If you've had fertility testing, chances are AMH was on the list. It's become a go-to test for assessing ovarian reserve—how many eggs remain in your ovaries. But the results can be confusing, and there's a lot of misunderstanding about what AMH actually tells you (and what it doesn't).
What Is AMH?
Anti-Müllerian Hormone (AMH) is produced by the small follicles in your ovaries—specifically, the granulosa cells of pre-antral and small antral follicles. The more of these follicles you have, the higher your AMH level.
Because AMH reflects the pool of developing follicles, it serves as a marker for your remaining egg supply. Higher AMH generally indicates more eggs; lower AMH indicates fewer.
Key advantages of AMH testing:
- Can be done on any day of your cycle (unlike FSH testing)
- Relatively stable month-to-month (though it does decline over years)
- Simple blood test with results in days
- Helps predict response to ovarian stimulation for IVF
AMH Reference Ranges
AMH is typically measured in ng/mL (nanograms per milliliter) in the US, or pmol/L in other countries. Here's how results are generally interpreted:
AMH Levels at a Glance
Important: These ranges are general guidelines. What's "normal" depends on your age—AMH naturally declines as you get older. A 25-year-old and a 40-year-old with the same AMH are in very different situations.
AMH by Age: What's Normal?
| Age | Low AMH | Normal AMH | High AMH |
|---|---|---|---|
| 25-30 | <1.5 ng/mL | 1.5-4.0 ng/mL | >4.0 ng/mL |
| 31-35 | <1.0 ng/mL | 1.0-3.5 ng/mL | >3.5 ng/mL |
| 36-40 | <0.75 ng/mL | 0.75-2.5 ng/mL | >2.5 ng/mL |
| 41-45 | <0.5 ng/mL | 0.5-1.5 ng/mL | >1.5 ng/mL |
Interpreting Your Results
Your ovarian reserve appears typical for your age group. This suggests you likely have an adequate egg supply and would be expected to respond well to fertility treatments if needed.
What This Means
- Good indicator that egg supply is age-appropriate
- Expected to respond well to IVF stimulation
- No urgent time pressure beyond normal age-related decline
- Natural conception remains a reasonable path to try
Your ovarian reserve is lower than typical for your age. This suggests fewer eggs remain than expected, which may impact fertility treatment options and timeline.
What This Means
- Fewer eggs in reserve than average for your age
- May need higher medication doses or multiple IVF cycles
- Time may be more of a factor—consider not delaying TTC
- Natural conception is still possible—you only need one good egg
- Consult a reproductive endocrinologist for personalized guidance
Your ovarian reserve is significantly reduced. This indicates a limited egg supply, which impacts both natural conception chances and response to fertility treatments.
What This Means
- Egg supply is quite limited
- May respond poorly to IVF stimulation (fewer eggs retrieved)
- Multiple IVF cycles or mini-IVF protocols may be recommended
- Donor eggs may be discussed as an option
- Natural conception can still happen but is less likely
- Don't delay—see a specialist soon if pregnancy is a goal
Elevated AMH can indicate a larger than average egg supply—good news for fertility. However, very high levels (especially above 5-6 ng/mL) are often associated with PCOS (Polycystic Ovary Syndrome).
What This Means
- Likely have a robust egg supply
- High responder to IVF medications (risk of overstimulation)
- If very high, may indicate PCOS—discuss with your doctor
- PCOS can cause irregular ovulation, which affects conception
- Good news: many eggs to work with if treatment is needed
AMH tells you approximately how many eggs remain—not how good those eggs are. Egg quality is primarily determined by age and can only be assessed through IVF (by embryo grading). A 38-year-old with a high AMH still has 38-year-old eggs with higher rates of chromosomal abnormalities than a 28-year-old with low AMH.
What AMH Doesn't Tell You
AMH is useful, but it has significant limitations:
It doesn't predict natural conception. Studies show AMH is a poor predictor of whether you'll conceive naturally. Women with low AMH conceive naturally all the time. You only need one egg per month, and one good egg to get pregnant.
It doesn't measure egg quality. A high AMH doesn't mean your eggs are high quality, and a low AMH doesn't mean your remaining eggs are poor quality. Age is a much better predictor of egg quality.
It doesn't tell you when menopause will occur. While very low AMH may suggest earlier menopause, it's not a reliable predictor of when you'll stop having periods.
It can vary between labs. Different assays may give slightly different results. Compare your result to the reference range provided by your specific lab.
"AMH is like checking how much gas is left in the tank. It tells you something useful, but it doesn't tell you how far you'll actually be able to drive."
AMH and IVF: Where It Matters Most
Where AMH really shines is predicting IVF response. It helps reproductive endocrinologists:
- Choose medication doses: Low AMH = higher doses needed; High AMH = lower doses to avoid overstimulation
- Predict egg retrieval numbers: Higher AMH generally means more eggs retrieved
- Counsel on realistic expectations: Very low AMH may mean fewer eggs per cycle
- Assess ovarian hyperstimulation risk: High AMH indicates higher OHSS risk
If you're considering IVF, AMH is valuable information. If you're trying naturally, it's useful context but not determinative.
Other Tests That Complement AMH
AMH is usually interpreted alongside other markers:
AFC (Antral Follicle Count): An ultrasound that counts small follicles visible on your ovaries. Together with AMH, gives a more complete picture of ovarian reserve.
FSH (Follicle-Stimulating Hormone): Tested on day 2-4 of your cycle. Elevated FSH (above 10) suggests the brain is working harder to stimulate ovaries, indicating lower reserve. Best interpreted alongside estradiol.
Estradiol (E2): Also tested on day 2-4. If elevated early in the cycle, it can artificially suppress FSH, masking diminished reserve.
A complete fertility evaluation includes all of these, plus assessment of your partner's sperm, your fallopian tubes, uterine cavity, and ovulation patterns.
Can You Improve Your AMH?
Honestly? Probably not significantly. AMH reflects your remaining egg supply, which is largely determined by genetics and age. Some research suggests:
- DHEA supplementation may modestly improve AMH in some women with diminished reserve (controversial, requires doctor supervision)
- Vitamin D deficiency correction may slightly improve levels in deficient women
- Lifestyle factors (not smoking, healthy weight) support overall ovarian function
But don't expect dramatic changes. The focus should be on optimizing egg quality through lifestyle and supplements, rather than trying to change your AMH number.
Where Are You in Your Fertility Journey?
Our quiz can help you understand your situation and what steps to consider next.
Take the Fertility Quiz →The Bottom Line
AMH is a useful snapshot of your ovarian reserve—but it's just one piece of information. Key takeaways:
- AMH measures egg quantity, not quality. Age is a better predictor of quality.
- Normal ranges depend on age. A 1.0 ng/mL is concerning at 28 but acceptable at 38.
- Low AMH doesn't mean you can't conceive naturally. You only need one good egg.
- AMH is most useful for IVF planning—predicting response to stimulation.
- Interpret results with other tests: AFC, FSH, and your overall clinical picture.
- Don't delay if AMH is low—time matters more when reserve is diminished.
If you've received concerning AMH results, take a breath. Talk to a reproductive endocrinologist who can put your results in context and discuss your individual situation. Numbers aren't destiny.