How to interpret your AMH test results

One of the first tests we ask new female patients to get is an anti-Mullerian hormone test. Having a baseline AMH is extremely important to understanding your present fertility potential and developing subsequent treatment plans. We also want to make sure that you understand your AMH test results as well.

Why get AMH testing?

Anti-Mullerian hormone, or AMH, is a hormone continuously produced by the ovarian granulosa cells in the small, egg-containing follicles within your ovaries. These cells started producing AMH before you were even born, and continue to do so throughout your life, until you reach menopause. Because these levels decline the closer you get to menopause, they are an excellent indicator of your remaining egg supply, or ovarian reserve.

Because AMH testing can explain so much about the causes of infertility, it’s often the first test we order for women who have been struggling to conceive. The information provided by an AMH test can assist your physician in developing the best treatment plan for you.

Knowing your AMH can also help plan for your future family. For example, if your AMH is in a normal range, you might feel more comfortable waiting a few more years to finish an education or start a career before feeling the need to start a family. On the other hand, if your AMH is low, it may lead you down the path of trying to get pregnant sooner or electing to freeze the eggs you have now for later use.

Understanding your AMH test results

Your AMH levels are assessed via a simple blood test that can be performed at any time during your menstrual cycle. An AMH test tells approximately how many remaining eggs you have and whether your ovaries might be aging too quickly. It may reveal that you have a shorter window to get pregnant. An AMH test may also reveal how well you will respond to fertility drugs used in preparation for in vitro fertilization (IVF).

AMH test results typically fall into these three distinct categories:

• Normal (1.0-4.0 ng/mL) – Women with high anti-Mullerian hormone levels have a higher ovarian reserve, meaning there are more eggs in their ovaries. If these women need IVF or want to pursue fertility preservation through egg freezing, they tend to respond better to ovarian stimulation medications and are likely to have more eggs retrieved.
• High (> 4.0 ng/mL) – A very high AMH level can indicate PCOS, as well as put a woman at higher risk for ovarian hyperstimulation syndrome (OHSS) when taking ovarian stimulation medications during fertility treatment.
• Low (<1.0 ng/mL) – Women with low levels of AMH typically have low ovarian reserve, and very low levels indicate that a woman is approaching or in menopause. Women with low AMH levels often don’t produce many eggs, even with intense ovarian stimulation, making it harder to achieve pregnancy.

What can’t AMH test results tell you?

It’s important to remember when interpreting AMH test results that it is a marker of egg quantity, not egg quality, and therefore can’t predict your fertility. Even if your AMH levels are in the normal range, other factors may influence your ability to get pregnant, such as:

• Age
• An underlying medical condition
• Lifestyle choices, such as smoking or vaping
• Underlying fertility issues, such as ovulation disorders, blocked fallopian tubes, endometriosis, and uterine abnormalities like fibroids
• Issues with your partner’s sperm 

Additionally, a low AMH level does not necessarily mean you are infertile and cannot get pregnant. It takes only one high-quality egg to achieve a healthy pregnancy. Focusing your efforts on enhancing egg quality through lifestyle choices and better health will help you produce better eggs that can lead to a healthy pregnancy.