AMH test explained

Anti-Müllerian hormone is a protein that in women is produced by the growing follicles in the ovaries, and in men by the testes. In women the amount of AMH reflects the number of follicles that are left, and therefore of potential eggs — this measure is called the ovarian reserve. Unlike FSH or estradiol, the AMH level changes little across the menstrual cycle, so the test can be done on any day of the cycle. With age the number of follicles decreases, so AMH also falls naturally, and as menopause approaches it drops to very low values. According to MedlinePlus, an AMH test is most often used when planning a pregnancy at an older age and when preparing for in vitro fertilisation (IVF) — to predict how the ovaries will respond to fertility drugs. It is also used when PCOS is suspected (where AMH tends to be raised) or when an early weakening of ovarian function is suspected. In boys and in newborns the test is used in rarer cases — for example, when assessing undescended testicles or ambiguous genitalia. Important: AMH shows only the quantity of follicles, not the quality of the eggs, so on its own it does not predict whether conception will succeed.

• To assess the ovarian reserve in women planning a pregnancy at an older age
• When preparing for in vitro fertilisation (IVF) — to predict how the ovaries may respond to fertility treatment
• When there is difficulty conceiving, or infertility is suspected
• When approaching menopause or a premature weakening of ovarian function is suspected
• When the menstrual cycle is irregular and polycystic ovary syndrome (PCOS) is suspected
• In rare cases in boys — when assessing undescended testicles; in newborns — when the genitalia are ambiguous

There is no general standardised AMH range — the value depends on age, on the laboratory's method and on the reason for testing. MedlinePlus states that the result is always interpreted individually, according to age and the clinical context, so the exact interval is the one printed on your own laboratory report.

A raised AMH

A raised AMH most often means a larger number of follicles in the ovaries — which can be favourable when planning IVF. According to MedlinePlus, a high AMH is also one of the signs pointing to possible polycystic ovary syndrome (PCOS). Less often, a raised AMH is linked with certain ovarian tumours.

• A larger number of follicles in women of fertile age — a natural variant
• Polycystic ovary syndrome (PCOS)
• Certain ovarian tumours (rarely)

What to discuss with a doctor

• Discussing the result together with other hormones (FSH, LH, estradiol) and the clinical picture
• If PCOS is suspected — assessing the other signs: cycle disturbances, ultrasound, androgen levels
• Discussing with a doctor whether further tests are needed to assess the condition of the ovaries

A low AMH indicates a declining ovarian reserve — fewer follicles that can mature. According to MedlinePlus, this happens naturally with age and as menopause approaches, and it can also mean a premature weakening of ovarian function. A low AMH can mean a lower chance of conceiving, but the test does not assess the quality of the eggs. According to MedlinePlus, in a boy tested for undescended testicles, little or no AMH may mean that the testicles are not working or are missing completely.

• The natural age-related decline of the ovarian reserve
• Menopause approaching or already begun
• A premature weakening of ovarian function (early ovarian insufficiency)
• In boys — testicles that are not working or are missing completely (when tested for undescended testicles)

What is usually assessed after a low result

• Discussing fertility plans and possible IVF strategies with a doctor, if relevant
• Assessing other hormones (FSH, estradiol) for an overall picture of ovarian function
• Remembering that a low AMH does not assess egg quality and on its own does not mean infertility

Laboratory ranges and related pages

The AMH value depends on age and on the laboratory's method, so the exact interval is the one printed on your own report. A doctor assesses the result together with other hormones — FSH, LH and estradiol — and the clinical picture. Related pages: progesterone, prolactin, how to prepare for a blood test and how to read blood test results.