AMH Level: Meaning, Normal Values and Fertility
The AMH level reflects a woman´s ovarian reserve and is measured through a blood test. It is a key marker used in fertility assessments and family planning treatments such as IVF.
Things worth knowing about "AMH Level"
The AMH level reflects a woman´s ovarian reserve and is measured through a blood test. It is a key marker used in fertility assessments and family planning treatments such as IVF.
What Is the AMH Level?
The AMH level (Anti-Mullerian Hormone level) is a blood test result that measures the concentration of Anti-Mullerian Hormone in a woman´s blood. This hormone is produced by small follicles in the ovaries and serves as a reliable indicator of a woman´s ovarian reserve – that is, the remaining quantity and quality of her eggs. In general, a higher number of active follicles corresponds to a higher AMH level.
The AMH level plays a central role in reproductive medicine and is routinely measured as part of fertility evaluations or prior to assisted reproduction treatments such as in vitro fertilization (IVF). Unlike many other hormonal markers, AMH levels remain relatively stable throughout the menstrual cycle, making it possible to measure them at any point during the cycle.
Reference Values and Interpretation
Normal AMH levels vary depending on a woman´s age and the specific assay used. The following values serve as general guidelines:
- Under 20 years: approx. 1.5 – 8.0 ng/ml
- 20 – 29 years: approx. 1.0 – 6.8 ng/ml
- 30 – 34 years: approx. 0.7 – 5.0 ng/ml
- 35 – 39 years: approx. 0.3 – 3.5 ng/ml
- Age 40 and above: below 1.0 ng/ml is often considered low
A low AMH level may indicate a diminished ovarian reserve, which can affect a woman´s natural fertility and response to fertility treatments. A high AMH level may be associated with polycystic ovary syndrome (PCOS), a condition in which many small follicles are present in the ovaries, collectively producing more AMH.
Causes of Altered AMH Levels
Low AMH Level
- Advanced reproductive age
- Premature ovarian insufficiency (early menopause)
- Previous ovarian surgeries
- Chemotherapy or radiation therapy
- Genetic factors
- Smoking
High AMH Level
- Polycystic ovary syndrome (PCOS)
- Granulosa cell tumors of the ovaries (rare)
- Young age with a high number of antral follicles
Diagnosis and Measurement
The AMH level is determined through a simple blood draw, with the sample analyzed in a laboratory. Because AMH levels are largely unaffected by the menstrual cycle, no specific timing is required. However, some gynecologists recommend testing during the early follicular phase for consistency and comparability.
The AMH test is often combined with an antral follicle count (AFC) via ultrasound and other hormonal tests such as FSH and estradiol to provide a comprehensive picture of ovarian reserve.
Relevance for Fertility and Assisted Reproduction
In reproductive medicine, the AMH level helps predict how well the ovaries will respond to hormonal stimulation before an IVF cycle. A low AMH level does not necessarily mean that pregnancy is impossible – it indicates that there may be less time available and that early medical consultation is advisable. When AMH levels are very low, fertility specialists can adjust hormonal stimulation protocols accordingly.
For women who wish to preserve their fertility for the future through egg freezing (also called social freezing or elective egg freezing), the AMH level is an important decision-making parameter.
When Should You Test Your AMH Level?
- When trying to conceive without success over several months
- Before starting fertility treatments such as IVF or ICSI
- When PCOS or premature ovarian insufficiency is suspected
- Before chemotherapy or ovarian surgery
- As part of a general fertility check-up
References
- La Marca A, Sighinolfi G, Radi D, et al. - Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Human Reproduction Update, 2010.
- Broer SL, Mol BW, Hendriks D, Broekmans FJ. - The role of antimullerian hormone in prediction of outcome after IVF. Fertility and Sterility, 2009.
- Practice Committee of the American Society for Reproductive Medicine - Testing and interpreting measures of ovarian reserve. Fertility and Sterility, 2020.
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