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Anti-Müllerian Hormone (AMH)

The AMH test measures serum anti-Müllerian hormone, a granulosa-cell glycoprotein that reflects the ovarian follicle pool. It is the preferred cycle-independent marker of ovarian reserve, used to assess fertility potential, predict IVF response, diagnose polycystic ovary syndrome, and investigate premature ovarian insufficiency.

1

Biomarkers

Blood (serum)

Sample

2–4 business days

Turnaround

No

Fasting

What is the AMH test?

The Anti-Müllerian Hormone test measures serum AMH, a direct marker of the ovarian follicle pool produced by granulosa cells of small growing follicles. It is ordered primarily to assess ovarian reserve — the quantity (though not quality) of remaining oocytes — in women planning pregnancy, undergoing fertility evaluation, or considering assisted reproduction. Unlike the traditional day-3 FSH and oestradiol, AMH does not require cycle-day timing and shows minimal intra-cycle variation, making it the most convenient and reproducible ovarian-reserve marker. Beyond fertility assessment, AMH aids diagnosis and monitoring of polycystic ovary syndrome, where elevated levels reflect the polyfollicular ovarian morphology, and it has niche applications in granulosa-cell tumour surveillance and the investigation of primary amenorrhoea or premature ovarian insufficiency. Practitioners interpret AMH in context: a low value indicates reduced quantitative reserve but does not preclude spontaneous conception, and a high value in PCOS correlates with metabolic severity and IVF hyper-response risk.

What does the AMH test measure?

1
AMH(Anti-Müllerian Hormone)
Range: Age-dependent; approximately 1.0–4.0 ng/mL in reproductive years, declining with age.Optimal: Reproductive-age women typically show 1.0–4.0 ng/mL; values below 1.0 ng/mL suggest diminished reserve, and those below 0.5 ng/mL indicate very low reserve and poor IVF prognosis.ng/mL / pmol/L

Anti-Müllerian hormone is a glycoprotein member of the transforming growth factor-β superfamily, secreted by granulosa cells of growing pre-antral and small antral ovarian follicles. In males it causes regression of the Müllerian ducts during foetal development; in females its principal role is paracrine inhibition of primordial follicle recruitment and modulation of FSH sensitivity in developing follicles. Because AMH is produced by the cohort of small growing follicles, its serum concentration reflects the size of the remaining ovarian follicle pool and declines steadily from the mid-twenties onward, reaching undetectable levels at menopause.

AMH is the most stable and reliable peripheral marker of ovarian reserve. Unlike FSH and oestradiol, which fluctuate across the menstrual cycle, AMH remains relatively constant and can be measured on any day, making it the cornerstone of fertility assessment and ovarian-reserve testing. In assisted-reproduction settings it predicts ovarian response to stimulation and guides protocol selection. It also has diagnostic utility in polycystic ovary syndrome, where elevated AMH reflects the increased number of small antral follicles, and in the investigation of disorders of sex development and ovarian tumours.

Why is the AMH test ordered?

  • Assessment of ovarian reserve in women planning pregnancy, particularly those over 35 years or with a family history of early menopause
  • Work-up of infertility or subfertility, interpreted alongside antral follicle count, FSH, and menstrual history
  • Pre-treatment counselling and protocol selection for in-vitro fertilisation, where AMH predicts response to ovarian stimulation
  • Diagnosis and phenotyping of polycystic ovary syndrome, in which elevated AMH supports the Rotterdam criteria and correlates with metabolic severity
  • Investigation of premature ovarian insufficiency or primary amenorrhoea, where very low or undetectable AMH confirms follicle depletion
  • Monitoring of granulosa-cell tumours, which may secrete AMH, though this is a specialist application
  • Pre-oncology fertility preservation counselling, to estimate the remaining ovarian reserve before gonadotoxic chemotherapy or radiotherapy
  • Assessment of ovarian function recovery after treatment for hypothalamic amenorrhoea or withdrawal from long-term hormonal contraception

Sample collection and turnaround

Sample type

Blood (serum)

Fasting required

No

Collection method

Venipuncture at patient service centre

Turnaround

2–4 business days

Collection notes

Phlebotomy at a LabCorp patient service centre. AMH can be measured on any day of the menstrual cycle, as it shows minimal intra-cycle variation. No special preparation is required, though practitioners should note current or recent hormonal contraceptive use, which may lower results.

Specimen requirements

Minimum 0.5 mL serum (gel separator acceptable). Centrifuge and separate serum within two hours of collection; AMH is stable refrigerated for up to five days and frozen for longer storage. Note the assay platform (LabCorp uses the Access AMH assay) for serial comparability.

What can affect AMH results?

reducesAge

AMH declines steadily with age as the primordial follicle pool is depleted; age-specific reference ranges are essential for interpretation and single values must be contextualised by the patient's age.

reducesHormonal contraceptives (combined oral contraceptive pill)

Oestrogen-progestogen contraceptives suppress folliculogenesis and reduce AMH by approximately 20–30%; levels typically recover within a few months of discontinuation, so testing may be deferred or the result interpreted cautiously.

elevatesPolycystic ovary syndrome

PCOS increases the number of small antral follicles, raising AMH, often to two to three times the age-matched median; this elevation is diagnostically useful but does not indicate enhanced fertility.

reducesObesity

Higher body mass index is associated with modestly lower AMH, possibly through altered hormone metabolism or increased distribution volume; the clinical significance of this reduction is debated.

variableVitamin D deficiency

Some studies report an association between low vitamin D and reduced AMH, though the relationship is inconsistent and the mechanism unclear; practitioners may consider vitamin D status in the broader fertility assessment.

variableAssay platform and lot variation

AMH assays have undergone substantial evolution, with older manual assays showing poor inter-lot consistency; current automated platforms (e.g. Access, Elecsys) are more robust but not interchangeable, so serial monitoring should use the same assay.

What do AMH results mean?

Elevated

High AMH (typically >5–6 ng/mL in reproductive-age women) is seen in polycystic ovary syndrome, where it reflects increased follicle number and correlates with anovulation and metabolic features. In IVF it predicts high ovarian response and raised risk of ovarian hyperstimulation syndrome, prompting protocol modification. Rarely, very elevated AMH may indicate a granulosa-cell tumour.

Normal

AMH within the age-appropriate range suggests adequate ovarian reserve, though it reflects follicle quantity rather than oocyte quality, which declines independently with age. A normal AMH does not guarantee fertility, and interpretation must integrate the partner's semen analysis, tubal patency, ovulation status, and the woman's reproductive goals.

Reduced

Low AMH (<1.0 ng/mL) indicates diminished ovarian reserve and is associated with reduced oocyte yield in IVF and shorter time to menopause. Values below 0.5 ng/mL suggest very poor reserve and low pregnancy probability with assisted reproduction, though spontaneous conception remains possible. AMH falls in premature ovarian insufficiency, after ovarian surgery, and following gonadotoxic treatment.

Note: AMH is cycle-independent and does not require specific timing, but results are assay-dependent and not directly comparable between platforms. It predicts ovarian response to stimulation and time to menopause but is not a direct measure of fertility or conception probability. Contraceptive use, PCOS, and obesity all influence results and must be factored into interpretation.

Frequently asked questions

AMH is secreted by granulosa cells in small growing ovarian follicles, so its serum concentration directly reflects the size of the remaining follicle pool. It is the most stable and convenient ovarian-reserve marker because it does not require cycle-day timing.

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:
  1. Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. (2020)
  2. Dewailly D, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update. (2014)
  3. Teede HJ, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. (2023)
  4. La Marca A, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. (2010)
  5. Nelson SM, et al. Biomarkers of ovarian response: current and future applications. Fertil Steril. (2013)

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.