Anti-Müllerian Hormone (AMH) is a really important hormone for fertility. It can give insight into your ovarian reserve and how many eggs you have left. But what is a good AMH level for your age? Here’s everything you need to know about AMH levels. 

Quick facts:

• AMH is produced by the follicles in our ovaries. 
• AMH levels help determine the number of eggs we have left (ovarian reserve).
• AMH levels naturally decline with age after our mid-20s. 
• High AMH levels and low AMH levels can both impact our fertility.
• Taking an AMH blood test is the least invasive way to determine whether your AMH levels are normal for your age.

What is AMH?

Anti-Müllerian Hormone (AMH) is an incredibly important hormone when it comes to fertility and overall reproductive health. 

AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs. Because of this close relationship with your eggs, testing your AMH levels can therefore give you an insight into your ovarian reserve, or how many eggs you have at the time of testing. 

We are all born with all of the eggs we’ll ever have. As we age, both our egg quality and quantity declines. This is due to both the natural ageing process and eggs being lost with each menstrual cycle. This happens right up until menopause when all your eggs are gone.

As our egg count diminishes, generally so do our AMH levels, unless we have an underlying condition or lifestyle factor which is affecting our AMH levels (like PCOS). 

What is a normal AMH level for my age?

AMH levels will steadily decrease year after year from your mid-20s onwards. This occurs in tandem with your ovarian reserve declining. 

After your mid-30s, AMH decline becomes much more rapid. It completely drops off as you near menopause (usually between 45 and 55 years old). 

Although the overall levels of AMH by age is a general downward trend, each person has an individual rate of decline depending on genetics, lifestyle, medication and underlying conditions.

What is a good AMH level?

The higher your AMH the better, right? Well… not exactly. Like all of our hormones, too much or too little can indicate problems. 

High AMH levels

In general, higher AMH levels indicate a larger number of ovarian follicles and therefore a larger ovarian reserve. 

However, some underlying reproductive health conditions like polycystic ovarian syndrome PCOS are associated with high AMH levels too. PCOS can cause hormonal imbalances which can negatively impact your fertility.

Symptoms of high AMH levels

Generally, high AMH levels don’t have any specific symptoms. But if you’re experiencing any symptoms that indicate a possible problem with your cycle you should test your hormones including AMH levels to investigate the possibility of PCOS.

These symptoms could be things like irregular or no periods, or any other PCOS symptoms like acne, excessive body or facial hair, hair thinning or loss. 

Low AMH levels

On the flip side, low AMH levels can indicate lower numbers of remaining follicles and therefore, a smaller ovarian reserve. 

Very low AMH levels are often seen in premature ovarian insufficiency (POI), which is a condition where menopause occurs before the age of 40 or even when you are going to experience menopause. Ovarian surgery can also carry a risk of low AMH levels afterwards.

Some lifestyle factors have also been linked to low AMH levels – smoking, obesity, and poor diet and nutrition—specifically insufficient Vitamin D levels. 

How to increase AMH levels?

Unfortunately, you can’t stop your AMH from declining with age. That being said, there are some lifestyle and diet changes that can improve your fertility. 

Monitoring your AMH levels with an at-home blood test if you have low AMH levels and are actively trying to conceive, or wanting to do so soon is a good idea to understand your rate of decline.

Additionally, if you’re worried about your future fertility but not ready to have kids yet, you may want to consider egg freezing. Or, if you have low AMH levels and are struggling with conceiving, IVF treatment could be a good option for you. 

If you’re concerned about your AMH levels, you can speak to our Private Gynaecologists at any time. Our Doctors can help you with a care plan that’s right for you and your body. 

Do AMH levels fluctuate?

Unlike your menstrual hormones which are cyclical, meaning their levels fluctuate throughout the month, your AMH levels stay relatively stable throughout your menstrual cycle.

How do I know if I have normal AMH levels? 

Testing your hormones is the only way to definitively know if your AMH levels are within the normal range for your age. 

Doing an AMH blood test can give you an accurate insight into your current AMH levels, and give you an insight into your reproductive health because it is reflective of your ovarian reserve (egg count).

Your AMH levels can also be used as an indication of whether you have polycystic ovaries, however, it can not currently be used to diagnose PCOS based on current guidelines.

Understanding your AMH levels and ovarian reserve can also help to determine if you would be suitable for certain fertility treatments like IVF or egg freezing. 

During fertility treatment, AMH levels are often tested to help determine the doses of medication and to predict the outcomes of the egg collection process. 

Investigation of AMH levels is often done in combination with an Antral follicle count (AFC), which is an internal ultrasound scan where the number of small follicles seen on the ovary is counted.

What is a good AMH level to get pregnant or to have IVF?

Successfully getting pregnant is not entirely dependent on your AMH levels and ovarian reserve. Other factors can affect fertility such as:

• the quality of your eggs
• the quality of sperm 
• whether you’re ovulating regularly
• whether you have structural issues with your reproductive organs.

There is, therefore, no evidence of a good AMH level to increase the likelihood of pregnancy. 

The success of IVF treatment is also dependent on many different factors. However, there is evidence that an AMH level lower than 5.4 pmol/L may have a poorer response to fertility medications. This is why some NHS IVF clinics will not accept patients who have an AMH level lower than this threshold.  

Resources:

1. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/anti-mullerian-hormone-amh
2. https://www.yourhormones.info/hormones/anti-mullerian-hormone/
3. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/the-use-of-antimullerian-hormone-in-women-not-seeking-fertility-care
4. ​​M. Dólleman, W. M. M. Verschuren, M. J. C. Eijkemans, M. E. T. Dollé, E. H. J. M. Jansen, F. J. M. Broekmans, Y. T. van der Schouw, Reproductive and Lifestyle Determinants of Anti-Müllerian Hormone in a Large Population-based Study, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 5, 1 May 2013, Pages 2106–2115, https://doi.org/10.1210/jc.2012-3995 
5. Oh, S. R., Choe, S. Y., & Cho, Y. J. (2019). Clinical application of serum anti-Müllerian hormone in women. Clinical and experimental reproductive medicine, 46(2), 50–59. https://doi.org/10.5653/cerm.2019.46.2.50