When should AMH be tested?

AMH can be tested on any day of the menstrual cycle, as it does not fluctuate significantly across the cycle. This cycle-independence makes it more convenient than day-3 FSH, which requires early-follicular timing.

What is a normal AMH level?

Normal AMH is age-dependent. Reproductive-age women typically show 1.0–4.0 ng/mL; values decline from the mid-20s onward. Very low ( 4.0–5.0 ng/mL) may indicate polycystic ovary syndrome. Always interpret with age-specific references.

Does a low AMH mean I cannot conceive?

No. Low AMH reflects reduced follicle quantity, not oocyte quality or the ability to conceive naturally. Many women with low AMH conceive spontaneously. It does signal a shortened fertility window and predicts poorer response to ovarian stimulation, so accelerated fertility planning may be warranted.

Why is AMH elevated in polycystic ovary syndrome?

PCOS is characterised by an increased number of small antral follicles, which raises the granulosa-cell mass and AMH secretion. Elevated AMH is part of the diagnostic picture and also predicts a higher risk of ovarian hyperstimulation during fertility treatment.

Can AMH results differ between laboratories?

Yes. Different immunoassay platforms (Beckman, Roche, Ansh) yield systematically different numerical results, and reference ranges are platform-specific. Serial AMH monitoring should use the same laboratory and assay to ensure comparability.

Does AMH predict time to menopause?

AMH can help estimate the menopausal transition window, especially in perimenopausal women, but age remains the strongest predictor. Very low or undetectable AMH suggests menopause is near, though it is not routinely used for this purpose in asymptomatic women.

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Anti-Müllerian Hormone (AMH), Female

Q: What does AMH measure in women?

AMH measures the quantity of anti-Müllerian hormone secreted by small ovarian follicles. Serum AMH correlates with the number of resting follicles — the ovarian reserve — and is the primary biochemical marker used to estimate a woman's remaining egg supply.

Q: Does hormonal contraception affect AMH?

Yes. Combined oral contraceptives suppress follicle development and lower AMH by roughly 20–30 per cent. Levels recover after discontinuation. Progestogen-only methods have a smaller effect. Some practitioners prefer to test AMH after stopping combined pills, though this is debated.

The AMH test measures serum anti-Müllerian hormone, a granulosa-cell product that correlates with the ovarian follicle pool. It is the leading biochemical marker of ovarian reserve, cycle-independent, used to predict response to ovarian stimulation in assisted reproduction, guide fertility counselling, and aid diagnosis of polycystic ovary syndrome and premature ovarian insufficiency.

Biomarkers

Blood (serum)

Sample

2–4 business days

Turnaround

Fasting

What is the AMH test?

The Anti-Müllerian Hormone (AMH) test quantifies serum AMH, a granulosa-cell product that mirrors the size of the resting follicle pool. It is the most stable and convenient biochemical index of ovarian reserve, ordered to estimate a woman's remaining egg supply and to predict her likely response to ovarian stimulation in assisted reproduction. Practitioners interpret AMH alongside age, antral follicle count on ultrasound, and day-3 FSH to build a complete reserve picture. Because AMH is independent of menstrual-cycle day and does not require timed phlebotomy, it has largely supplanted early-follicular FSH as the first-line reserve test. Beyond fertility assessment, AMH contributes to the work-up of oligo-/amenorrhoea — elevated in polycystic ovary syndrome, low or undetectable in premature ovarian insufficiency — and aids in monitoring granulosa-cell tumours.

What does the AMH test measure?

AMH(Anti-Müllerian Hormone)

Range: Age-dependent; peak reproductive years approximately 1.0–4.0 ng/mL, declining with age. Premenopausal <0.16 ng/mL typically signals very low ovarian reserve.Optimal: Optimal values are context-dependent — reproductive-age women seeking fertility typically aim for 1.0–4.0 ng/mL, but higher values may signal polycystic morphology, while very low values (<0.5 ng/mL) prompt accelerated fertility planning or oocyte preservation counselling.ng/mL / pmol/L

Anti-Müllerian hormone is a dimeric glycoprotein secreted by granulosa cells of preantral and small antral follicles in the ovary. It regulates follicle recruitment by inhibiting the transition of primordial follicles to the growing pool and by modulating FSH sensitivity. Serum AMH correlates with the number of resting follicles — the ovarian reserve — and declines steadily from the mid-20s through the menopausal transition, becoming undetectable after menopause. Unlike FSH and oestradiol, AMH shows little cyclical variation across the menstrual cycle, making it suitable for random-cycle sampling.

AMH is the leading biochemical marker of ovarian reserve, used to estimate the quantity (not quality) of remaining oocytes. Reproductive-medicine practitioners order it to guide assisted-reproduction protocols, predict ovarian response to gonadotrophin stimulation, and counsel patients on fertility potential and the window for conception. AMH also has diagnostic utility in polycystic ovary syndrome, where it is typically elevated, and in evaluating amenorrhoea and premature ovarian insufficiency.

Why is the AMH test ordered?

Pre-treatment assessment of ovarian reserve in women planning in-vitro fertilisation or other assisted-reproduction procedures, to tailor gonadotrophin dosing and predict hyper- or poor response
Fertility counselling in reproductive-age women considering delayed childbearing, recurrent pregnancy loss, or a history of ovarian surgery or chemotherapy
Diagnostic evaluation of oligo-/amenorrhoea, where elevated AMH supports a diagnosis of polycystic ovary syndrome and very low AMH suggests premature ovarian insufficiency
Investigation of suspected premature ovarian insufficiency (age <40 years) in combination with FSH and oestradiol
Prediction of time to menopause in perimenopausal women, though age remains the dominant predictor
Surveillance of granulosa-cell tumours, where AMH may serve as a tumour marker in selected cases
Evaluation of discordant menstrual history and FSH, or when cycle-day timing for FSH sampling is impractical
Assessment of ovarian reserve after cancer treatment or in women with endometriosis or a family history of early menopause

Sample collection and turnaround

Sample type

Blood (serum)

Fasting required

Collection method

Venipuncture at patient service centre

Turnaround

2–4 business days

Collection notes

Phlebotomy at the processing laboratory's draw site (Quest or Access Medical Laboratories, depending on routing). AMH can be drawn on any day of the menstrual cycle; no cycle-day timing or special preparation is required. Centrifuge and separate serum promptly; AMH is stable refrigerated for several days and frozen for months.

Specimen requirements

Minimum 0.5 mL serum. Separate from cells within two hours; avoid haemolysis. Note the performing laboratory and assay platform for serial comparability, as reference ranges and numerical results differ between platforms.

What can affect AMH results?

reducesHormonal contraception

Combined oral contraceptives suppress ovarian follicle development and lower AMH by approximately 20–30 per cent; levels recover after discontinuation. Progestogen-only methods have less effect.

elevatesPolycystic ovary syndrome

The increased follicle number in PCOS raises granulosa-cell mass and AMH secretion, often to values two- to threefold higher than age-matched controls.

reducesRecent ovarian surgery or unilateral oophorectomy

Surgical removal or damage to ovarian tissue directly reduces follicle number; post-operative AMH reflects remaining reserve and may predict residual fertility.

reducesAge

AMH declines progressively from the mid-20s as the primordial follicle pool is depleted; age-specific reference ranges are essential for interpretation.

variableAssay platform and calibration

Immunoassay platforms (Beckman, Roche, Ansh) yield systematically different numerical results, and earlier-generation assays showed greater variability; results are not interchangeable across methods, so serial monitoring should use the same laboratory and platform.

reducesBody mass index

Higher BMI is weakly associated with lower AMH, independent of ovarian reserve, though the clinical significance of this relationship remains debated.

What do AMH results mean?

Elevated

Elevated AMH (typically >4.0–5.0 ng/mL in reproductive-age women) is most commonly seen in polycystic ovary syndrome and signals an increased risk of ovarian hyperstimulation syndrome during assisted reproduction. Very high values may also be seen in granulosa-cell tumours.

Normal

Age-appropriate AMH suggests adequate ovarian reserve for the woman's stage of reproductive life. It does not guarantee oocyte quality, embryo competence, or fertility — age and other factors dominate those outcomes — but it reassures that the quantity of remaining follicles is typical.

Reduced

Low AMH (<0.5–1.0 ng/mL, depending on age and assay) indicates diminished ovarian reserve, seen with advancing reproductive age, premature ovarian insufficiency, prior chemotherapy or pelvic radiation, endometriosis, and ovarian surgery. It predicts poor response to gonadotrophin stimulation and a shortened window for natural conception.

Note: AMH reflects follicle quantity, not oocyte quality; older women with normal AMH may still face age-related decline in embryo competence. Results must be interpreted with age-specific references and the performing assay platform noted. Serial values should come from the same laboratory. AMH does not predict time to natural conception in couples without infertility, and it should not be used to discourage pregnancy attempts in women with low values who wish to conceive.

Frequently asked questions

AMH measures the quantity of anti-Müllerian hormone secreted by small ovarian follicles. Serum AMH correlates with the number of resting follicles — the ovarian reserve — and is the primary biochemical marker used to estimate a woman's remaining egg supply.

How to access the AMH test

The AMH reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.

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About this page

Published: October 7, 2026

Last reviewed: October 7, 2026

References:

Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. (2020)
La Marca A, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. (2010)
Dewailly D, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update. (2014)
NICE guideline: Fertility problems — assessment and treatment. National Institute for Health and Care Excellence. (2023)

This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.

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