One of the first steps in a fertility workup is measuring markers that help estimate how many eggs you have. One of those markers is anti-mullerian hormone (AMH). What does AMH tell you about your fertility? Here’s what you need to know.
What is anti-mullerian hormone (AMH)?
Anti-mullerian hormone is a hormone secreted by the supportive cells surrounding the eggs in your ovaries. The more eggs you have, the more AMH your body will produce.
How do you test AMH?
Testing AMH is as simple as rolling up your sleeve for a blood test. Your doctor can test AMH at any point in your menstrual cycle, since the measurement remains relatively stable throughout your cycle.
What do AMH levels tell you about your fertility?
“Anti-mullerian hormone (AMH) is a vital test for checking ovarian reserve,” according to the American Society for Reproductive Medicine. Ovarian reserve is the number of eggs in a woman’s ovaries. As women age, their ovarian reserve declines, and AMH levels decrease until menopause.
Having a low AMH level doesn’t mean that you won’t be able to get pregnant. It just suggests that you may have a bit less time to work with when trying to conceive. AMH levels can also help guide fertility treatment options, but they don’t predict whether or not you’ll get pregnant on your own.
“Don’t give up!” says What to Expect Community mom SarahEM32, who had a low AMH at age 36. “Low AMH doesn’t mean you can’t get pregnant, it just might be more difficult than expected. Letrozole and timed intercourse is what helped me get pregnant.”
What’s a normal AMH level?
There are age-specific averages for AMH levels, but in general, an AMH level more than 1.0 nanograms per milliliter (ng/mL) is considered reassuring. What’s considered “normal,” however, depends largely on your age and individual circumstances.
What’s a low AMH level?
AMH levels under 1.0 ng/mL are usually considered low, suggesting a somewhat lower supply of eggs. AMH levels less than 0.1 ng/mL may indicate a woman is approaching menopause, though timing varies widely from person to person.
Can you still get pregnant with low AMH?
Yes! Many women with low level AMH levels get pregnant naturally. AMH is just one number among many that doctors consider during a fertility evaluation, and it doesn’t measure egg quality or guarantee fertility outcomes.
“My AMH was 0.2 and I got pregnant naturally in 3 months,” says What to Expect Community mom capecod515151. “I just turned 34, so it was incredibly low for my age. Don’t give up hope!”
Can you improve your egg quality or your anti-mullerian hormone level?
A number of supplements, like antioxidant coEnzyme Q-10 (CoQ1O) and DHEA, have been promoted as ways to boost ovarian reserve, but there’s no reliable science to back up those claims.
Some studies have suggested that there may be a relationship between adequate levels of vitamin D and a higher AMH level, but again, there’s no conclusive data confirming that vitamin D supplements increase AMH levels or improves egg quality.
Still, it can’t hurt to make sure you don’t have a deficit. Talk with your healthcare provider about which supplements might be right for you.
Causes of low AMH
Factors that may contribute to low AMH levels include:
- Age. This is the most common reason for low AMH. As you get older, your ovarian reserve — and your AMH levels — naturally decline.
- Genetics. Your DNA may influence how quickly your egg supply decreases.
- Certain medical conditions. Chronic conditions such as endometriosis, as well as some autoimmune disorders (including autoimmune thyroid disease), may be associated with lower ovarian reserve.
- Ovarian surgery. Procedures for ovarian cysts or endometriosis can sometimes reduce AMH levels.
- Cancer treatment. A history of radiation or chemotherapy may lead to a low AMH and early menopause.
At your preconception checkup, your doctor may recommend testing AMH and other markers, such as follicle-stimulating hormone (FSH) and estradiol. These tests won't tell the whole story with 100% accuracy, but — along with your age, health history, and other factors — they’ll help piece together a picture of your fertility.
If you have any concerns, talk to your doctor, and if necessary establish a plan to work with a fertility specialist if you’re having difficulty conceiving.
Connect with other parents who are trying to conceive in the What to Expect app, where you can also keep track of your ovulation, appointments, and test results.
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