AMH (Anti-Müllerian Hormone)
Last updated: March 2026
What is AMH?
AMH (anti-Müllerian hormone) is a biomarker of ovarian reserve. The quantity of remaining eggs (Cleveland Clinic). “AMH plays a key role in developing a fetus’s sex organs while in the uterus” (Cleveland Clinic). Unlike other hormone tests, AMH can be measured at any point in the menstrual cycle (Cleveland Clinic).
Typical AMH levels by age
| Age | AMH (ng/mL) |
|---|---|
| 25 | 3.0 |
| 30 | 2.5 |
| 35 | 1.5 |
| 40 | 1.0 |
| 45 | 0.5 |
Average range: 1.0–3.0 ng/mL. Low: under 1.0 ng/mL. Severely low: 0.4 ng/mL (Cleveland Clinic).
How clinics use AMH
Your AMH level determines your stimulation protocol. Low AMH (below 1.2 ng/mL): higher doses of gonadotropins, typically 300-450 IU FSH. High AMH (above 3.5 ng/mL): lower doses (100-150 IU) to reduce the risk of ovarian hyperstimulation syndrome. Normal AMH: standard doses, 150-225 IU (ESHRE Ovarian Stimulation Consensus, 2020).
The POSEIDON classification system uses AMH at the 1.2 ng/mL threshold to separate adequate from poor ovarian reserve. Groups 1-2 have adequate reserve but responded poorly to stimulation: a protocol problem, potentially fixable by changing the approach. Groups 3-4 have genuinely low reserve: a biology problem, harder to fix (Alviggi et al., Fertility and Sterility, 2016).
What AMH does not tell you
AMH measures egg quantity, not quality. “It doesn’t predict your fertility (with or without treatments), or when you’ll go through menopause” (Cleveland Clinic).
A 2017 JAMA study of 750 women trying to conceive naturally found that low AMH (below 0.7 ng/mL) was not associated with reduced fecundability compared to normal AMH after 12 months (Steiner et al., JAMA, 2017). A low AMH may mean fewer eggs during IVF stimulation, but it does not predict whether those eggs will produce a baby. Age remains the strongest predictor of egg quality and live birth rate.
ACOG explicitly advises against using AMH as a screening test for infertility in the general population. A normal result does not guarantee fertility. A low result does not mean you cannot conceive naturally (ACOG Committee Opinion 773, 2019). The commercial “fertility MOT” industry sells AMH tests to young women without this context.
AMH vs AFC
Antral follicle count (AFC) measures the same thing from a different angle: an ultrasound counts visible follicles on the ovaries instead of a blood test measuring the hormone they produce. A meta-analysis found similar accuracy for predicting ovarian response (AUC 0.78 for AMH vs 0.76 for AFC), with neither significantly superior (Broer et al., Human Reproduction Update, 2013). AMH has practical advantages: it’s a blood test taken any cycle day, with no operator variability. AFC requires a transvaginal ultrasound but also reveals ovarian pathology.
What to ask your clinic
- What does my AMH level mean for the number of eggs expected during stimulation?
- How will my AMH affect the stimulation protocol and drug doses?
- Should I consider PGT-A screening given my results?
- How does my AMH factor into choosing between IUI and IVF?
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Sources
- Cleveland Clinic. Anti-Müllerian Hormone Test: https://my.clevelandclinic.org/health/diagnostics/22681-anti-mullerian-hormone-test
- Steiner et al. Association Between Biomarkers of Ovarian Reserve and Infertility. JAMA, 2017;318(14):1367-1376.
- ACOG Committee Opinion No. 773. Infertility Workup for the Women’s Health Specialist. 2019.
- Broer et al. AMH and AFC as predictors of excessive response. Human Reproduction Update, 2013.
- Alviggi et al. (POSEIDON Group). A new stratification of low responders. Fertility and Sterility, 2016.
This page is for informational purposes only and does not constitute medical advice. Always consult a qualified fertility specialist before making treatment decisions.