Many women today are looking to science for information about their reproductive future, as conversations about fertility have become more open and inclusive. Anti-Mullerian Hormone, or AMH, is a hormone that has been receiving a lot more attention. AMH, which is often described as “a window” into the ovarian reserves, has become a common topic in fertility discussions, clinics and social media. AMH and Fertility
How much importance should we give to this hormone? AMH can predict your fertility, but is it accurate? Are we putting too much trust in the number?
You’re not the only one who has considered getting AMH tested or seen it in your bloodwork. We’ll explore what AMH is, what you can learn about your fertility from it, and what it cannot.
What is AMH? : AMH and Fertility
AMH is short for Anti-Mullerian hormone. It’s produced by your small follicles, the same ones that contain your immature egg. AMH can be thought of as a marker for your reserve or the number of eggs that you still have.
Women are born with a limited number of eggs. The number of eggs decreases as we age. It starts slowly in our late 20s, and then accelerates after 35. The egg supply has almost been depleted by the time of menopause.
Where does AMH fit in? Your AMH level can give you a rough idea of how many eggs are left in your ovaries. This hormone can be a key factor in determining whether a woman should freeze her eggs or do IVF.
What does the AMH test measure?
AMH is an easy blood test. One of its greatest conveniences is the fact that you can do it at any time during your cycle. AMH is a stable hormone throughout the month, unlike other hormonal tests, which need to be done on certain days.
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This number is usually measured in nanograms/millilitre (ng/mL). Here’s an approximate breakdown:
- Ovarian reserve is considered “normal” when it exceeds 1.0 ng/mL.
- Below 1.0 ng/mL is often considered “low,” indicating fewer eggs remaining
- Above 3.0-4.0ng/mL: Could indicate a greater ovarian reserve, but can be seen with conditions such as PCOS
You should be aware that laboratory ranges can vary, and “normal” may depend on your medical history and age. Most clinicians are in agreement that the test is a snapshot of quantity and not quality.
Why your years still matter most
It gets confusing: AMH only tells you how many eggs are left. But it doesn’t say anything about the quality. When it comes to creating babies, it is king.
As you get older, your egg quality will naturally decrease. It’s for this reason that a woman in her 40s with an “average” AMH may still have difficulty conceiving, while a woman in her 30s with a lower AMH could get pregnant easily. Your age is the best predictor of egg quality and, therefore, natural fertility.
If you are in your early or late 40s, the AMH level may give some indication of how your fertility declines. But it is only a part of a larger picture.
The AMH Test can tell you
You can benefit from getting your AMH level tested, particularly if you are planning to have children in the future.
What can the AMH test offer?
- An image of your egg reserve gives you an idea of the number of eggs that may still be in your ovaries.
- Useful in fertility planning: Your AMH level will help your doctor decide the amount of medication you may need.
- Early warning of potential problems: Extremely low levels of AMH in younger age could indicate something like premature ovarian failure (POI), requiring closer medical attention.
- Insights into ovarian responses. For those who are undergoing IVF, AMH is used to estimate the response of your ovaries to stimulation drugs. Women with low AMH could have fewer eggs in a cycle. Women with high AMH are at risk of overstimulating.
The test is a powerful tool in these situations, especially when combined with other medical evaluations.
The AMH Test Doesn’t Tell You Everything
Here are the limitations. There are a lot.
- Your AMH does not determine your ability to conceive naturally. Some women with low AMH can conceive easily, while other women with high AMH might still have difficulties.
- The test does not measure the quality of eggs. Egg quality is the main factor that determines whether or not fertilisation, embryonic development, and a healthy pregnancy are possible. Currently, no test can accurately measure egg quality.
- It does not predict the time until menopause. Although very low AMH may indicate that you are nearing your reproductive window, it cannot give a specific timeline.
- The AMH level can be affected by external factors. Recent weight loss and hormonal birth control can temporarily lower the AMH level. This can lead to misleading results.
AMH can be a useful tool, but it is not the only factor to consider.
The AMH test might cause unnecessary stress
Even if they have no immediate plans for pregnancy, a low AMH can be devastating to many women. You may panic, thinking that low egg means “no chances.” But reality is much more nuanced.
A low AMH does not mean that you are infertile. Instead, it simply indicates you have fewer eggs. And quality always trumps quantity.
A high level of AMH is not a guarantee of easy fertility. Even women with high ovarian reserves can still have failed cycles or miscarriages. Fertility specialists advise people not to view AMH results as a fail/pass test.
The AMH Test is Helpful
AMH testing is incredibly useful – when used correctly. Here are some scenarios where it may make sense:
- You are over 35 years old, and you’re starting to plan your family
- You want to know the number of cycles required to freeze your eggs
- You have a history of POI or early menopause in your family.
- You have been trying to get pregnant for some time, and you want to know more about your fertility.
- You are preparing to undergo IVF or another fertility treatment
AMH can provide actionable information to help guide medical decision-making in these situations. It should be interpreted by an experienced fertility specialist in conjunction with other tests such as ultrasounds (to count the number of antral follicles), FSH and a discussion about your reproductive goals.
Do You Need to Get an AMH Test?
If you are curious about fertility or want to plan, the AMH is a great tool. It should be approached cautiously and supportively. One test result should not dictate your feelings about your body and your future.
Question yourself:
- What would I change if my result was low vs. high?
- Are you ready to feel the emotional impact when I see the number?
- Have I consulted a health professional with whom I am comfortable discussing the results?
You can test for curiosity. But be emotionally prepared. AMH testing, like other fertility tools, can cause a lot of emotions.
Last Thoughts: More than a number
It’s important to remember the big picture in a world where fertility is often reduced to numbers – your age, AMH or egg count.
Fertility is deeply emotional, personal, and complex. Science can provide useful tools, but it cannot predict your journey. AMH isn’t a fortune teller. It is a guidepost. It’s a guidepost. A small piece of a larger map.
You should take the test from a position of empowerment, not fear. It should be the starting point of a discussion with your doctor and not a judgment on your future. Whatever your path to parenthood may be, it is about. It’s so much more than a number in a lab report.
