AMH Levels Explained: A Complete Guide to Anti-Müllerian Hormone, Fertility, and Ovarian Reserve
- Dr. Michelle Hislop ND
- 6 days ago
- 3 min read
Understanding your fertility begins with understanding your ovarian reserve—and one of the most reliable ways to measure it is through AMH levels. AMH, or anti-Müllerian hormone, is a peptide produced by the small, growing follicles in the ovaries. Because these follicles represent your remaining egg supply, AMH has become a key marker in reproductive health, fertility planning, and hormone evaluation.
In this guide, we break down what AMH is, how it relates to fertility, how to interpret your levels, and what AMH can and cannot predict.
What Is AMH and Why It Matters for Fertility
AMH is produced by preantral and small antral follicles—the earliest stages of developing eggs. Unlike many reproductive hormones, AMH stays stable throughout the menstrual cycle and is not affected by birth control or most hormonal medications. This makes AMH testing convenient, accurate, and consistent at any time of the month.
Because AMH declines as ovarian reserve decreases, it’s one of the most useful tools for assessing future reproductive capacity.
How AMH Levels Reflect Ovarian Reserve
A woman is born with all the eggs she will ever have. As she ages, this egg supply gradually diminishes. AMH levels naturally mirror this decline.
High AMH → larger number of follicles
Low AMH → smaller remaining follicle pool
Very low AMH → ovarian reserve is nearing depletion
AMH levels typically peak around age 24.5 and gradually decline through the reproductive years.
Factors that may influence AMH include:
Age
BMI
Polycystic ovarian morphology
Ethnicity/ancestry
What AMH Levels Can Tell You About Fertility
AMH is an incredibly useful hormone in reproductive medicine. Here’s how it’s commonly used:
Predicting Egg Supply
AMH helps estimate how many eggs remain in the ovaries. While it cannot measure the exact number, it provides a reliable snapshot of ovarian reserve.
Predicting Menopause
AMH can help estimate the timing of menopause within roughly four years. Very low levels may indicate that menopause is approaching.
Guiding Fertility Treatment & IVF
AMH plays a major role in planning ovarian stimulation:
AMH < 0.5 ng/mL → may produce fewer than 3 follicles during IVF stimulation
AMH > 3.5 ng/mL → often indicates a robust egg supply, requiring gentler stimulation to avoid ovarian hyperstimulation syndrome (OHSS)
Clinicians use AMH to personalize medication dosing and reduce treatment risks.
Diagnosing PCOS
AMH is now considered a helpful tool in diagnosing polycystic ovary syndrome (PCOS), especially when ultrasound is unavailable.
Exception: AMH should not be used for PCOS diagnosis within 8 years post-menarche, because AMH levels are naturally elevated in adolescents.
What AMH Cannot Predict
Even though AMH is a valuable fertility marker, it has limitations:
It does not predict natural pregnancy success
It does not predict miscarriage or live birth rates
It does not measure egg quality
Age still matters more than AMH for IVF success
AMH is one important piece of the fertility picture—but not the whole story.
Normal AMH Ranges and What Your Levels Mean
AMH Levels & Ovarian Reserve
AMH Level (pmol/L) | Equivalent (ng/mL) | Interpretation |
< 7 pmol/L | < 1.0 ng/mL | Low ovarian reserve |
7–25 pmol/L | 1.0–3.5 ng/mL | Typical / average ovarian reserve |
> 25 pmol/L | > 3.5 ng/mL | High ovarian reserve (commonly seen in PCOS) |
High AMH is not inherently good or bad—it simply reflects follicle count, not egg quality.
Note: ranges can vary slightly between laboratories.
When and How to Test AMH
One of the greatest benefits of AMH testing is its simplicity.
Can be tested any day of your cycle
Not influenced by oral contraceptives
Not influenced by most hormone-based medications
This makes AMH one of the most accessible and flexible fertility blood tests.
How AMH Changes With Age
Peaks around 24.5 years old
Gradually declines until perimenopause
Very low levels are common as menopause approaches
These changes are normal and expected, which is why age must always be considered when interpreting AMH.
Key Takeaways About AMH and Fertility
AMH is a reliable, cycle-independent marker of ovarian reserve.
It helps predict menopause timing, guide fertility treatment, and support PCOS diagnosis.
AMH declines naturally with age but varies among individuals.
AMH measures egg quantity, not quality—and does not determine your ability to carry a pregnancy.
If you’re interpreting your AMH results or planning fertility treatment, a reproductive specialist can help you understand what your levels mean for your goals.
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