AMH Levels & Fertility: Understanding Tests & the Results

When it comes to fertility, there is no shortage of tips, tricks, and tests to help you understand what’s going on with your body. 

One test in particular, known as an anti-mullerian hormone (AMH) test, can provide insight into your fertility status and overall reproductive health. Read on to discover everything you need to know about your AMH levels, what they have to say about your overall fertility, and how you can test for AMH from the comfort of your home. 

What is AMH? 

Produced in reproductive tissues, the anti-mullerian hormone (or AMH) is a protein hormone found in both male and female individuals. 

Soon after conception, an embryo starts developing reproductive organs aligned with its genes. Male embryos have higher levels of AMH, which prevents female sex organs from developing. In female embryos, AMH levels are low to allow for reproductive organs to develop.

Among ovulating individuals, the role of AMH changes at the start of puberty. At this point, ovarian follicles begin producing AMH, with AMH levels increasing alongside the production of egg cells. 

AMH levels can be tested in the blood, and doctors can use AMH testing to estimate egg count and the number of follicles in the ovaries. Thus, your AMH levels are a good indicator of ovarian reserve.

All About AMH Levels 

While your AMH levels don’t change much throughout your menstrual cycle, they do change as you age. In female individuals, AMH levels rise throughout childhood and peak right before puberty. Throughout an individual’s most fertile years, AMH levels gradually decrease along with ovarian reserve. 

As an individual reaches puberty and the reproductive years, egg count and AMH levels begin to drop. After age 25, egg count decreases at a higher rate. Again, at 30 and 35, the loss becomes more rapid until menopause when an individual’s egg count reaches zero. AMH levels also decrease with age alongside egg count, making AMH an important hormone to track if you are trying to conceive.

 

AMH changes over time 

AMH levels are important to monitor over time because they reflect the size of our ovarian reserve – i.e. the number of healthy eggs we have available for fertilization. This is an accurate measure of ovarian function because only healthy, functional follicles produce AMH.

Studies show that AMH correlates well with the number of follicles in the ovaries. Even so, AMH levels vary widely between individuals and across different age groups. AMH levels also change over time, though they remain fairly stable throughout most of the menstrual cycle.

Among ovulating individuals ages 18-24 with normal AMH levels, this number does not change much from cycle to cycle, though it can fluctuate. Individuals with high AMH levels have been found to have large fluctuations in their AMH measurements over time, while individuals with low AMH have been found to have smaller fluctuations. Because AMH levels are higher in younger individuals, this means that younger individuals may have greater fluctuations in their AMH levels compared to individuals who are older. 

The most significant changes in AMH, however, occur with age. Read on to learn more about how AMH levels change as you age — and what that means for your fertility.

AMH levels by age

We already know that our egg reserves decline as we get older. Correspondingly, research clearly demonstrates that AMH levels decrease steadily with age. One study of over 2,700+ women confirmed that AMH levels were negatively associated with age — and that is just one of many studies we have to support this conclusion.

According to research, normal AMH levels for presumably healthy women by age are estimated to be:

Age	Median AMH Levels
<25	3.59 ng/mL
25	3.91 ng/mL
26	4.23 ng/mL
27	3.33 ng/mL
28	4.24 ng/mL
29	3.87 ng/mL
30	3.51 ng/mL
31	3.23 ng/mL
32	3.50 ng/mL
33	2.80 ng/mL
34	2.54 ng/mL
35	3.10 ng/mL
36	2.62 ng/mL
37	1.72 ng/mL
38	2.16 ng/mL
39	1.74 ng/mL
40	1.62 ng/mL
41	1.17 ng/mL
42	1.26 ng/mL
43	0.79 ng/mL
>43	0.88 ng/mL

AMH’s role in fertility

AMH levels can be used to help individuals determine the best time to start trying for a baby. Not only do AMH levels vary by age, but they also vary widely from person to person. Thus, individuals who already have a low AMH level to start with may want to start trying to conceive as quickly and efficiently as possible. 

AMH & ovarian reserve

AMH levels are a relatively accurate reflection of ovarian reserve — or the number of healthy eggs you have stored in your ovaries. We already know that the number of healthy eggs decreases with age, most significantly after age 35. Thus, you can reasonably expect that AMH levels will decline with age, too.

AMH & infertility

Your doctor may want to measure your AMH levels if you are having trouble getting pregnant naturally. An AMH test can help your doctor assess whether or not you might be suffering from diminished ovarian reserve or another condition affecting fertility. A normal AMH level for fertile individuals is 1-4 ng/mL. Levels less than 1 ng/mL or greater than 4 ng/mL might indicate an underlying health condition. 

AMH & miscarriages

An AMH level of less than 1 ng/mL could be an indicator of fertility issues. Low AMH levels may also increase your risk of having a miscarriage once you are pregnant. One study found that women with an AMH level of 0.4 ng/mL or lower had a higher risk of miscarriage over time. In this study, the most significant increase in risk for pregnant women occurred between six and seven weeks gestation.

What is a Good AMH Level for Getting Pregnant?

What’s considered a “good” AMH level will vary depending on the individual. However, as a general rule of thumb, anything within the “normal” range (1-4 ng/mL) would be considered a “good” level for getting pregnant. 

If you are concerned about your AMH levels and how they relate to your fertility, speak with your doctor and they can provide the best advice for your individual situation. 

Testing for AMH

At the doctor’s office

An AMH blood test is a simple, low-risk procedure. It requires no special preparation (i.e. fasting) and should take less than five minutes at the doctor’s office. As with any blood test, you may feel a slight sting when the needle is inserted and bruising may occur. 

At home

It is also possible to test your AMH levels from the comfort of your home. This is often cheaper and more convenient than visiting your doctor’s office. 

There are a number of different at-home AMH tests to choose from – including Mira’s own Fertility Panorama Lab Test. Mira’s test is unique in that it not only tests for AMH, but it also tests for several other fertility hormones including thyroid stimulating hormone (TSH), Free Thyroxine (fT4), Prolactin, and Free Testosterone. 

Testing at home is simple – all you have to do is follow the instructions for taking a finger-prick sample of blood, send off your sample to the lab, and wait for your results to arrive within approximately three days. In addition to receiving your numeric hormone results, you’ll also receive a detailed, personalized hormone report with actionable steps and insights into your ovarian reserve, thyroid functioning, menstrual cycle, hormone balance, and overall fertility health. 

What is AMH testing used for?

AMH tests can give insights into an individual’s current egg count. Test results can also be used by a doctor to predict, assess, and/or diagnose several conditions including: 

• Early menopause
• Menopause
• Amenorrhea
• Polycystic ovary syndrome (PCOS)
• Ovarian cancer

Testing for AMH is very common when working with a fertility specialist. For example, if your levels are found to be lower than what is considered appropriate for your age group, you will be considered to have a diminished ovarian reserve. Your doctor may recommend egg freezing if you aren’t ready to get pregnant, or, they may suggest other fertility treatments if you are currently trying to conceive.

Knowing your AMH levels can help understand your chances of successfully using assisted reproductive technology (ART) for conception. For example, if you have normal levels for your age, there is a higher chance that a larger number of eggs will be retrieved for freezing or IVF. Understanding your AMH levels is only one piece of the puzzle, but it gives you important information to help make your fertility plan.

Remember, your AMH levels give you a picture of what your current ovarian reserve looks like. It cannot be used to indicate what it will look like in the future or how quickly the number of eggs available will change. However, it is a great starting point for conversations with your doctor about your fertility plans.

Low AMH: What it Means

Your AMH levels are a representation of your ovarian reserve. Because AMH levels naturally decrease as you age, your doctor should interpret your results by comparing them to the average numbers for your age group.

If your AMH levels are lower than your doctor would expect for your age, it may mean that you have fewer eggs than other women in your age group. This condition — known as diminished ovarian reserve — can create challenges with fertility.

High AMH: What it Means

You might think that high AMH is a good thing. After all, doesn’t that mean you have more eggs in your ovarian reserve?

Not exactly.

In some cases, dramatically high AMH levels can indicate a condition called polycystic ovarian syndrome (PCOS), which causes many follicles to grow on the ovaries. Despite high AMH levels, individuals with PCOS often struggle with infertility. Why? Because although these follicles produce AMH, not all of them can release an egg. This is why a high AMH level is not necessarily associated with a higher ovarian reserve in some cases. 

AMH FAQs 

Can I get pregnant with low AMH? 

It is possible to get pregnant naturally even with low AMH, however, you may need some help from an assisted reproductive technology (ART). 

It is possible to get pregnant naturally with low AMH, but it’s less likely. Those who have low AMH are more likely to need fertility treatments to conceive. AMH levels can also be used to gauge your chances of success with treatments such as IVF.

If you already have fewer eggs to retrieve for treatments, your chances of successfully using those eggs are lower than if you had a large number of eggs. That being said, every individual is different. For some individuals with low AMH, it’s still possible to get pregnant without any intervention.

How can you increase your AMH levels?

As of right now, there is no proven way to increase your AMH levels. Some studies suggest that consuming more vitamin D and DHEA, whether through food or supplements, can help raise your AMH levels. However, there is no indication that increasing your AMH levels will actually improve your chances of getting pregnant. 

The truth is that there is no way to completely stop your eggs from aging (besides freezing them). However, you can slow down the process through healthy lifestyle choices. Once your eggs are gone, however, there is no way to get them back. Thus, increasing your AMH levels won’t necessarily increase your ovarian reserve or make you more likely to get pregnant.

What are the causes of low AMH?

Diminished ovarian reserve most often happens with age, but it can occur earlier than expected in some individuals. Here are a few reasons why some may begin to lose eggs at a higher rate in their 20s or 30s: 

• Genetics. Genes can play a part in how fast your ovarian reserve declines compared to the average population.
• Medical conditions. Chronic illnesses such as endometriosis and certain autoimmune disorders can lead to lower ovarian reserve.
• Surgery on the ovaries. Surgery on the ovaries for certain reproductive health conditions can occasionally lead to scarring or damage, resulting in diminished ovarian reserve.

Should you get an AMH test?

You will likely get an AMH test if you decide to visit a fertility specialist for assistance getting pregnant. Women who are under 35 and have been trying to get pregnant naturally for one year, or women over 35 who have been trying for six months, should see a fertility specialist if they do not have success.

Your doctor might also want to test your AMH if you are having symptoms of perimenopause or menopause. AMH levels can be used to predict when you are approaching and/or entering menopause, indicating that you are no longer fertile.