AMH Explained: What an Anti-Müllerian Hormone Test Can Tell You
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AMH is the number most at-home “fertility tests” are built around, and it is one of the most misunderstood results in reproductive medicine. It tells you something real about your ovaries. It does not tell you whether you can get pregnant. This guide explains both halves, using ASRM’s committee opinion on ovarian reserve testing and the largest US study of AMH and natural conception.12
What is AMH?
Anti-Müllerian hormone is made by the granulosa cells of small, early follicles in the ovary.1 Because those follicles are the pool that future eggs come from, AMH reflects ovarian reserve: the number of eggs remaining, which is quantity, not quality.1 Unlike FSH, AMH does not depend on the pituitary’s cycle signals, so it stays fairly stable within and between cycles.1
ASRM calls AMH and the antral follicle count (follicles counted on ultrasound) the most sensitive and reliable markers of ovarian reserve.1 AMH tends to fall before FSH rises, which is why it has largely replaced day-3 FSH and estradiol for this purpose.1
What can an AMH test tell you?
| Question | Does AMH answer it? |
|---|---|
| Roughly how many eggs do I have compared with others my age? | Yes, as an estimate |
| How many eggs might IVF stimulation retrieve? | Yes, well |
| Am I at risk of over- or under-responding to IVF drugs? | Yes |
| What is the quality of my eggs? | No |
| What is my chance of getting pregnant naturally this year? | No |
ASRM summarizes the evidence this way: ovarian reserve markers are good predictors of egg yield, but poor independent predictors of reproductive potential, so they should not be used as a fertility test or to deny access to treatment.1
Does AMH predict natural fertility?
No. ASRM says that in prospective cohort studies, ovarian reserve markers did not predict fecundability (the chance of conceiving in a given cycle), cumulative pregnancy or infertility in women with unproven fertility.1
The key US study is Time to Conceive, published in JAMA in 2017. It followed 750 women aged 30 to 44 with no history of infertility who had been trying for three months or less.2
| Group | Conceived by 6 cycles | Conceived by 12 cycles |
|---|---|---|
| Low AMH (below 0.7 ng/mL), n = 84 | 65% | 84% |
| Normal AMH, n = 579 | 62% | 75% |
| High FSH (above 10 mIU/mL), n = 83 | 63% | 82% |
| Normal FSH, n = 654 | 62% | 75% |
Predicted cumulative probabilities from the study abstract; none of the differences was statistically significant.2 A separate trial cited by ASRM, in women aged 18 to 40 with prior pregnancy loss, found women with AMH below 1 ng/mL had similar cumulative pregnancy rates to those with normal values.1 Among people already diagnosed with infertility, ASRM says ovarian reserve tests are no more useful than age alone for predicting pregnancy without treatment.1
How is AMH used in fertility treatment?
AMH is most useful once IVF is on the table. ASRM says AMH and antral follicle count predict egg yield and poor or excessive response to stimulation drugs, which helps clinicians choose doses.1 Even very low values should not be used to refuse treatment: in national data on more than 5,000 fresh IVF cycles in women with AMH below 0.16 ng/mL, 54% of cycles were canceled, but the live birth rate was still 9.5% per cycle started.1 AMH also did not predict pregnancy after ovarian stimulation with IUI in a trial of 900 women with unexplained infertility.1
AMH has only a weak link with egg quality, clinical pregnancy and live birth after IVF.1 Age is the stronger factor.1 For treatment options, see IUI vs IVF.
What affects AMH results?
- Age. AMH falls as ovarian reserve declines with age.1
- Hormonal contraception. ASRM says AMH may be lower in people using hormonal contraceptives and should be interpreted with caution.1 LetsGetChecked flags use in the past three months.6
- PCOS. The 2023 International PCOS Guideline says serum AMH can be used to define polycystic ovarian morphology in adults, but not as a single diagnostic test and not in adolescents.3
- Ovarian surgery. The ESHRE endometriosis guideline notes that surgery for ovarian endometriomas is likely to have a negative impact on ovarian reserve.5
Should you test your AMH?
It depends on why. Reasonable reasons include planning IVF, weighing treatment options with a specialist, or wanting a baseline before a conversation about family planning. ASRM says ovarian reserve tests should add to, not replace, counseling based on age and diagnosis, and that female age is the single most important predictor of fertility.4
Less useful reasons: trying to decide whether to keep trying naturally, or whether you are “fertile”. ASRM says AMH should not be used as a fertility test in people who are not infertile or whose fertility is untested, and should not be used to promote planned egg freezing.1 If you are weighing egg freezing, base the decision on your plans and age, and see egg freezing cost.
If you want a number anyway, at-home AMH tests are available; the LetsGetChecked Ovarian Reserve Test measures AMH on its own and can be collected on any day.6
What to do with a low result
A low AMH is a reason to keep the timeline tight, not a reason to stop trying. If you are 35 or older and have been trying for 6 months, or under 35 and trying for 12, get a full evaluation for both partners. Read low AMH for what it means at different ages, and when to see a fertility specialist for what the workup includes. The rest of the Investigate hub covers other results.
Frequently asked questions
This page is educational and is not medical advice. Talk to a clinician about your own situation, and seek urgent care for heavy bleeding, severe pain or fainting.
Keep reading
Low AMH: Can You Still Get Pregnant?
Low AMH means fewer eggs, not infertility. What the JAMA Time to Conceive study found, how low AMH changes IVF, and when a low result should speed up your timeline.
Getting Pregnant After 35: Your Chances and Your Timeline
Getting pregnant after 35: what studies show about monthly and yearly chances, why ACOG and ASRM say to get evaluated after 6 months, and what you can do now.
How Much Does Egg Freezing Cost, and Does It Work?
Egg freezing cost in the US: more than $15,000 per cycle in FertilityIQ data, plus storage and future IVF, with success rates per egg by age and insurance options.
Step 4: Investigate
When to get a fertility evaluation, what tests both partners need, and what at-home fertility and sperm tests can and can’t tell you.
Sources
- 1Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. ASRM Practice Committee, Fertil Steril 2020;114:1151–1157
- 2Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA. Steiner AZ et al., 2017;318(14):1367–1376. 750 women aged 30–44
- 3Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism. Teede HJ et al., 2023;108(10):2447–2469
- 4Fertility evaluation of infertile women: a committee opinion. Fertility and Sterility. ASRM Practice Committee, Fertil Steril 2021;116:1255–1265
- 5ESHRE guideline: endometriosis. Human Reproduction Open. Becker CM et al., 2022
- 6Ovarian Reserve Test product page. LetsGetChecked. AMH, any cycle day, $139; checked Oct 18, 2026