What is the AMH Test? Frequently Asked Questions About Anti-Müllerian Hormone

One of the most important indicators of female fertility is the AMH (Anti-Müllerian Hormone) level. In recent years, women have become more familiar with this test due to factors such as in vitro fertilization (IVF), egg freezing, and the risk of premature menopause. However, there is a lot of misinformation circulating about AMH. In this article, we will explore what AMH is, what it indicates, what it should be, and what it means when it's low, based on scientific data but in a language everyone can understand.

What is AMH (Anti-Müllerian Hormone)?

AMH is a hormone secreted by the tiny follicles in the ovaries (the structures where egg cells develop). It gives us an idea of a woman's ovarian reserve, that is, the number of eggs that survive and can develop in the future .

• High AMH → Indicates good ovarian reserve.

• Low AMH → Indicates decreased ovarian reserve.

AMH is found not only in women but also in men. In men, it's related to testicular function, but it's a much more common test in women for reproductive health.

In summary: AMH is one of the most reliable indicators of a woman's fertility potential.

When and for Whom Should the AMH Test Be Performed?

The AMH test is a simple blood test that can be performed on any day of your menstrual cycle. It is especially recommended if:

• Women over 30 who plan to have children

• To adjust medication doses before in vitro fertilization treatment

• For women considering egg freezing

• Those with a family history of early menopause

• Women with menstrual irregularities, polycystic ovary syndrome (PCOS), or who have had ovarian surgery

Thanks to this test, both the possibility of natural pregnancy and the number of eggs to be retrieved in in vitro fertilization can be predicted.

What Should the AMH Value Be?

There is no universal "one true value" for AMH because the testing methods used can vary. However, in general:

• 1.5 – 4 ng/mL : Normal reserve

• 1 – 1.5 ng/mL : Borderline

• 0.5 – 1 ng/mL : Low reserve

• <0.5 ng/mL : Very low reserve

• >4 ng/mL : High (usually seen in polycystic ovary syndrome)

The important point here is this: AMH values cannot be evaluated in isolation . They should be interpreted together with the woman's age, FSH hormone levels, ultrasound findings, and clinical history.

Relationship between AMH and Age

A woman's ovarian reserve declines with age. The number of eggs, which is approximately 1–2 million at birth, decreases to 300,000–400,000 by adolescence. The decline accelerates after age 30, becomes more pronounced after age 35, and reserve diminishes significantly after age 40.

AMH also reflects this decline. In general:

• In your 20s → around 3–4 ng/mL

• In your 30s → 2–3 ng/mL

• After age 35 → 1–2 ng/mL

• After age 40 → It may fall below 0.5–1 ng/mL

Therefore, the AMH test should be evaluated according to the woman's age.

What Does Low AMH Mean?

Low AMH indicates diminished ovarian reserve and a narrowing of a woman's fertility window. The main causes of this are:

• Advancing age

• Genetic factors (history of early menopause)

• Ovarian surgery (chocolate cyst surgery, cyst operations)

• Chemotherapy / radiotherapy

• Smoking

However, a low AMH result doesn't mean you can never become a mother. The important thing here is that your reserve is low, and it's not directly related to egg quality.

Can You Get Pregnant When AMH Is Low?

This question is the one that women are most curious about.

• Natural pregnancy : Even if AMH is low, pregnancy is possible as long as ovulation continues.

• IVF treatment : If AMH is low, fewer eggs are usually retrieved. However, these eggs can be of good quality and a healthy pregnancy can occur.

• The most important factor affecting success is age . A woman under 40 with low AMH may have a higher chance than a woman aged 42 with normal AMH.

In short, low AMH is not a cause for despair, but rather an indication that the right steps should be taken without wasting time.

Does AMH Increase?

AMH levels don't naturally rise because ovarian reserve isn't constant and constantly declines. However, some supplements can have an impact on egg quality and function.

• DHEA (dehydroepiandrosterone)

• Coenzyme Q10

• Vitamin D, omega-3

• Healthy lifestyle (quitting smoking, regular nutrition, stress management)

Scientific studies show that these supplements don't increase ovarian reserve, but they can improve the quality of the eggs retrieved. So, the expectation that "my AMH will increase" is incorrect.

The Role of AMH Testing in IVF Treatment

The role of AMH in IVF treatment is very important.

• It predicts the response of the ovaries to treatment.

• Provides guidance in determining drug doses.

• Very low AMH indicates low egg count.

• Very high AMH (e.g., in PCOS) may predict the risk of overstimulation syndrome (OHSS).

However, it should be emphasized again that AMH alone does not indicate the chance of pregnancy occurring .

Misconceptions About AMH

1. "AMH accurately indicates the chance of pregnancy." False. AMH only indicates egg reserve. Many factors, such as egg quality, sperm quality, and uterine health, play a role in pregnancy.

2. "If AMH is low, you can never become a mother." False. Even if AMH is low, a healthy pregnancy is possible through natural pregnancy or in vitro fertilization.

3. "AMH levels increase." False. There is no definitive treatment to increase AMH levels. However, lifestyle changes and supplements can positively affect egg quality.

4. "AMH alone is sufficient." False. It should be evaluated along with factors such as FSH, ultrasound, and age.

How is the AMH Test Performed?

• It is a simple blood test .

• It doesn't matter whether you are hungry or full.

• It can be done on any day of the menstrual cycle.

• Results are available within a few days.

Its advantage is that it can be performed independently of the menstrual period and reflects the ovarian reserve almost accurately.

AMH and Its Psychological Effects

AMH results can put significant psychological pressure on women. Especially when the result is low, many women feel inadequate or anxious about the future.

The important point here is this: AMH results are not fate. With the right information, the right timing, and appropriate treatment, a healthy pregnancy is possible. It's crucial for women to receive expert support during this process.

Conclusion: AMH Value Guides Your Future

AMH is an important guide in a woman's fertility journey. However, this value should not be evaluated alone, but rather in conjunction with age, clinical history, and other tests .

A low AMH result shouldn't be disappointing. Even with low reserve, pregnancy is possible with high-quality eggs. Modern reproductive methods like in vitro fertilization (IVF) and egg freezing offer women a powerful option in this regard.

Prof. Dr. Birol Vural

We know that each of our patients' stories is unique. By evaluating your AMH test and other results together, we can determine the most appropriate treatment plan for you.

Remember: AMH value is not destiny, it is just a road sign.