Anti-Müllerian Hormone: What Does the Level Test Tell You?

Unless you grew up in a family of endocrinologists, Anti-Müllerian Hormone (AMH) probably doesn’t come up in conversation that often. However, Anti-Müllerian Hormone levels is an important hormone to know your ovarian reserve. Let’s go through the role this hormone plays in your reproductive system, and what low or high AMH levels can mean for getting pregnant.

Anti-Müllerian Hormone: What is it?

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Anti-Müllerian Hormone (AMH) is a hormone released by the granulosa cells of growing follicles in the ovaries. These follicles are what house the dormant egg cells in the ovaries, and a girl is born with all of the follicles she’s ever going to have. When the follicles are exposed to the hormone changes over the course of a menstrual cycle, only one lucky follicle is able to mature until it’s ready for ovulation. The other smaller follicles secrete AMH.

This means AMH levels can be a good indicator of how many ovarian follicles you have remaining. In general, research suggests women with higher levels of AMH tend to respond better to ovarian stimulation and have more eggs retrieved.

Getting an AMH Test

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Anti-Müllerian Hormone levels can be measured with a blood test and your doctor may offer AMH test during infertility assessments. One benefit of this test is that your blood levels of AMH don’t vary in accordance with the menstrual cycle, so you won’t need to wait until your period before the test can be performed. It can even be given to women on birth control pills.

AMH levels: What do they mean, and what’s normal?

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Levels of AMH tend to decline with increasing age, and what’s normal depends on the woman’s individual make-up. However, the test is still quite a new technology, and experts haven’t come to a consensus on what levels are “normal”.

That said, current test guidelines give the following reference values for women:

  • Under age 2: <4.7 ng/mL
  • Age 2 to Age 12: <8.8 ng/mL
  • Age 13 to Age 45: 0.9 – 9.5 ng/mL
  • Over Age 45: <1.0 ng/mL

Once levels of AMH drop below 1.0 ng/mL, it’s thought that the number of follicles is very small.

What do AMH levels mean for fertility?

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Doctors are still coming to a consensus on the normal range, but low levels of Anti-Müllerian Hormone are associated with a small number of follicles. However, it’s certainly not as a simple as saying “Low AMH means you can’t get pregnant, high AMH means you can”.

Levels of AMH is a measure of egg quantity, not quality, and egg quality is the main factor in conceiving. If your eggs are in good shape, certainly possible to get pregnant with low AMH values. Conversely, women with a normal ovarian reserve and AMH levels can still have difficulty conceiving – particularly if they’re older.

On the other hand, high AMH levels can also be an indicator of trouble getting pregnant in their own right. Higher than expected levels of AMH are associated with Polycystic Ovary Syndrome (PCOS), a hormonal condition that can lead to infertility among other health problems.

High AMH levels (above 3 ng/mL) can also indicate a tendency towards ovarian hyperstimulation – a potentially dangerous condition in which too many eggs are “woken up” in response to fertility drugs, causing abdominal pain.

Anti-Müllerian Hormone is just one factor in your fertility

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An AMH test certainly isn’t the only indicator of your fertility, but it can give a good indication of how many eggs you have left, and how long to go until menopause is likely to begin. Alongside other tests of your reproductive health, this can be one of the factors that help your healthcare team decide on the best treatment plan for your pregnancy goals.

If you’re currently undergoing fertility treatment, or planning a first pregnancy past your 30s, consider asking your fertility specialist if you’re likely to benefit from a check of your AMH levels.