What is anti-Müllerian Hormone (AMH)?

What’s an AMH blood test?

An AMH blood test is a helpful way to understand if your AMH levels fall in the normal range for your age. It’s typically measured alongside thyroid, testosterone, FSH and oestrogen.

Unlike other hormones, AMH doesn’t fluctuate throughout the month. This means you can do an AMH blood test anytime during your cycle.

It’s important to remember an AMH test can’t directly predict your fertility or the time it will take to conceive. A specialist can give you a comprehensive assessment if you’re trying to get pregnant or want to learn more about your reproductive health.

You can check your egg reserve as part of our AMH blood test.

What’s the normal range for AMH?

The normal range for AMH depends on your age group: 

• 18 to 25 — 7.28-104.46 pmol/L
• 26 to 30 — 4.93-95.60 pmol/L
• 31 to 35 — 2.57-71.90 pmol/L
• 36 to 40 — 1.29-40.56 pmol/L
• 41 to 50 — 0.07-21.35 pmol/L

Why is AMH important?

You’re born with a set number of eggs — up to 1-2 million. One of your ovaries releases a mature egg every month when you ovulate. Sometimes you might release multiple eggs. This means that the number of eggs you have left decreases over time. This number is called your ovarian reserve. And the rate at which you lose eggs is unique to you.

How does AMH affect ovulation?

The more eggs you have left, the higher the level of AMH in your blood. This is why it’s thought that your AMH levels might be able to indicate:

• your ovarian reserve
• your chances of getting pregnant
• your remaining fertile years

What causes low AMH levels?

AMH levels naturally decline with age, usually starting in your mid-20s. Low AMH levels might indicate lower numbers of remaining follicles and a smaller ovarian reserve. 

Certain medical conditions can lead to low AMH levels, including:

• Crohn’s disease — an autoimmune disease where your body attacks parts of your digestive system.
• Rheumatoid arthritis (RA) — a long-term condition that causes painful, swollen, and stiff joints.
• Premature ovarian insufficiency (POI) — you start menopause before age 40.

Other lifestyle factors can lead to low AMH levels, like:

• smoking
• obesity
• poor diet and nutrition — like a vitamin D deficiency 
• ovarian surgery 

What are the symptoms of low AMH? 

The most common symptoms of low AMH levels include irregular periods and difficulty getting pregnant.

Can you improve your AMH levels?

Unfortunately, you can’t stop your AMH levels from declining with age. It’s a natural process. But the good news is that you can follow healthy lifestyle habits to improve your fertility. 

These include:

• Following a Mediterranean diet — eating lots of fruits and vegetables, legumes, nuts, beans, cereals, grains, and fish.
• Consuming fewer red and processed meats, sugary drinks, and processed foods.
• Avoiding excessive alcohol intake, smoking, and recreational drugs.
• Losing weight if you’re overweight.
• Staying active — aim for 75 minutes of vigorous-intensity activity or 150 minutes of moderate-intensity activity a week.
• Consider taking supplements — like vitamin D, vitamin B12, omega-3, and folic acid.

AMH and fertility

Recent evidence suggests that low AMH levels alone aren’t a good predictor of getting pregnant within your first year of trying. Women (aged between 30-40 years) with low AMH levels had similar chances of getting pregnant compared to women with normal levels.

But it might be a helpful test to include if you’re considering IVF or thinking about family planning. Some fertility specialists measure your AMH levels at the start of your IVF journey — higher AMH levels make it more likely that healthy eggs can be harvested. It’s really important to remember that in IVF, a woman is under the care of a specialist who can properly interpret their results and provide emotional support.

AMH and miscarriage

A recently published paper found that deficient AMH levels were associated with a higher risk of miscarriage. Although this is an interesting new finding, it’s based on one small study. More research is needed to confirm these findings and to investigate the possible link between AMH and your risk of miscarriage. 

AMH and PCOS

High AMH levels are associated with polycystic ovaries and polycystic ovary syndrome (PCOS) — a common condition affecting how your ovaries work. 

You can monitor this condition by doing regular PCOS blood testing. 

AMH and egg freezing

If you don’t want to get pregnant until some time in the future, you might have considered freezing your eggs.

Since your AMH levels indicate your ovarian reserve, testing your AMH levels helps you make an informed decision about whether you want to freeze your eggs.

When it comes to harvesting your eggs, most women aim to harvest 12-15 eggs — in a normal cycle, you usually only release one egg. So for this to happen, your ovaries need to be hyper-stimulated with hormones. One study found that your AMH levels might be a good predictor of the number of harvested eggs.

AMH and menopause

Menopause is when you permanently stop having periods and can’t get pregnant naturally anymore.

A blood test can’t diagnose menopause. It’s typically based on your age and symptoms. But some research suggests that AMH is an excellent marker for predicting menopause. 

The only test which can reliably tell you that you’re not releasing eggs anymore is to measure your follicle-stimulating hormone (FSH) levels.