AMH Test: What Is Ovarian Reserve and When to Test?

AMH (Anti-Müllerian Hormone) is a hormone secreted from small follicles in the ovaries. It is one of the best indicators of a woman's ovarian reserve (remaining egg pool). It shows the QUANTITY of eggs, NOT the QUALITY — this is an important nuance.

When requested:

• At the start of infertility workup
• Conception planning at age 35+
• PCOS evaluation (high AMH = sign of PCOS)
• Before egg freezing
• IVF treatment planning (medication dose adjustment)
• Suspicion of premature menopause
• Before chemo/radiotherapy ovarian function evaluation
• Before/after ovarian surgery

Test characteristics: Can be drawn on any day of the menstrual cycle (not bound to specific day like FSH — this is a major advantage). No fasting required. Single blood test sufficient, results in 1-3 days. Hormonal contraception (pill, IUD) can temporarily lower AMH by 20-30% — repeat after 1-2 months off if needed.

Age-based normal ranges (ng/ml):

• Age 25-30: 2.0-6.8
• Age 30-35: 1.5-5.0
• Age 35-40: 1.0-3.5
• Age 40-45: 0.5-2.5
• Age 45+: <1.0

Note: Ranges differ between laboratories; use your own reference values.

Result interpretation:

• High AMH (>4.0): Generally good reserve but may indicate PCOS (evaluate with clinical picture). Excessive response risk in IVF (OHSS).
• Normal range: Age-appropriate — pregnancy chance normal.
• Low AMH (<1.0): Diminished ovarian reserve (DOR). Reduced natural conception chance, low response expected in IVF.
• Very low (<0.4): Raises suspicion for premature ovarian insufficiency (POI); however, POI is not diagnosed by AMH alone — your doctor evaluates it together with a history of menstrual irregularity and high FSH on two separate measurements.

AMH does NOT directly determine conception chance: Many women with low AMH have conceived, many with high AMH have struggled. AMH helps answer "how much time do I have," doesn't clarify "will I conceive now."

Tests to evaluate together (comprehensive ovarian reserve):

• AMH (egg pool)
• FSH and estradiol (cycle days 2-5)
• Antral follicle count (AFC) — pelvic ultrasound counting 2-9 mm follicles in each ovary

All three together is more reliable.

Lifestyle effect on AMH:

• Smoking → AMH decline (ovarian aging)
• Endometriosis → may lower AMH, surgeries (especially endometrioma) reduce AMH
• Genetics (BRCA1/2 mutation) — faster AMH decline
• Chemo/radiotherapy → ovarian damage
• Heavy stress, insufficient sleep — small temporary effects

Note: There is no proven lifestyle to "raise" AMH. DHEA supplement may help in selected cases (with doctor approval).

Action: AMH result is not a report card judging you, it's a planning tool. Low AMH in a young woman can speed up the egg-freezing decision. High AMH should not create the "I might not be in a hurry" misconception — age is still the most important factor. Interpret the result with a reproductive specialist, plan according to your age and goals.