What Does AMH Testing Tell You? 5 Key Insights About Your Fertility

Anti-Müllerian Hormone (AMH) is one of the most talked-about fertility hormones, but also one of the most misunderstood. Because AMH is closely linked to your eggs, testing it can offer valuable insight into your ovarian reserve (the number of eggs you have left). But it’s not a fertility “yes or no” test.

In this guide, we break down exactly what AMH testing can and can’t tell you about your reproductive health. 

Quick facts:

• AMH testing can help you understand roughly the number of eggs you have (your ovarian reserve).
• AMH can’t tell you definitively whether or not you are fertile as it only gives insight into potential egg quantity, not quality. 
• AMH testing also can’t give insight into the health of the Fallopian tubes or uterus, which are also important for female fertility and conception. 
• AMH levels naturally decline with age, but there are also certain medical conditions, lifestyle and dietary habits that may impact its levels.

What is AMH and why is it so important?

Anti-müllerian hormone (AMH) is made by small fluid-filled sacs in the ovaries called follicles, each of which houses an immature egg. Because AMH is made by these follicles, your AMH level gives an indication of how many eggs you may have remaining at a given time. However, this is only one piece of the fertility puzzle.

There are a few myths out there about what exactly AMH testing can tell us. In this article, we cover the main things an AMH test can and can’t tell you. Let’s get into it.

What can AMH testing tell me?

Whether your ovarian reserve is a normal for your age

AMH testing will give you insights into whether your ovarian or egg reserve is what is expected with other healthy people in your age group. It helps you understand whether your egg reserve is higher, average, or lower than expected for your age.

If you are not using any hormonal contraception, testing other hormones, like follicle-stimulating hormone (FSH) and oestradiol alongside AMH can also help to build a more complete picture of egg reserve. Generally, people with low egg reserves are known to have higher levels of FSH and lower levels of oestradiol.

Whether you have polycystic ovaries or polycystic ovary syndrome

AMH testing can also be used as an indicator of whether you could have polycystic ovaries (PCO). PCO is a common reproductive health condition affecting around 30% of reproductive-aged people assigned female-at-birth. PCO is benign and does not affect fertility, but it can cause other unwanted symptoms. 

People with PCO have a higher-than-expected number of immature follicles in their ovaries. More follicles mean a higher level of AMH in the blood. 

Some people with PCO also have the syndrome that can be associated with it polycystic ovary syndrome (PCOS), which often presents as symptoms like irregular periods, acne, hair thinning or loss and high testosterone levels. According to updated guidelines, AMH can now be used as an indicator for polycystic ovaries in place of doing an ultrasound scan for the diagnosis of PCOS. However, at Hertility, we would always recommend getting a pelvic ultrasound scan to further assess your ovarian reserve. During this scan, your ovaries are assessed to determine your antral follicle count (the number of eggs sacs seen within your ovaries) and to confirm the diagnosis.

Whether IVF or egg freezing could be right for you

In fertility treatment settings, AMH plays an important role in guiding decisions around interventions such as IVF and egg freezing . It is commonly used to estimate how the ovaries may respond to stimulation and to guide medication dosing. 

Lower AMH levels are generally associated with retrieving fewer eggs during IVF, while higher levels may indicate a stronger response but also carry a risk of developing a rare but potentially life threatening condition called OHSS (ovarian hyperstimulation syndrome). This makes AMH a valuable tool for planning treatment safely and effectively.

Many NHS-funded and private IVF clinics therefore require a minimum AMH level for you to be eligible for a free IVF treatment cycle. The minimum level on the NHS will depend on where in the UK you are currently residing.

Whether you may be perimenopausal or menopausal or have POI

Menopause marks the point at which your periods stop permanently, typically between the ages of 45 and 55, with the average age for menopause in the UK being 51. After menopause, natural conception is no longer possible. It is associated with a very low, or completely depleted, ovarian reserve. Clinically, menopause is usually diagnosed retrospectively, after 12 consecutive months without a period in someone not using hormonal contraception.

In individuals under the age of 45, follicle-stimulating hormone (FSH) is more commonly used as a diagnostic marker, as levels tend to rise when ovarian function declines. While AMH is not currently recommended as a standalone test to diagnose menopause, it is well established that AMH levels fall to very low levels as ovarian reserve diminishes.

This makes AMH a useful indicator of overall ovarian activity. Declining or very low AMH levels can suggest that you are approaching menopause, although it cannot predict the exact timing. In younger individuals, particularly those under 40, significantly low AMH levels may raise suspicion of premature ovarian insufficiency (POI), a condition in which the ovaries stop functioning earlier than expected.

What can’t AMH testing tell me?

While AMH testing is a useful tool for understanding your ovarian reserve, it only represents one part of your overall fertility picture. There are several important limitations to be aware of, and understanding these can help you interpret your results more accurately and avoid common misconceptions.

It can’t determine your egg quality

One of the biggest limitations is that AMH cannot tell you anything about your egg quality. Although AMH reflects the number of eggs you may have remaining, it does not provide any insight into how healthy those eggs are. Egg quality is one of the most important factors influencing fertility and pregnancy outcomes, and it is largely driven by age and genetics. At present, there is no reliable test to measure egg quality directly, except through assessing embryos during IVF treatment.

It can’t determine your exact egg quantity

AMH also cannot determine your exact number of eggs. While it gives an indication of the size of your ovarian reserve, it is not a precise measurement. This is because AMH is made by ovarian follicles, and each follicle can release different amounts of the hormone depending on its size and stage of development. As a result, AMH provides an estimate rather than a definitive count.

To build a more complete picture, AMH is often interpreted alongside an antral follicle count (AFC), which is measured using a pelvic ultrasound. AFC estimates the number of small follicles visible in the ovaries at a given time. 

While AMH and AFC are generally well correlated, this relationship is not always consistent. For example, individuals with polycystic ovary syndrome (PCOS), with PCOS accumulate high numbers of immature follicles in their ovaries, resulting in higher levels of AMH in the blood. Many of the immature follicles in those with PCOS, which show up as multiple cysts on a pelvic ultrasound scan, will likely not release eggs. This means that AMH levels in those with PCOS may not be representative of the size of their remaining egg reserve, or what their AFC will be in a pelvic ultrasound scan.

Similarly, in cases of very low ovarian reserve, AMH and AFC may not align perfectly, and the reasons for this are still being explored.For the most comprehensive analysis of ovarian reserve, both advanced hormone and fertility test and pelvic ultrasound of the ovaries is recommended.

It can’t determine the health of your reproductive organs

Another important limitation is that AMH cannot assess the health or function of your reproductive organs. Fertility depends not only on the presence of eggs, but also on the proper functioning of the fallopian tubes, uterus, and ovaries. AMH testing cannot detect structural issues such as blocked fallopian tubes, uterine abnormalities, or conditions like endometriosis. These require imaging, such as a pelvic ultrasound, or further clinical investigations.

It can’t tell you if you are infertile

Finally, AMH cannot tell you whether or not you are infertile. A low AMH level does not mean that you cannot conceive naturally. Research has shown that AMH levels alone are not strongly predictive of natural pregnancy rates. Fertility is influenced by a wide range of factors, including ovulation, sperm health, timing of intercourse, and overall health. No single test, including AMH, can definitively determine your fertility status.

AMH testing with Hertility

Even if your AMH levels fall within the expected range, it does not guarantee that your fertility is unaffected. Reproductive health is complex and influenced by a wide range of hormonal, medical, and lifestyle factors. This is why, at Hertility, AMH is never assessed in isolation. Instead, it is interpreted alongside other hormones (we test up to 10) and a detailed clinical history, including your age, symptoms, medical background, medications, and lifestyle behaviours.

To provide a more comprehensive assessment, AMH is analysed in combination with key reproductive hormones such as follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, testosterone, prolactin, and thyroid hormones. This allows us to screen for a wide range of potential risk factors and underlying conditions that may impact fertility, including up to 18 different reproductive and hormonal health conditions.

Importantly, each hormone panel is tailored to the individual. Rather than taking a one-size-fits-all approach, your results are interpreted in the context of your unique health profile and concerns. This enables a more accurate, personalised, and clinically meaningful understanding of your reproductive health, far beyond what a single hormone test can offer.

If you want to take the first step toward understanding your fertility and reproductive health, get started with an at-home Hormone & Fertility Test today. 

Why can’t I get an AMH test on the NHS?

Access to AMH testing on the NHS is often limited, as it is typically prioritised for individuals who are already experiencing fertility challenges or are being assessed for fertility treatment, such as IVF. It is not routinely offered as part of initial investigations for people who are simply curious about their fertility or planning for the future.

In most cases, NHS-funded AMH testing is only available if specific clinical criteria are met. This usually includes individuals who have been trying to conceive through regular unprotected sex for 12 months, or for 6 months if they are aged 35 or over, without success. Eligibility may also extend to single individuals or same-sex couples who have undergone a number of cycles of unstimulated artificial insemination without conceiving. In addition, AMH testing may be offered if there is a known or suspected reproductive health issue affecting either partner.

However, access is not consistent across the UK. Policies are determined locally by Integrated Care Boards (ICBs), which means availability, eligibility criteria, and even AMH thresholds for accessing NHS-funded fertility treatment can vary depending on where you live. If you are unsure about your eligibility or local guidelines, it is best to speak to your GP, who can advise on the options available to you.

Can I test my AMH if I’m using hormonal contraception?

Yes, you can still test your AMH while using hormonal contraception, but it’s important to understand how it may affect your results. Hormonal contraception works by suppressing ovulation and overall ovarian activity, which can in turn lead to a temporary reduction in AMH levels.

Some research suggests that certain types of hormonal contraception, particularly the combined oral contraceptive pill, may lower AMH levels by up to around 30%. However, this effect is not consistent. The degree of suppression can vary depending on the individual, the type of contraception used, and how long it has been taken.

At Hertility, we still offer AMH testing to those using hormonal contraception because even while on contraception, AMH can still provide useful insights, particularly in identifying low ovarian reserve or patterns consistent with PCOS.

Reassuringly, studies show that any suppression of AMH caused by hormonal contraception is temporary. Levels typically return to what is normal for that individual after stopping contraception. If you are planning to come off hormonal contraception and want the most accurate reflection of your baseline hormone levels, we recommend you wait for three months before testing, as this allows time for your natural hormonal patterns to re-establish and will give you the most accurate insight.

FAQs About AMH Testing and Fertility

What does AMH testing actually tell you?

AMH testing tells you about your ovarian reserve, which is the number of eggs you may have remaining. It helps indicate whether your egg reserve is higher, average, or lower than expected for your age. However, it does not measure egg quality or predict your chances of getting pregnant.

Can AMH predict fertility or chances of getting pregnant?

No, AMH cannot predict your ability to conceive. While it provides information about egg quantity, fertility depends on many factors including egg quality, ovulation, sperm health, and overall reproductive health. Many people with low AMH can still conceive naturally.

Is a low AMH level a sign of infertility?

No, a low AMH level does not mean you are infertile. It simply indicates a lower ovarian reserve. Studies show that AMH levels alone are not strongly linked to natural pregnancy rates, so it should always be interpreted alongside other factors.

What is a normal AMH level for my age?

AMH levels vary significantly depending on age, and what is considered “normal” changes over time. In general, AMH naturally declines as you get older. Results are best interpreted in relation to age-specific reference ranges rather than a single universal cutoff.

Can you test AMH while on birth control?

Yes, you can test AMH while on hormonal contraception. However, some types of contraception may temporarily lower AMH levels. This effect is usually reversible, and levels typically return to normal after stopping contraception.

Does AMH testing tell you egg quality?

No, AMH does not measure egg quality. Egg quality is primarily influenced by age and genetics, and there is currently no direct test for it outside of testing embryos that are made during the IVF process. 

Can AMH levels predict menopause?

AMH levels decline as you approach menopause and can give some indication of ovarian ageing. However, AMH cannot accurately predict exactly when menopause will happen and should not be used as a standalone diagnostic tool.

References:

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