Anti-Müllerian Hormone (AMH) Test : Normal Levels, Purpose & Results

What is an AMH Test?

An AMH test is a simple blood test that measures the level of anti-Müllerian hormone (AMH) in your bloodstream. This hormone, produced by small follicles in your ovaries, serves as a reliable indicator of your remaining egg supply, known as ovarian reserve. Unlike other fertility hormones that fluctuate throughout your menstrual cycle, AMH levels remain relatively stable, making the AMH test particularly valuable for assessing reproductive health.

The anti-Müllerian hormone test has become increasingly important in modern fertility care. Healthcare providers use this test to evaluate women's reproductive potential, guide treatment decisions, and provide realistic expectations about conception chances. Whether you're planning a family, experiencing difficulty conceiving, or simply curious about your fertility status, the AMH test offers crucial insights into your reproductive timeline.

What Does the AMH Test Measure?

The AMH test measures the concentration of anti-Müllerian hormone circulating in your blood. This hormone directly reflects the number of developing follicles in your ovaries, each containing an immature egg. Higher AMH levels generally indicate a larger pool of developing follicles, while lower levels suggest a reduced ovarian reserve.

Why is an AMH Test Done?

• Fertility assessment: Evaluating your ovarian reserve before attempting conception.
• IVF planning: Determining appropriate medication dosages for ovarian stimulation.
• PCOS diagnosis: Identifying polycystic ovary syndrome, which often causes elevated AMH levels.
• Menopause prediction: Estimating proximity to menopause, though AMH alone cannot precisely determine the exact timing.
• Treatment monitoring: Tracking ovarian function during cancer treatments.
• Reproductive counselling: Providing realistic expectations about fertility potential.

How the AMH Test Works (Hormone Function Explained)

The anti-Müllerian hormone plays a crucial role in regulating your reproductive system. In women, this hormone controls the rate at which primordial follicles develop into mature eggs ready for ovulation. By measuring AMH levels, the test provides a snapshot of your current ovarian activity and remaining egg supply.

The hormone acts as a natural brake system, preventing too many follicles from developing simultaneously. When AMH levels are optimal, this system works efficiently. However, as your egg supply diminishes with age, AMH production decreases, signalling reduced fertility potential. This biological process makes the AMH test an invaluable tool for understanding your reproductive health status.

When Do Doctors Recommend an AMH Test?

• Difficulty conceiving after six months to one year of trying.
• Family planning for women over 35 years old.
• Pre-IVF evaluation to determine treatment protocols.
• Irregular menstrual cycles that might indicate hormonal imbalances.
• PCOS symptoms, such as excessive hair growth or weight gain.
• Cancer treatment planning to assess potential fertility preservation needs.
• Genetic risk factors for early menopause.

AMH Test Preparation Guidelines

Preparing for your AMH test is straightforward and requires minimal effort:

• No fasting required: You can eat normally before your appointment.
• Any cycle day works: Unlike other hormone tests, timing doesn't matter.
• Continue medications: Most treatments won't affect results significantly.
• Biotin caution: Leave an 8-hour gap if taking high doses (>5 mg/day).
• Stay hydrated: This helps with blood collection.

AMH Test Procedure

The AMH test procedure is simple and quick:

1. Blood sample collection: A healthcare professional draws blood from a vein in your arm.
2. Laboratory analysis: Your sample is processed using advanced testing methods.
3. Result compilation: Laboratory technicians quantify AMH levels using immunoassay or ELISA-based methods.
4. Report generation: Results are typically available within 6–8 hours after the sample reaches the laboratory.

Understanding AMH Levels

Interpreting your AMH test result requires understanding what different levels indicate for your fertility or infertility testing. Remember that AMH levels naturally decline with age, so what's considered a normal AMH test range varies significantly depending on how old you are. Your healthcare provider will interpret your results within the context of your age, medical history, and fertility goals.

• Low AMH levels may indicate reduced ovarian reserve, but don't eliminate pregnancy possibilities.
• Normal AMH levels (approximately 1.0–4.0 ng/mL in reproductive-age women) generally suggest healthy ovarian function for your age group.
• High AMH levels might indicate PCOS or excellent ovarian reserve.

Typical AMH Levels by Age (approximate ranges)

According to a Frontiers in Endocrinology study, the following approximate reference ranges reflect the decline in AMH with age for AMH by age, confirming a significant decrease in AMH levels after age 35.

Low AMH Levels: Causes & What They Mean

• Natural ageing: The most common cause of declining hormone levels.
• Genetic factors: Some women naturally have lower AMH levels.
• Previous ovarian surgery: Procedures that remove ovarian tissue.
• Chemotherapy or radiation: Cancer treatments that may damage ovarian follicles and reduce AMH levels.
• Smoking: Tobacco use accelerates ovarian ageing.
• Autoimmune conditions: Diseases affecting ovarian tissue.

High AMH Levels: Causes & What They Mean

• PCOS: Polycystic ovary syndrome commonly causes high AMH levels.
• Younger age: Naturally associated with higher ovarian reserve and AMH levels.
• Ovarian hyperstimulation: A temporary rise in AMH due to response to fertility medications.
• Certain medications: Some treatments can temporarily elevate levels.
• Genetic variations: Natural predisposition to higher AMH production.

Benefits of the AMH Test

• Fertility planning: Helps you make informed decisions about timing pregnancies.
• Treatment personalisation: Guides fertility specialists in customising protocols.
• Realistic expectations: Provides an honest assessment of conception chances.
• Early intervention: Identifies potential fertility challenges before they become critical.
• Peace of mind: Reduces anxiety by providing concrete information about reproductive status.

AMH Test for Fertility & IVF Planning

The purpose of the AMH test is to help assess your ovarian reserve and guide fertility treatment decisions. Your AMH level helps fertility specialists tailor the stimulation protocol and medication dosage for IVF.

Women with higher AMH levels usually respond well to lower medication doses, while those with lower AMH may need more intensive stimulation. This personalised adjustment is key to improving treatment success and reducing risks such as ovarian hyperstimulation syndrome.

AMH Test vs. Other Ovarian Reserve Tests

Several tests evaluate ovarian reserve, each offering unique benefits:

• AMH test: Can be performed on any day of your menstrual cycle because levels remain relatively stable
• FSH testing: Requires specific cycle timing but provides additional hormonal information
• Antral follicle count: Uses ultrasound imaging to visualise developing follicles
• Oestradiol levels: Often combined with FSH for a comprehensive assessment
• Inhibin B: Another hormone marker less commonly used than AMH

Risks & Limitations of the AMH Test

The AMH test carries minimal physical risks, similar to any routine blood draw. However, understanding its limitations is important for proper interpretation. The test does not assess egg quality, which is a key factor influencing fertility potential. Additionally, AMH levels don't guarantee natural conception success or failure.

Some women with low AMH levels conceive naturally, while others with normal levels may face fertility challenges. The test provides valuable information but should be interpreted alongside other fertility assessments and your overall health status for the most accurate reproductive counselling.

Factors That Can Affect AMH Test Accuracy

• Age: The most significant factor affecting AMH levels
• Hormonal contraceptives: May temporarily suppress AMH production
• Pregnancy and breastfeeding: Naturally alter hormone levels
• Laboratory methods: Different testing techniques may yield varying results
• Medical conditions: PCOS, endometriosis, and other disorders affect levels
• Lifestyle factors: Smoking, chronic stress, obesity, and poor nutrition can influence hormonal balance and AMH levels

When to Repeat the AMH Test

Consider retesting your AMH levels in these circumstances:

• Unexpected results: Confirming initially surprising findings
• Treatment monitoring: Tracking changes during fertility interventions
• Annual assessments: Recommended for women actively planning pregnancy or undergoing fertility evaluation
• Lifestyle changes: After significant health improvements or setbacks
• Pre-treatment planning: Before starting new fertility protocols

Conclusion

Whether you're planning a family, exploring infertility testing options, or simply curious about your ovarian health, the AMH test provides valuable insights into your fertility potential. Remember that AMH levels represent just one piece of your fertility puzzle - age, overall health, and lifestyle factors all contribute to your reproductive success.

At Metropolis Healthcare, we understand the importance of accurate, reliable diagnostic testing for your reproductive health decisions. Our comprehensive portfolio of over 4,000 tests includes advanced hormonal assessments like the AMH test, performed in our state-of-the-art laboratories with precision and care. With our convenient home sample collection service spanning 10,000+ touchpoints across India, you can access essential fertility testing from the comfort of your home, receiving accurate results that guide your healthcare decisions.

FAQs

What is a good AMH level for fertility?

A good AMH level for fertility varies by age. For women in their twenties and early thirties, levels between 1.4-4.2 ng/mL are considered optimal. However, successful pregnancies can occur even with lower AMH levels, so discuss your specific results with your healthcare provider.

What happens if AMH levels are low?

Low AMH levels indicate reduced ovarian reserve, but don't eliminate pregnancy possibilities. Your doctor may recommend more aggressive treatment approaches or suggest considering fertility preservation options like egg freezing.

Can AMH levels increase naturally?

AMH levels generally decline with age and cannot be significantly increased through natural methods. However, maintaining a healthy lifestyle, managing stress, avoiding smoking, and treating underlying conditions like PCOS may help optimise your existing ovarian function and potentially stabilise AMH levels.

Does the AMH test require fasting?

No, the AMH test doesn't require fasting. But high doses of biotin supplements (>5 mg/day) may interfere with some immunoassays; wait at least 8 hours before giving your sample.

Does AMH predict egg quality?

The AMH test measures egg quantity, not quality.

At what age do AMH levels drop?

AMH levels begin declining in your late twenties and drop more significantly after age 35. Regular monitoring helps track your individual pattern.

Is the AMH test useful for PCOS diagnosis?

Yes, the AMH test is valuable for PCOS diagnosis. Women with PCOS typically have elevated AMH levels, often 2-3 times higher than normal ranges. However, doctors use AMH results alongside other criteria like irregular periods and ovarian ultrasound findings for accurate PCOS diagnosis.

Can birth control affect AMH levels?

Hormonal contraceptives may temporarily suppress AMH levels, potentially leading to misleadingly low results. If you're currently using hormonal birth control and considering fertility testing, discuss with your doctor whether to discontinue contraception before testing or interpret results with this factor in mind.