovulate regularly.


Key Takeaways

  • AMH is a valuable indicator of ovarian reserve, useful in fertility evaluations and reproductive planning.

  • Low levels may indicate reduced fertility or approaching menopause, while high levels may suggest PCOS.

  • AMH is one of several markers that should be interpreted alongside clinical history, other hormone tests (like FSH, LH, estradiol), and ultrasound findings.

  • This test is also important in fertility preservation discussions and during IVF cycle planning.

What does it mean if your Anti-Mullerian Hormone (AMH) result is too high?

Elevated Anti-Müllerian Hormone (AMH): What It Means for Your Fertility

Anti-Müllerian Hormone (AMH) is a hormone produced by small, developing follicles in a woman’s ovaries. It’s widely used by OBGYNs and fertility specialists to assess ovarian reserve—that is, how many potential eggs (oocytes) a woman has left. AMH serves as a useful marker because its levels are relatively stable throughout the menstrual cycle and correlate closely with the number of antral follicles in the ovaries.


What Does a High AMH Level Indicate?

Higher AMH levels—generally above 1.0 ng/mL or 7.14 pmol/L—are typically a sign of a healthy or robust ovarian reserve. This can mean that:

  • You may have more eggs available for ovulation or retrieval

  • You are more likely to respond well to fertility treatments like IVF or egg freezing

  • You may have a longer reproductive window

However, very high AMH levels—often seen above 3.0–5.0 ng/mL (or 21–36 pmol/L)—can sometimes signal an underlying condition, such as:

1. Polycystic Ovary Syndrome (PCOS)

Women with PCOS often have significantly elevated AMH levels due to the presence of many small follicles that do not mature and ovulate regularly. While this suggests a large egg reserve, ovulation dysfunction can still make it harder to conceive without treatment.

2. Increased Risk of Ovarian Hyperstimulation

In fertility treatments, high AMH may predict a strong response to injectable medications. This can be helpful in retrieving more eggs, but it also raises the risk of Ovarian Hyperstimulation Syndrome (OHSS), a potentially serious condition.

3. Granulosa Cell Tumors (Rare)

In rare cases, an abnormally high AMH level may indicate the presence of a granulosa cell tumor—a type of ovarian tumor that produces excess AMH. If your AMH is extremely elevated without other explanation, further evaluation may be needed.


Does High AMH Mean High Fertility?

Not necessarily. While a high AMH suggests a greater number of eggs, it doesn't guarantee fertility success. Egg quality still matters, especially as women age. For example, a 40-year-old woman with high AMH may still have lower egg quality compared to a younger woman.


Key Takeaways

  • Elevated AMH is generally a good sign for ovarian reserve and fertility treatment response.

  • Very high levels may indicate PCOS or other conditions and should be interpreted in context.

  • AMH alone doesn’t measure egg quality or predict natural conception outcomes.

  • Always interpret AMH results alongside other fertility tests and your clinical history.

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What does it mean if your Anti-Mullerian Hormone (AMH) result is too low?

Low Anti-Müllerian Hormone (AMH): What It Means for Your Fertility

Anti-Müllerian Hormone (AMH) is a hormone released by small follicles in the ovaries and is widely used as a marker of a woman’s ovarian reserve—her remaining egg supply. AMH levels naturally decline with age, and women in their 40s often have low AMH as part of the normal aging process.


What Do Low AMH Levels Indicate?

Low AMH levels generally suggest that the number of eggs in your ovaries is reduced. While this does not automatically mean infertility, it may affect how easily you can conceive, especially as you get older.

  • AMH levels above 21.98 pmol/L (or 3 ng/mL) are typically considered satisfactory for fertility, but interpretation must account for age and individual circumstances.

  • Low AMH (typically below 5.4 pmol/L or 0.8 ng/mL) may indicate diminished ovarian reserve (DOR), meaning fewer developing follicles and potentially a reduced response to fertility treatments.


Causes of Low AMH

  • Natural aging – The most common cause. Ovarian reserve begins to decline in the mid-30s and often drops sharply in the 40s.

  • Premature ovarian insufficiency (POI) – When ovarian function declines earlier than expected, often before age 40.

  • Genetic factors – A family history of early menopause may increase your risk.

  • Medical treatments – Chemotherapy, radiation, or ovarian surgery can reduce AMH levels by damaging ovarian tissue.

  • Environmental and lifestyle factors – Smoking, extreme stress, and poor nutrition may also contribute.

Low AMH is normal in prepubescent girls and in women after menopause, when ovarian activity naturally slows or stops.


Symptoms and Diagnosis

Low AMH typically does not cause symptoms, but in some cases, women may experience:

  • Irregular or missed periods

  • Difficulty conceiving

  • Early signs of menopause (hot flashes, night sweats, mood changes)

The only reliable way to assess AMH is through a blood test, which can be done at any point in your menstrual cycle.


Does Low AMH Mean You Can’t Get Pregnant?

Not necessarily. AMH reflects the quantity, not the quality, of your eggs. Many women with low AMH conceive naturally, particularly if they are younger and ovulating regularly. However, fertility may decline more quickly, and assisted reproductive options like IVF may be less successful or require adjusted protocols.

In women with age-related low AMH, egg quality may also be lower due to accumulated DNA damage in aging eggs, increasing the risk of miscarriage or chromosomal abnormalities.


Key Takeaways

  • Low AMH means reduced ovarian reserve, which may affect fertility and response to treatment.

  • It doesn’t guarantee infertility, but it may shorten the window of opportunity for conception.

  • Your age, menstrual cycle regularity, and overall health are essential when interpreting AMH.

  • Early testing can help guide fertility planning, including options like egg freezing or IVF.

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