A female fertility workup has several components, and one of the critical components is the assessment of hormone levels, including anti-Mullerian hormone (AMH). This hormone plays a crucial role in the development of reproductive organs and is found in both males and females. However, it doesn’t play the same role in both. In men, AMH is produced in the testicles. Until puberty, AMH levels remain high and then tend to decrease.
In women, AMH regulates hormones that affect the ovaries and support egg growth during menstruation, having an effective role in fertility. This article covers the understanding of AMH’s role in pregnancy and the meaning of AMH blood test results.
What Is an AMH Blood Test?
Both males and females produce AMH. However, in women, an AMH test is done to get an insight into their reproductive health. AMH is involved in the development of a fetus’s sex organs while they are still in the uterus. Since male fetuses have higher AMH levels, this prevents the development of female reproductive organs. In females, only a small amount of AMH is enough for development.
Furthermore, the cells of the ovarian follicles produce AMH. So, AMH levels correspond to a female’s egg reserve or the number of eggs she has. Higher AMH levels mean that a female has more eggs, and lower AMH levels mean that she has fewer eggs. This fertility assessment test is also done to determine whether the ovarian mass is a tumour.
Why Is the AMH Blood Test Important for Fertility?
The AMH test for fertility can play a key role in infertility treatment. It helps with the following:
- Check the ovarian reserve or the number of eggs left in the ovaries. As women age, the ovarian reserve tends to decrease. An ovarian reserve test can provide an estimate of remaining egg supply. However, it isn’t used to determine egg health or whether the patient will be able to get pregnant.
- Predict the response to fertility medicine. Ovaries prepare one egg each month for fertilisation. Women undergoing the IVF treatment are prescribed fertility medicines to make the ovaries prepare multiple eggs simultaneously. The AMH test helps doctors understand the dose of fertility medicine needed to get the best response.
- Find out if you have begun menopause or are close to it. When this happens, the egg supply shrinks, lowering AMH levels. That is why this fertility blood test can be used to check for premature or early menopause. However, the AMH blood test for fertility doesn’t predict when the patient will reach menopause.
- Diagnose problems with the ovaries that might be causing high AMH levels. Such conditions include ovarian cancer and Polycystic Ovary Syndrome (PCOS).
AMH Blood Test Results Explained: What Do AMH Levels Mean?
A normal range for AMH levels is between 1.0 and 3.0 ng/mL. This means that the woman has a healthy egg supply.
- Over 3.0 ng/ml – Very high levels (can be an indicator of PCOS)
- 0 – 3.0 ng/ml – Normal levels
- 7 – 0.9 ng/ml – Low normal AMH levels
- 3 – 0.7 ng/ml – Low AMH levels
- Less than 0.3 ng/ml – Very low AMH levels
Very low AMH levels may still be detectable depending on the assay used. Please note that AMH only reveals the egg quantity and does not measure egg quality.
Normal AMH levels by age
AMH levels decline with age. So, older women, in their 30s, 40s, and 50s, have lower AMH levels and a lower ovarian reserve. Here are the average AMH levels for women, depending on their age:
| Age | Average AMH Levels |
| 25 years | 3.0 ng/mL |
| 30 years | 2.5 ng/mL |
| 35 years | 1.5 ng/mL |
| 40 years | 1 ng/mL |
| 45 years | 0.5 ng/mL |
Low AMH levels and Pregnancy
Yes, it is possible to get pregnant with low AMH levels. AMH is used to assess ovarian reserve. It doesn’t provide any information about egg quality or whether the woman can conceive. Since women with low AMH blood test results still ovulate, they can get pregnant naturally. However, fertility declines quickly as women age, so the IVF treatment might not be as effective.
AMH Test Before IVF
Here is how an AMH test before IVF is interpreted:
| AMH Levels | What It Means |
| Over 4.0 ng/mL | Risk of Ovarian Hyperstimulation Syndrome (OHSS) |
| 1.6 – 4.0 ng/mL | Normal ovarian response |
| 1.0 – 1.6 ng/mL | Reduced egg yield |
| Under 1.0 ng/mL | Poor ovarian response |
| Under 0.4 ng/mL | Risk of cycle cancellation |
What Causes Low AMH Levels?
There can be several factors that can cause low AMH levels:
- Age – This is the most influential factor impacting the AMH levels. Women are born with a supply of immature eggs. From the start of menstruation until menopause, these eggs mature and are released during the menstrual cycle. Over time, the ovarian reserve decreases, lowering AMH levels as well.
- Poor diet – Unhealthy intake of food like processed food and excess fat can cause several reproductive issues and impact AMH levels.
- Medical History – Hormonal disorders can decrease AMH levels. Also, if a woman has had an ovarian surgery because of a condition like endometriosis, ovarian torsion, or ovarian cysts, her ovarian function and AMH levels might be impacted.
- Mental Health – Stress can lower AMH levels. Also, living with hyper stress or mental pressure can result in failure to conceive.
- Other Factors – In addition to the ones mentioned above, inherited genetic disorders, autoimmune attack on the ovaries, cancer treatment, and environmental factors can affect AMH levels.
What Causes High AMH Levels?
The following factors can cause high AMH levels:
- Polycystic Ovary Syndrome (PCOS)
- Ovarian tumours such as granulosa cell tumours
- Ovarian hyperstimulation during fertility treatments
- Natural higher follicle activity
When Should You Consider Fertility Testing?
If you have been trying to conceive for over a year and haven’t been successful, it might be time to consult with a doctor regarding fertility testing. Certain conditions can make conceiving more difficult. You should immediately consult with a fertility expert if the woman has a history of:
- Ectopic pregnancy
- Repeated miscarriages
- Irregular periods
- Cystic fibrosis
- Pelvic inflammatory disease
- Thyroid problems
Women over the age of 35 should consider infertility testing if they haven’t been able to get pregnant after 6 months of trying.
Conclusion
The AMH blood test is a tool used by fertility specialists to assess a woman’s ovarian reserve. While it does provide useful information about egg count, it is not used to determine fertility on its own. Several other components play key roles in pregnancy outcomes. If you have received AMH test results or are starting with pregnancy planning, book a consultation at Santhathi IVF Clinic.
Frequently Asked Questions
Q. What is a normal AMH level for my age?
The normal AMH level depends on age. Younger women have higher AMH levels. As you age, these levels decline naturally. In most cases, an AMH level in the range of 1-3 ng/mL is considered normal.
Q. Do low AMH levels mean I cannot get pregnant?
No, low AMH levels indicate reduced ovarian reserve but don’t provide any information about egg quality. Many women with low AMH levels are able to conceive naturally.
Q. Can AMH levels improve naturally?
No, AMH levels decline as you age and cannot be significantly increased naturally. However, with the right treatment and lifestyle changes, you can improve your fertility.
Q. When should I take an AMH test?
Unlike many hormone tests, AMH testing can usually be performed on any day of the menstrual cycle.