AMH is a hormone made by reproductive tissues including egg follicles. A follicle is a small sac of fluid in the ovaries that contains the developing egg.
The total number of healthy, immature eggs in the ovaries is called the ovarian reserve. You are born with a lifetime supply of eggs. At birth, you have about one million eggs which decreases naturally during childhood to about 500,000. Only a small number of these remaining eggs will go through follicle maturation, usually one at a time as part of the monthly menstrual cycle.
Your AMH levels correspond with the number of eggs you have. This is called your ovarian reserve.
AMH is not predictive of fertility
AMH can indicate the size of your ovarian reserve and compare it to what is typical for your age. It does not measure the quality of the remaining eggs. You can still become pregnant with fewer eggs or have more eggs but not be able to become pregnant.
Even if your AMH levels are at the level considered to be right for your age, difficulties in becoming pregnant can be due to many factors. These include your age, your general health and lifestyle, and uterine conditions such as endometriosis, fibroids or blocked fallopian tubes.
The AMH test has been the subject of controversy because it has been promoted as being able to predict fertility. However, the AMH test cannot predict the likelihood of conception or how long it will take to get pregnant. If you’re trying to get pregnant and struggling to conceive, you need a full assessment from a specialist doctor. They will take a full clinical history and order several blood tests and scans. Your partner’s fertility may also need to be assessed.
AMH is not predictive of menopause
AMH levels gradually decline with age, as the number of eggs decreases over time. AMH levels drop significantly as menopause approaches and typically becomes almost undetectable after menopause.
However, it is not possible to predict the rate of decline of fertility for an individual woman. Each person is different and the variations in AMH levels between people mean the use of AMH testing for predicting menopause is not accurate and is not recommended.
IVF
Measuring AMH is most useful in predicting the number of eggs that may be obtained from a cycle in IVF treatment.
Polycystic ovary syndrome (PCOS)
The AMH test is often used in assessing if someone has polycystic ovary syndrome (PCOS) but it cannot diagnose this condition alone. PCOS is a hormonal condition associated with irregular menstrual cycles, facial and body hair growth, obesity and reduced fertility. AMH levels are used to support the diagnosis of PCOS and if you have this condition, you may have an AMH level up to four times the normal level for your age.
If you have cancer
Cancer treatments like chemotherapy and radiation can reduce the ovarian reserve making it difficult to become pregnant in the future. Testing AMH levels before treatment can be useful in predicting the long-term loss of ovarian function during treatment. Having low levels before starting treatment may indicate that freezing eggs could be helpful in preserving fertility.
Infants
AMH is one of several tests used to assess newborn babies who are not clearly male or female due to underdevelopment of their genitals (penis or vagina). A male baby is normally born with high levels of AMH. If the baby has no or low levels of AMH this may point to a problem with the gene that helps produce AMH in the body. This may be seen if the baby does not have testicles.
If a male baby has no obvious testicles at birth, the AMH test can be used to help decide if they have undescended testicles. This is a condition where the testicles do not drop into their proper place in the scrotum. If the baby has normal AMH levels it means they have healthy, working testicles, but they just haven't dropped into the scrotum.
Sample
Blood
Any preparation?
None
Reading your test report
Your results will be presented along with those of your other tests on the same form. You will see separate columns or lines for each of these tests.
AMH can be measured on any day of the menstrual cycle and does not vary from one cycle to another cycle. This is one of the reasons why many infertility specialists use AMH to check ovarian reserve.
There is substantial AMH test result variations between pathology laboratories and doctors should be familiar with the test used and reference interval of their chosen laboratory. If you are tracking your levels, it is best to use the same laboratory to avoid fluctuations in the results.
| Results | Interpretation |
| Low AMH levels | During your childbearing years, a lower level of AMH may indicate low ovarian reserve resulting in minimal or lower responsiveness to IVF treatment. An undetectable AMH level may be associated with ovarian failure, when the ovaries stop working, but the AMH level alone cannot be used to diagnose ovarian failure. Undetectable-to-low levels of AMH are normal during infancy and after menopause. |
| High AMH levels | Higher AMH levels indicate a greater number of eggs and a higher ovarian reserve but does not predict fertility outcomes. An increased level of AMH is often seen with PCOS. It may also indicate an increased or even excessive responsiveness to IVF treatment and a need to tailor the procedure accordingly. |
Reference intervals
Your results will be compared to reference intervals (sometimes called a normal range).
If your results are flagged as high or low this does not necessarily mean that anything is wrong. It depends on your personal situation. Your results need to be interpreted by your doctor.
For most women the AMH test is not considered necessary unless they are having fertility issues. The AMH test is most useful when assessing someone for IVF treatment.
The blood sample for this test can be collected by your GP or in a pathology collection centre. However the test is a specialist test and must be performed in a pathology laboratory. Your blood sample may need to be sent to a reference laboratory.
The choice of tests your doctor makes will be based on your medical history and symptoms. It is important that you tell them everything you think might help.
You play a central role in making sure your test results are accurate. Do everything you can to make sure the information you provide is correct and follow instructions closely.
Talk to your doctor about any medications you are taking. Find out if you need to fast or stop any particular foods or supplements. These may affect your results. Ask:
Pathology and diagnostic imaging reports can be added to your My Health Record.
You and your healthcare provider can now access your results whenever and wherever needed. Get further trustworthy health information and advice from healthdirect.