Anti-Müllerian Hormone (AMH) Test
The AMH test measures Anti-Müllerian hormone, a granulosa-cell glycoprotein whose level reflects the pool of small growing ovarian follicles and serves as an indirect index of ovarian reserve. Measured here from a capillary dried blood spot, it supports fertility counselling, prediction of ovarian response, and the assessment of PCOS.
1
Biomarkers
Dried blood spot
Sample
5–7 business days
Turnaround
No
Fasting
What is the AMH test?
The Anti-Müllerian Hormone (AMH) Test measures a granulosa-cell glycoprotein whose circulating level tracks the pool of small growing follicles and therefore approximates ovarian reserve. It is ordered to estimate where a patient sits on the reproductive time-course, to help predict ovarian response ahead of controlled ovarian stimulation, and as a supporting criterion in the assessment of polycystic ovary syndrome. Measured here from a capillary dried blood spot collected by finger-stick, it offers reserve assessment without attendance for a venous draw. In the diagnostic landscape AMH complements rather than replaces the antral follicle count on ultrasound and the day-3 FSH and oestradiol picture; its relative cycle-independence is a practical advantage over those cycle-timed markers. A central interpretive caution defines its proper use: AMH quantifies follicle number, not oocyte quality, and does not forecast natural fertility or guarantee conception. A low value in a woman not pursuing assisted reproduction has limited predictive value for spontaneous pregnancy, while a high value in PCOS reflects follicle excess rather than superior fertility.
What does the AMH test measure?
Anti-Müllerian hormone is a dimeric glycoprotein of the transforming growth factor-beta family, secreted in the adult ovary almost exclusively by the granulosa cells of preantral and small antral follicles. Because this pool of growing follicles is proportional to the resting primordial follicle population, circulating AMH serves as an indirect index of the remaining ovarian follicle reserve. Secretion falls away once follicles are selected for dominance and become FSH-responsive, so AMH reflects the recruitable cohort rather than the dominant follicle. Levels are comparatively stable across the menstrual cycle relative to FSH, oestradiol, or inhibin B, which is why a single timed draw is generally not required. Concentrations rise through adolescence, peak in the early-to-mid twenties, and then decline progressively with age toward the menopausal transition.
AMH is used chiefly as a quantitative estimate of ovarian reserve: to counsel on relative reproductive time-course, to anticipate ovarian response before assisted reproduction, and to support the biochemical picture of polycystic ovary syndrome, in which an expanded small-antral-follicle pool characteristically raises AMH. On a dried-blood-spot matrix the analyte is measured from capillary whole blood dried onto a filter card, which suits remote and serial workflows; because calibration differs from venous serum platforms, a result is best interpreted against the same method and the laboratory's own age bands rather than cross-compared with a serum figure.
Why is the AMH test ordered?
- Practitioners counselling patients on relative ovarian reserve and reproductive time-course as part of a fertility assessment
- Reproductive and functional-medicine clinicians predicting likely ovarian response before controlled ovarian stimulation or egg retrieval
- Assessment of suspected polycystic ovary syndrome, where an elevated AMH supports the follicular-excess picture alongside clinical and ultrasound findings
- Evaluation of suspected diminished ovarian reserve or premature ovarian insufficiency, interpreted with FSH, oestradiol, and antral follicle count
- Remote or telehealth practice where a patient-collected finger-stick card removes the need to attend a phlebotomy site
- Serial monitoring across time where trending on a single consistent dried-blood-spot method matters more than cross-lab comparison
- Baseline reserve documentation before gonadotoxic therapy or planned ovarian surgery, where feasible within the clinical timeline
- Women considering oocyte cryopreservation who want an indicative reserve estimate to inform the discussion
Sample collection and turnaround
Sample type
Dried blood spot
Fasting required
No
Collection method
Finger prick
Turnaround
5–7 business days
Collection notes
Self-collected capillary dried blood spot using the ZRT Laboratory kit: finger-stick lancet onto the supplied filter card, fully air-dried, then returned to the laboratory per kit instructions. Fill the required spots completely without milking the finger. Record age, menstrual status, and current hormonal contraceptive use, each of which materially affects interpretation.
Specimen requirements
Adequately filled, fully dried blood-spot card per ZRT specification. Return promptly; avoid heat and humidity in transit.
What can affect AMH results?
AMH declines progressively with age as the primordial follicle pool is depleted, so a result is uninterpretable without the patient's age; the same figure means very different things at 25 and at 42.
Current oestrogen-progestogen contraceptive use suppresses the small-antral-follicle pool and can lower measured AMH by a clinically relevant margin; values may partially recover after discontinuation, so contraceptive status should be recorded.
The expanded cohort of small antral follicles in PCOS raises AMH, which supports the diagnosis but can overstate usable reserve and should not be read as enhanced fertility.
Insufficient blood volume, incompletely filled or layered spots, or squeezing (milking) the finger can bias a dried-blood-spot result; adherence to the kit instructions is essential to a valid specimen.
Excess humidity, heat, or prolonged transit can degrade dried-card specimen quality; cards should be fully air-dried and returned promptly per kit instructions.
AMH figures differ between platforms, and a dried-blood-spot value is calibrated to a whole-blood matrix; results are not numerically interchangeable with venous serum assays and should not be compared directly across methods.
What do AMH results mean?
Elevated
A high AMH for age most often reflects polycystic ovary syndrome with its expanded small-antral-follicle pool, and flags a higher risk of an exaggerated response and ovarian hyperstimulation during assisted reproduction. Rarely, markedly elevated values prompt consideration of a granulosa-cell tumour, assessed in the appropriate clinical context. A high value reflects follicle number, not oocyte quality or guaranteed fertility.
Normal
An AMH within the age-appropriate dried-blood-spot band indicates reserve consistent with age for that method; it does not confirm fertility or oocyte quality. Interpret serial results against the same dried-blood-spot assay and age bands rather than switching matrices mid-monitoring.
Reduced
A low AMH for age suggests diminished ovarian reserve and, in assisted reproduction, predicts a poorer oocyte yield; very low values support premature ovarian insufficiency when corroborated by elevated FSH. In a woman conceiving naturally, a low AMH has limited power to predict inability to conceive and should not on its own drive reproductive decisions. Exclude current hormonal contraception and a collection-quality issue before attributing a low result solely to reserve.
Note: AMH estimates follicle quantity, not quality, and does not forecast natural conception or guarantee a live birth. It is interpreted alongside age, antral follicle count, and FSH/oestradiol, never in isolation. This dried-blood-spot result is matrix- and method-specific and is not interchangeable with venous serum AMH; contraceptive use and collection quality are material determinants of the value.
Frequently asked questions
AMH estimates ovarian reserve — the size of the remaining pool of small growing follicles. It helps counsel on relative reproductive time-course, predict ovarian response before assisted reproduction, and support the assessment of PCOS. It reflects follicle quantity, not oocyte quality.
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.
Create Free AccountAbout this page
Published: October 7, 2026
Last reviewed: October 7, 2026
- Dewailly D, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update. (2014)
- Practice Committee of the American Society for Reproductive Medicine. Testing and interpretation of measures of ovarian reserve: a committee opinion. Fertil Steril. (2020)
- Teede HJ, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. (verify citation/PMID). (2023)
- Steiner AZ, et al. Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA. (2017)
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.