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AMH will inform you of your ovarian reserve and how likely you are to reach early menopause.
Written by Leanne Edermaniger
April 12, 2024
Reviewed by:
Dr Thom PhillipsAnti-Müllerian hormone (AMH) is produced by the developing egg sacs in a woman’s ovaries called follicles, and in the testes in men.
In the womb, AMH is pivotal in developing a baby’s sex organs. Male babies have high levels of AMH to stop them from developing female sexual organs[1]. AMH levels are low at birth in women but gradually rise through puberty.
After puberty, women produce more AMH in their ovarian follicles and high levels can indicate a larger supply of eggs. This is known as your ovarian reserve.
Women are born with a definitive quantity of eggs, which declines as they age because of monthly ovulation and the natural breakdown of the ovarian follicles. AMH levels start to fall from the age of 25 to undetectable levels at menopause[2].
Low AMH levels are not a cause of infertility, but they can give a good indication of the health of your ovarian reserve.
A study published in 2022 involving 665 Indian women undergoing IVF, found that those who had a serum AMH level of ≥1.10 ng/mL (2.46 pmol/L) had:
NICE guidelines state that an AMH level of 5.4 pmol/L or 0.8 ng/mL predicts a low response to ovarian hyperstimulation during IVF treatment while levels above 25.0 pmol/L (3.6 ng/mL) are indicative of a high response[4]. However, other factors may need to be taken into consideration, such as age and other hormone levels.
It is important to remember that a lower AMH level will not inform you of your chances of getting pregnant, but it can give you an insight into how many eggs you have and if you might reach menopause earlier than average.
Recent research has also shown that high levels of AMH in women could indicate polycystic ovary syndrome (PCOS), a condition which affects 8 to 13% of women of childbearing age[5]. In these women, rather than reflect ovarian reserve, high AMH could be a biomarker for PCOS severity and indicate a poor reproductive prognosis[6].
The reference range for AMH is 1.1 – 53.5 pmol/L.
You can measure your AMH levels with an AMH blood test to get a better understanding of whether your levels are within a normal range for your age.
Unlike other sex hormones, such as follicle-stimulating hormone (FSH), luteinising hormone, oestrogen, and progesterone, AMH doesn’t fluctuate throughout your menstrual cycle, so you can take an AMH blood test at any time.
An AMH blood test can give insight into a woman’s fertility and can identify the number of eggs in the ovaries. It may also help to identify ovarian-related conditions, such as PCOS.
If you are looking to start a family or finding it difficult to conceive, you can check your AMH levels alongside other key fertility hormones with our Female Fertility Blood Test.
A lower AMH level can indicate that a woman has fewer eggs in her ovarian reserve than average for her age.
Lower levels are more common as you age, particularly after the age of 40. A low AMH level in younger women can sometimes indicate an increased risk of early menopause.
Research shows that Crohn’s Disease is linked to low AMH and that women of reproductive age with the condition have a lower ovarian reserve[7].
There are several lifestyle and environmental factors which may contribute to reduced AMH levels. For example, women with higher vitamin D levels maintain their ovarian reserve for longer, meaning this nutrient can have a direct effect on AMH production[8]. Other factors include:
Common symptoms of low AMH are irregular periods that may become shorter or longer and difficulty getting pregnant.
Depending on the cause of low AMH levels, you may experience symptoms associated with an underlying medical condition.
Several recent studies have found a link between low AMH levels and an increased risk of miscarriage. Schumacher et al., (2018) looked at the association between AMH and miscarriage in naturally conceived pregnancies. There were 533 women aged between 30 and 44 with no history of infertility, PCOS or endometriosis included in the study.
The results found that women with significantly low AMH (≤0.4 ng/ml) experienced miscarriages at double the rate of women who had an AMH level of 1 ng/ml or more[13].
A further study published in 2022, found that early miscarriage rates were lower in women aged under 35 who were having their first egg retrievals for IVF or intracytoplasmic sperm injection (ICSI), with a medium AMH level compared to women with low or high AMH. Young women with a high AMH level were at a significant risk of early miscarriage[14].
A high AMH level in women could be a sign of polycystic ovary syndrome or PCOS. PCOS is a common hormonal condition which affects how a woman’s ovaries function[15]. With PCOS, the ovarian follicles with eggs inside, but the eggs do not fully mature or turn into cysts, resulting in irregular or no ovulation.
Generally, AMH levels are high during foetal development and up until about 6 months of age in boys, slowly declining through childhood before falling to low levels during puberty[16]. In adult men, high AMH levels could indicate underlying conditions, such as:
If high AMH symptoms in women are caused by PCOS, the symptoms may include:
No, AMH levels tell you how many eggs you have left, also known as your ovarian reserve, it doesn’t reflect the health of your eggs. There is no diagnostic test for egg quality, but naturally, it declines with age.
Although you cannot stop the natural decline in AMH as you age, there are several things you can do to support your fertility. They are:
Testing your AMH levels will only give you part of your fertility picture. The results will tell you what your ovarian reserve looks like, but it won’t tell you the quality or quantity of your eggs or if your reproductive organs are healthy.
It is possible to have normal AMH levels and still have trouble conceiving. At Forth, we have a Female Fertility Blood Test which measures seven biomarkers that influence the reproductive system, to give you a more accurate insight into your reproductive health. The biomarkers included in the test are:
By measuring this panel of hormones, we can assess for a wide range of risk factors associated with infertility.
Based in the UK, Leanne specialises in writing about health, medicine, nutrition, and fitness.
She has over 5 years of experience in writing about health and lifestyle and has a BSc (hons) Biomedical Science and an MSc Science, Communication and Society.
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Ghumman, S. (2016) Principles and practice of controlled ovarian stimulation in art. New Delhi: Springer.
Vale-Fernandes, E. et al. (2023) ‘Elevated anti-müllerian hormone as a prognostic factor for poor outcomes of in vitro fertilization in women with polycystic ovary syndrome’, Biomedicines, 11(12), p. 3150. doi:10.3390/biomedicines11123150.
Xiang, P. et al. (2023) ‘Clinical characteristics and risk factors of ovarian reserve decreases in women with crohn’s disease: A case-control study’, Journal of Ovarian Research, 16(1). doi:10.1186/s13048-023-01112-6.
de Angelis, C., Nardone, A., Garifalos, F., Pivonello, C., Sansone, A., Conforti, A., ... & Pivonello, R. (2020). Smoke, alcohol and drug addiction and female fertility. Reproductive Biology and Endocrinology, 18, 1-26.
Liu, X. et al. (2022) ‘Serum anti-müllerian hormone levels are associated with early miscarriage in the IVF/ICSI fresh cycle’, BMC Pregnancy and Childbirth, 22(1). doi:10.1186/s12884-022-04591-5.
Thom works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.
Dr Thom Phillips
Head of Clinical Services
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