Tag: low AMH

Anti-Mullerian Hormone (AMH) is one of the most talked-about markers in reproductive health, providing an insight into your hormonal health and ovarian reserve. But receiving a “low” AMH result can feel alarming, especially when you’re not sure what it actually means. The good news is that a low AMH is not a confirmation that you cannot conceive naturally. In this article, we explore what it means to have a low or out-of-range AMH result, what causes it, and what your options are; whether you’re trying to conceive now, or simply planning for the future. If you haven’t yet tested your AMH, our Advanced At-Home Hormone & Fertility Test can measure AMH alongside up to nine other key hormones, giving you a personalised, clinically meaningful picture of your reproductive health. Quick Facts: A low AMH result indicates a lower-than-expected ovarian reserve for your age, but does not mean you cannot conceive naturally AMH measures egg quantity only, it tells you nothing about egg quality, which is one of the most important factors in conception AMH naturally declines throughout life; a low result does not mean you have done anything to cause it. Certain factors, including hormonal contraception and some medical conditions can temporarily affect AMH levels. Low AMH may have implications for IVF planning and NHS eligibility, but a low result does not close the door on treatment Your AMH result should never be interpreted in isolation, it only makes sense alongside your age, other hormones, and clinical history What is AMH and what does it measure? Anti-Müllerian hormone (AMH)  is a hormone made by small fluid-filled sacs in the ovaries called follicles, each of which contains an immature egg. Because AMH is made by these follicles, your AMH level gives an indication of how many eggs you have remaining at a given time. This is known as your ovarian reserve. Unlike hormones such as FSH, oestradiol, and LH, which fluctuate significantly across the menstrual cycle, AMH remains relatively stable. This stability is one of the key reasons it became widely adopted in reproductive medicine: it can be measured on any day of your cycle and still give a meaningful result. It is worth noting, however, that more recent studies have shown that there may be some slight variation in AMH levels across the menstrual cycle, but this variation remains considerably smaller than that seen in other reproductive hormones. As a result AMH is still considered one of the most stable and reliable markers of ovarian reserve. AMH is now routinely used when someone is considering undergoing a fertility treatment to estimate how the ovaries are likely to respond to stimulation, guide medication dosage, and determine eligibility for treatment. For a deeper dive into everything AMH testing can and can’t tell you, including its role in identifying PCOS and guiding fertility treatment, read our full guide: What Does AMH Testing Tell You? 5 Key Insights About Your Fertility What Does “Low AMH” Actually Mean? When we refer to “low AMH,” we mean a result that falls below the expected range for your age group. Because AMH naturally declines as you get older, what counts as “low” is always interpreted relative to age-specific reference ranges, not a single universal cutoff. A low AMH result can suggest that your ovarian reserve may be lower than expected for someone your age. This is sometimes referred to as having a Diminished Ovarian Reserve (DOR). However, it is important to emphasise that a lower ovarian reserve does not automatically mean reduced fertility or an inability to conceive naturally. The most important thing to understand: AMH measures quantity, not quality This distinction is worth repeating, because it is the most common source of confusion and unnecessary distress after receiving a low AMH result. AMH tells you about egg quantity. It does not tell you anything about egg quality. Egg quality i.e. how healthy eggs are, how likely they are to be fertilised, and how likely they are to develop into a viable embryo is influenced primarily by age and genetics. Currently there is no reliable way to measure it directly outside of accessing embryos created during IVF. This matters enormously in practice. Research consistently shows that AMH levels alone are not strongly predictive of natural pregnancy rates. People with low AMH conceive naturally every day. Conversely, a normal or high AMH result does not guarantee fertility. Fertility is shaped by many factors: ovulation, sperm health, Fallopian tube function, uterine health, and overall wellbeing. In short: a low AMH result is not a diagnosis of infertility. Hertility’s own research found no significant association between low AMH and risk of miscarriage or recurrent pregnancy loss, an important finding that further underscores the limitations of AMH as a standalone predictor of pregnancy outcomes. What Causes Low AMH? In most cases, there is no single identifiable “cause” of a low AMH level in the way we typically think about causes of illness. It is important to know that if you have received a low AMH result, nothing you’ve done has caused this. AMH levels follow a natural trajectory across the reproductive lifespan; it peaks in the early-to-mid twenties, and then gradually declines toward menopause. This decline is a normal part of reproductive ageing, and the rate at which it happens varies between individuals, largely due to genetics. Some factors that may be associated with lower AMH levels include: Age – the most significant driver of declining AMH Genetics – family history can influence the rate of ovarian ageing Previous ovarian surgery – procedures to remove ovarian cysts or tissue (for example endometriosis) may reduce ovarian reserve Certain autoimmune conditions – which can affect ovarian function, for example Hashimoto’s disease, rheumatoid arthritis, and Addison’s disease. Cancer treatment – some types of chemotherapy and radiotherapy are referred to as gonadotoxic (i.e. toxic to the gonads such as the ovary) which can impact the ovaries Hormonal contraception – can cause a temporary, reversible reduction in AMH levels, typically by 15% to 30% and […]

AMH (anti-Müllerian hormone) is a hormone made by the small, developing follicles in your ovaries. Measured with a simple blood test, and is a marker of your ovarian reserve or broadly, how many eggs you have left. It reflects egg quantity, not quality, and it’s one important piece of your wider fertility picture, not the whole story. If you’ve come across it while looking into your fertility, egg freezing, or “checking your egg count,” you’re in the right place. Here’s what AMH actually is, what your result can and can’t tell you. Quick facts: What is AMH? Anti-Müllerian hormone (AMH) is made by cells surrounding the small, developing follicles in your ovaries. Each of these follicles contains an immature egg. Because the number of these follicles is related to the size of your remaining egg pool, the amount of AMH in your blood can provide an indication of your ovarian reserve. Think of AMH as an indirect marker rather than an egg counter. It cannot tell you exactly how many eggs are left in your ovaries, but it can help show whether your ovarian reserve appears higher, lower or around what would be expected for your age. You’re born with all the eggs you’ll ever have, as we age, both our egg quality and quantity declines. As the pool shrinks, so does your AMH, which is what makes it such a useful window into where your reserve sits for your age. What is a normal AMH level for my age? There is no single normal AMH level that applies at every age. AMH naturally declines as you get older. A level that might be considered relatively low for someone in their 20s could be entirely expected for someone in their early 40s. That means the most useful question is not if you levels are good or bad, but more about how your levels compare with what is expected for someone your age? Broadly, AMH is higher in your twenties and declines through your thirties, with a steeper drop from the mid-thirties onwards, though there’s wide natural variation, and some people have a lower reserve earlier than expected. AMH results are also assay-specific. Different labs use different testing platforms, and because there’s no single international standard for calibrating AMH, a number from one lab can’t be directly compared to a number from another. This is why a result is only meaningful when it’s read against the reference range of the exact lab that ran it. At Hertility, AMH is interpreted using age-stratified reference ranges, so your result is compared with the expected range for people of a similar age rather than against one universal cut-off. Your result should also be interpreted alongside factors such as your cycle history, symptoms, hormonal contraception, medical history and fertility goals. How does AMH change with age? AMH is generally highest earlier in reproductive life and decreases as the ovarian follicle pool declines with age. There is, however, a lot of variation between individuals. Two people of exactly the same age can have quite different AMH levels without either necessarily having a reproductive health problem. This is why age matters so much when interpreting AMH. AMH also shouldn’t be confused with egg quality. Although both egg number and egg quality decline with age AMH measures the follicle pool. It does not tell us whether the eggs within that pool are chromosomally healthy. What does a low AMH level mean? A low AMH result means your ovarian reserve appears lower than expected for your age. It does not mean that you cannot get pregnant. This distinction is really important. AMH is much better at predicting how your ovaries may respond to fertility medication than it is at predicting whether you will conceive naturally. Current NICE guidance specifically says AMH should not be used to predict the chance of pregnancy through spontaneous conception. Instead, AMH or an antral follicle count (AFC) can be used to predict ovarian response when planning assisted conception. So if your AMH is low, it may mean that fewer eggs would be expected to develop during an IVF or egg-freezing stimulation cycle. Depending on your age and plans for pregnancy, it may also be useful information when thinking about fertility timelines. But it does not tell us whether the eggs you have are healthy, whether you are ovulating, whether your fallopian tubes are open, whether there are any issues affecting your uterus or, where relevant, whether sperm factors could affect conception. Does low AMH mean I can’t get pregnant? Many people with low AMH conceive naturally and without difficulty, particularly when they are younger and their egg quality is high. What low AMH does mean is: It tells you that your egg quantity is lower than average for your age. If your AMH is very low, particularly if you are under 40 and also have irregular or absent periods or symptoms associated with early menopause, your doctor may want to investigate further for conditions such as premature or primary ovarian insufficiency (POI). AMH alone, however, does not diagnose POI. Does high AMH mean I am fertile and won’t have problems conceiving? A high AMH level usually means there are more small follicles in the ovaries than expected for your age. It does not automatically mean you are more fertile. This is another common misconception about AMH. More follicles may mean a larger ovarian reserve, but natural fertility depends on much more than egg quantity. AMH cannot tell you about egg quality, whether you ovulate regularly, the health of your fallopian tubes or uterus, or sperm quality. Higher AMH is also commonly seen in people with PMOS, formerly known as PCOS, because the ovaries often contain a greater number of small follicles. A high AMH result therefore needs context rather than being interpreted as simply “good”. Can AMH diagnose PMOS or PCOS? AMH can contribute to a PMOS/PCOS assessment in adults, but it cannot diagnose PMOS on its own. Under current international guidance, AMH […]